MORTUARY SERVICES & MASS FATALITY PLANNING PANDEMIC INFLUENZA For Knox County

1. MORTUARY SERVICES & MASS FATALITY PLANNING PANDEMIC INFLUENZA For Knox County

2. PLANNING ASSUMPTIONS • TWO TYPES OF MASS FATILITIES SINGLE INCIDENT IS STATIC-ACUTE( HURRICANE, TORONADO) TIME SPECIFIC, AND TYPICALLY EXTENDS THERE OR OCCURS WITHIN A SPECIFIC GEPGRAPHICAL REGION. OUTSIDE RESOURCES WILL EXIST A PI EVENT IS ONGOING-CHRONIC, EVERY JURSIDICTION WILL REQUIRE SIMILAR TYPES OF CRITICAL RESOURCES, SO DO NOT PLAN ON ASSISTANCE FROM THE FEDERAL/STATE AGENCIES. THIS INCLUDES DMORT.

3. DEATHS ARE LIKELY TO OCCUR OVER A PERIOD OF WEEKS TO MONTHS AND MAY INVOLVE MULTIPLE FAMILIES AT DIFFERENT TIMES. MOST BODIES WILL HAVE COMPLETE INTERGRITY AND WILL BE IDENTIFIED MORE READILY 50-75% OF THE DEATHS WILL OCCUR OUTSIDE OF A HOSPITAL OR MEDICAL TREATMENT FACILITY. IT IS LIKELY THAT DURING A PI EVENT THE NUMBER OF FATALITIES NEEDING STORAGE WILL EXCEED LOCAL CAPABILITY. LIMITED REFRIGERATED STORGE, OTHER FACTORS WILL CREATE NON-TRADITIONAL METHODS OF TEMPORARY SROARGE-IE. TEMPORARY INTERMENT.

4. PI RELATED DEATHS WILL FALL INTO TWO CATERGORIES ATTENDED – KNOWN IDENTITY – MAY HAVE SIGNED DEATH CERTIFICATE, AND RELATIVELY STRAIGHT FORWARD ( EMERGENCY ROOM, FAMILY DOCTOR) UNATTENDED – REQUIRES VERIFICATION OF IDENTITY, ISSUING DEATH CERTIFICATE , NOTIFYING THE NEXT OF KIN WHICH WILL BE LABOR INTENSIVE AND WILL REQUIRE THE MEDICAL EXAMINER TO PROCESS. DELAYS IN THE ISSUANCE OF DEATH CERTIFICATES FOR BOTH “ATTENDED AND UNATTENDED” WILL PLACE SUBSTANTIAL PRESSURE ON THE MEDICAL EXAMINER SO THAT NEXT OF KIN CAN MANAGE DECENDENTS ESTATE.

5. BODY STORAGE CAPABILITIES ( SURGE CAPACITY) FOR HOSPITALS AND FUNERAL HOMES WILL BE OVERHELMED THOSE WHO DIE DURING A PI MAY NEED TO BE STORED FOR AN EXTENDED PERIOD OF TIME UNTIL THE MEDICAL EXAMINER IS ABLE TO IDENTIFY REMAINS, DETERMINE CAUSE, MEANS OF DEATH AND ISSUE DEATH CERTIFCIATE. ESSENTIAL SUPPLIES ( BODY BAGS, ETC) WILL BE IN SHORT SUPPLY AND USUALLY NOT STOCKPILED TO MEET THE DEMAND.

6. STAFFING FOR FUNERAL HOMES, HOSPITALS, MEDCIAL EXAMINERS OFFICE WILL AFFECT THE TIMELY PROCESSING OF THE DECENDENTS. THIS INCLUDES NORMAL TRANSPORTATION OF DECENDENTS. THE ME AND LOCAL AUTHORIITIES WILL NEED TO ORGANIZE/TRAIN A SPECIAL GROUP OF “VOLUNTEERS” BEFORE THE INCIDENT OCCURS. SUITABLE VOLUNTEERS MAY COME FROM MEDCIAL SCHOOLS, INTERNSHIP PROGRAMS, FUNERAL DIRECTORS, EMBALMERS,MRC, CITIZENS CORPS. JUST IN TIME TRAINING TO INCLUDE PPE, FOR ME STAFF AND VOLUNTEERS.

7. THE AMERCIAN CULTURE HAS STRONG BELIEFS AND TRADATIONS REGARDING HANDLING DECENDENTS WITH DIGNITY • A PI EVENT WILL CHANGE THE FINAL DISPOSITION OF REMAINS • FUNERALS WILL NOT HAPPEN ( Social Distancing ) • SENIOR LEADERS IN LOCAL, STATE MUST BE PREPARED TO MAKE PUBLIC ANNOUNCMENTS REGARDING HOW FATILITIES WILL BE HANDLED WITH FOCUS ON DIGNITY IN DEATH AND PROTECTION OF THE PUBLIC’S HEALTH • IF NOT HANDLED PROPERLY • PUBLIC DISTRUST OF THE GOVERNMENT • GOVERNMENT HINDERING INDIVDUAL CIVIL LIBERTIES

8. Knox County Burden KNOX COUNTY, TN BURDEN OF ILLNESS FROM INFLUENZA PANDEMIC (Based on 2006 Knox County population estimate of 399,254) Rounding to nearest 5.

9. Where Do We Go From Here Begin meeting to organize our Mortuary Plan Each Funeral Home should send a representative The Knox County Medical Examiner’s Office will be heavily involved Consider Funeral Homes combining services as staff decline.