SHERIDAN — Wyoming is uniquely positioned — with comparatively few COVID-19 cases to other states — to answer preparatory questions about the health care system and post-death services before caution becomes emergency, as in many global communities today.

Sheridan Memorial Hospital CEO Mike McCafferty said Sheridan County is far from needing to employ contingency options available to the health care system if the medical situation surrounding the novel coronavirus escalates.

Still, more information comes to light each day as to how the virus moves through the region, looking backward in reflection and forward in preparation.

Sheridan County Deputy Coroner and funeral home owner Kevin Sessions said an autopsy completed Monday showed signs congruent with COVID-19, and postmortem tissue and blood samples were sent off for review.

No deaths from COVID-19 have been reported in the state. Transmission occurs primarily from a sick person through respiratory droplets or contaminated surfaces. However, in the early stages of infection, a test may return a negative result, according to the Centers for Disease Control and Prevention.

One unexpected death case last month showed unusual lung conditions as well, potentially indicative of the disease, Sessions said. CDC representatives have provided “top notch” assistance for coroners from all over the U.S. to help them feel comfortable and sufficiently supplied, Sessions said.  Kane Funeral Home has communicated with the CDC on potential positives from deceased individuals about four to five times since the pandemic erupted. Sessions said what is becoming known about the pandemic has caused him to think back to strange cases from recent months that didn’t make much sense at the time.

In some cases, staff did not have the information to determine the cause of certain lung conditions but later learned from family the deceased person had traveled, with potential exposure to COVID-19 when it began to rear its head in the U.S.

While the mortality rate for COVID-19 remains low, hovering around 5%, Sessions said many funeral directors are preparing for worst-case scenarios. The virus can be transmitted from a deceased person to a living person, so coroners have implemented personal protection protocols for handling bodies after death, Sessions said.

“The body turns on itself,” he said.

Widely publicized mortality rates are based on deaths reported relative to the number of confirmed cases, which is not accurately representative of the death rate from the virus, David Baud and others said in an article published March 12, “Real estimates of mortality following COVID-19 infection,” based on data from the World Health Organization.

The base number to calculate mortality “remains unknown because asymptomatic cases or patients with very mild symptoms might not be tested and will not be identified, “ according to the article. “Such cases therefore cannot be included in the estimation of actual mortality rates, since actual estimates pertain to clinically apparent COVID-19 cases.”

Sessions said he was recently advised that gatherings may soon be reduced from 10 to no more than five people, adding to the disruption of grieving services at funeral homes.

Sessions described the current environment surrounding funeral services as awkward — people cannot be consoled in traditional ways after a loss, like expressions of love and concern through close physical proximity in a group setting. The funeral industry has turned to technology to send documents, obtain signatures, post grave site service videos and communicate with families about coping with grief, he said.

McCafferty said visitation during end of life situations at Sheridan Memorial Hospital is restricted, with one visitor allowed at a time who passes screening checks for illness.

Marketing Manager Alan Dubberley clarified case by case exceptions may be made in end-of-life situations to accommodate families who wish to be together during a family member’s last moments. SMH maintains a hardline rule that no visiting family member may be sick at the time, he said. Movement in and out of the patient’s room and throughout the hospital is also restricted.

SMH is working within its Emergency Operations Plan to direct action surrounding end-of-life care. McCafferty said the team focusing on end of life care actions includes professionally-trained staff who interact with patients and families, mortuaries, medical staff, the county coroner, public health officials and the county health officer, “to assure all end of life care and communications are conducted in an ethical and dignified manner.”

Sessions said several funerals were canceled in recent weeks. Service members providing military honors for an interment will “walk away” if more than 10 people are on site for a service, Session said.

Changes in disposition protocols have been implemented and plans developed for transportation and equipment in case of an increased number of deaths for any reason, as a collaborative effort between the Board of the Wyoming Funeral Directors Association.

“We have definitely done our due diligence and have plans in place,” Sessions said.

Sessions emphasized Sheridan County is fortunate to have seen a large number of negative results to COVID-19 tests.

An inability to show tribute and respect to a life is difficult, as it represents a critical component of closure, he said. Sessions said he hopes the pandemic will pass in a timely manner such that gatherings can resume. In the meantime, funeral directors are following CDC recommendations and “dotting our Is and crossing our Ts,” he said.

 

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