If the decedent is suspected to have had COVID-19, it is prudent to assume others in the building where the death occurred could be infected. In addition, while body fluids other than respiratory secretions have not been clearly implicated in transmission of COVID-19, unprotected contact with other body fluids, including blood, stool, vomit, and urine, might put the investigator at risk of COVID-19 and other infectious diseases.
- Gather information regarding the circumstances of the death (as is standard practice) to aid in the hazard/risk assessment, including risk for possible COVID-19 and whether droplets, aerosols, body fluids, purge, or decomposition materials were expelled before or after the death.
- Plan for and implement physical distancing measures
- Minimize close contact with anyone at the scene, including family members, responsible person(s) of the decedent, and witnesses.
- Arrange to conduct pre-investigation interviews by telephone or video conference, if possible.
- If interviews cannot be conducted by telephone or other virtual means, conduct interviews outside the residence or building where the death occurred or in other outdoor spaces. During any in-person interview or other interactions, the investigator should practice physical distancing of at least 6 feet and encourage all persons being interviewed to do the same.
- The investigator and those being interviewed should wear cloth face coverings during the in-person interviews, especially if physical distancing of 6 feet or more cannot be maintained. Be aware of and follow state and local ordinances regarding use of face coverings.
- If the investigator determines that it is necessary to enter the residence or building where the death occurred, then it is important to:
- Carefully plan equipment needed for the investigation to avoid bringing unnecessary items into the structure. Plan to have extra face coverings for household members.
- Set up separate, designated locations for donning and doffing PPE outside the structure. The doffing station should be physically separated from the donning station because used PPE could be contaminated. Make sure the doffing station has hand sanitizer, disinfectant sprays or wipes, and waste containers or biohazard bags for used PPE. See Environmental Protection Agency (EPA)-approved disinfectants external iconfor use against SARS-CoV-2.
- Inquire if any persons in the building where the death occurred are experiencing symptoms consistent with COVID-19 (which may include fever, cough, shortness of breath) or have been diagnosed with COVID-19 or are awaiting test results. These individuals should be asked to remain outdoors or in a room of the structure that does not need to be accessed during the investigation.
- Ask anyone remaining inside the structure to wear facemasks or cloth face coverings and keep the face covering on throughout the investigation. The investigator should also wear a face covering throughout the investigation (see below for further details regarding respiratory protection).
- Alert all persons in the structure that the investigator will be entering and ask anyone remaining in the structure to move to a different room if possible, or to maintain physical distancing of at least 6 feet from the investigator.
If on-scene post-mortem COVID-19 specimen collection is planned for the decedent, follow the CDC Guidance for Postmortem Collection in close consultation with the supervising medical examiner or coroner.