Let’s talk about death: COVID-19 pandemic and beyond
Louise Aston, Wellbeing Director at Business in the Community (BITC) on the need for employers to engage staff on the taboo subject of mortality and the effect thousands of COVID-19-related deaths will have
All UK employers and employees will be touched by the issue of death.
With more than 30,000 COVID-19-related deaths in UK at the time of writing, modelling by researchers at the University of Washington predicts that Britain could suffer more than 43,000 coronavirus deaths by August.
Now is the time for employers to stop shying away from discussing this deeply taboo topic and talk about death. There is a need for all employers to take a pragmatic approach to considering the impact that thousands of deaths linked to coronavirus will have on those who are still alive.
The sensitivities of not handling COVID-19-related deaths well will risk mental health issues and post traumatic stress disorder (PTSD), and there can be serious implications if trauma is left untreated.
Bereavement in exceptional times
The experience of death by COVID-19 is extremely traumatic for both the patient and their loved ones. The loneliness and isolation of dying alone is excruciating for the individual and agonising for their family and friends. The use of a ventilator is intrusive and traumatic. It requires patients to be sedated and a tube inserted into their airway that connects to a machine. They are unable to communicate or move and sometimes, their lungs resist the machine so they have to be put in a medically induced coma.
Attitudes to death and to body disposal are culturally diverse but we are living at a time when religious rituals cannot necessarily be honoured.
Eight out of ten people who die in the UK are cremated, with 20% opting for burial1. But some faith groups – notably Muslims, Jews and Catholics – choose burial, creating additional pressure in areas where there are concentrations of those religions.
“Families face a significant
delay before funerals can take place,
and pressure is mounting on mortuary space.”
A paper on pandemic planning published last month by the University of Huddersfield, warned that death and bereavement services were likely to be overwhelmed2. Based on research carried out last year, the paper listed challenges including: delays in issuing death certificates; lack of equipment such as coffins, body bags and cremator ovens; a shortage of body storage space if funeral parlours, hospitals and mortuaries reach capacity; and a lack of cemetery space. All of these will potentially have serious consequences.
Deaths caused by the novel coronavirus are already putting pressure on body storage, creating backlogs at crematoria and morgues in disease hotspots. Families face a significant delay before funerals can take place, and pressure is mounting on mortuary space. Government guidelines on social distancing only allow a limited number of close family and friends to attend funerals, leaving remote grieving as the only alternative.
Impact of ‘indirect’ coronavirus deaths
From February to March, traffic to the website for the National Domestic Abuse Helpline increased by 156%3.
Additionally, speculation has started on whether the adverse health effects of a recession may be greater than the increased morbidity and mortality within the pandemic itself.
There is also a strong evidence base between unemployment and higher suicide rates. Unemployment in Britain is set to more than double in the coming months4, despite government efforts to incentivise employers to keep staff. Economists warn that the rise in the second quarter of the year will be even sharper than during the financial crisis in 2008.
Exacerbated by loneliness and social isolation, people with long and enduring mental health conditions are especially at risk.
Actions for employers
All employers need to introduce protocols and guidelines in the event of COVID-19 deaths, which also address the longer-term issues for those, most importantly, who are left alive.
It is unlikely that death by a coronavirus pandemic will be covered by an employer’s conventional bereavement policy, which is why we all need to revisit death-in-service policies, make sure pension/life providers are accessible, and prompt people to update death benefit nominees.
Using the principles of dignity, decency and respect, Business in the Community recommends that all employers should take these three actions:
- Acknowledge: Most employees will be affected by a COVID-19 death that is confirmed, suspected or related to the virus. All employers have a responsibility to support those who are bereaved.
- Respond: While acknowledging a death and accepting what has occurred in unusual times, employers need to support grieving employees and look after their wellbeing moving forward.
- Refer: Employers must inform all employees that help is available. Signpost staff to internal support or organisations the can help those affected by bereavement.
BITC’s and Public Health England’s Crisis Management in the Event of Suicide toolkit for employers has a lot of relevant information for other unexpected deaths in-service.
- Burial and cremation statistics 1855 to 2018 (2018); Office for National Statistics; available at ons.gov.uk
- Pandemic Continuity Planning: will coronavirus test local authority business continuity plans? A case study of a local authority in the north of England (2020); Helen-Marie Kruger et al; University of Huddersfield; available at pure.hud.ac.uk
- Coronavirus: Rise in domestic abuse-related web searches amid COVID-19 lockdown (2020); Emma Birchley; Sky News; available at news.sky.com
- Unemployment to double as coronavirus ravages economy (2020); David Smith et al; The Times; available at thetimes.co.uk