MORTUARY SERVICES & MASS MORTUARY SERVICES & MASS FATALITY PLANNINGFATALITY PLANNING

PANDEMIC INFLUENZAPANDEMIC INFLUENZA

For Knox County For Knox County

PLANNING ASSUMPTIONSPLANNING ASSUMPTIONS

►TWO TYPES OF MASS FATILITIESTWO TYPES OF MASS FATILITIES

SINGLE INCIDENT IS STATIC-ACUTE( HURRICANE, SINGLE INCIDENT IS STATIC-ACUTE( HURRICANE, TORONADO) TIME SPECIFIC, AND TYPICALLY EXTENDS TORONADO) TIME SPECIFIC, AND TYPICALLY EXTENDS THERE OR OCCURS WITHIN A SPECIFIC GEPGRAPHICAL THERE OR OCCURS WITHIN A SPECIFIC GEPGRAPHICAL REGION. REGION.

OUTSIDE RESOURCES WILL EXIST OUTSIDE RESOURCES WILL EXIST

A PI EVENT IS ONGOING-CHRONIC, EVERY JURSIDICTION A PI EVENT IS ONGOING-CHRONIC, EVERY JURSIDICTION WILL REQUIRE SIMILAR TYPES OF CRITICAL RESOURCES, WILL REQUIRE SIMILAR TYPES OF CRITICAL RESOURCES, SO DO NOT PLAN ON ASSISTANCE FROM THE SO DO NOT PLAN ON ASSISTANCE FROM THE FEDERAL/STATE AGENCIES. THIS INCLUDES DMORT. FEDERAL/STATE AGENCIES. THIS INCLUDES DMORT.

► DEATHS ARE LIKELY TO OCCUR OVER A PERIOD OF WEEKS DEATHS ARE LIKELY TO OCCUR OVER A PERIOD OF WEEKS TO MONTHS AND MAY INVOLVE MULTIPLE FAMILIES AT TO MONTHS AND MAY INVOLVE MULTIPLE FAMILIES AT DIFFERENT TIMES.DIFFERENT TIMES.

► MOST BODIES WILL HAVE COMPLETE INTERGRITY AND WILL MOST BODIES WILL HAVE COMPLETE INTERGRITY AND WILL BE IDENTIFIED MORE READILYBE IDENTIFIED MORE READILY

► 50-75% OF THE DEATHS WILL OCCUR OUTSIDE OF A 50-75% OF THE DEATHS WILL OCCUR OUTSIDE OF A HOSPITAL OR MEDICAL TREATMENT FACILITY.HOSPITAL OR MEDICAL TREATMENT FACILITY.

► IT IS LIKELY THAT DURING A PI EVENT THE NUMBER OF IT IS LIKELY THAT DURING A PI EVENT THE NUMBER OF FATALITIES NEEDING STORAGE WILL EXCEED LOCAL FATALITIES NEEDING STORAGE WILL EXCEED LOCAL CAPABILITY.CAPABILITY.

► LIMITED REFRIGERATED STORGE, OTHER FACTORS WILL LIMITED REFRIGERATED STORGE, OTHER FACTORS WILL CREATE NON-TRADITIONAL METHODS OF TEMPORARY CREATE NON-TRADITIONAL METHODS OF TEMPORARY SROARGE-IE. TEMPORARY INTERMENT.SROARGE-IE. TEMPORARY INTERMENT.

PI RELATED DEATHS WILL FALL INTO TWO CATERGORIESPI RELATED DEATHS WILL FALL INTO TWO CATERGORIES

ATTENDEDATTENDED – KNOWN IDENTITY – MAY HAVE SIGNED – KNOWN IDENTITY – MAY HAVE SIGNED DEATH CERTIFICATE, AND RELATIVELY STRAIGHT DEATH CERTIFICATE, AND RELATIVELY STRAIGHT FORWARD ( EMERGENCY ROOM, FAMILY DOCTOR)FORWARD ( EMERGENCY ROOM, FAMILY DOCTOR)

UNATTENDEDUNATTENDED – REQUIRES VERIFICATION OF IDENTITY, – REQUIRES VERIFICATION OF IDENTITY, ISSUING DEATH CERTIFICATE , NOTIFYING THE NEXT ISSUING DEATH CERTIFICATE , NOTIFYING THE NEXT OF KIN WHICH WILL BE LABOR INTENSIVE AND WILL OF KIN WHICH WILL BE LABOR INTENSIVE AND WILL REQUIRE THE MEDICAL EXAMINER TO PROCESS. REQUIRE THE MEDICAL EXAMINER TO PROCESS.

DELAYS IN THE ISSUANCE OF DEATH CERTIFICATES FOR DELAYS IN THE ISSUANCE OF DEATH CERTIFICATES FOR BOTH “ATTENDED AND UNATTENDED” WILL PLACE BOTH “ATTENDED AND UNATTENDED” WILL PLACE SUBSTANTIAL PRESSURE ON THE MEDICAL EXAMINER SUBSTANTIAL PRESSURE ON THE MEDICAL EXAMINER SO THAT NEXT OF KIN CAN MANAGE DECENDENTS SO THAT NEXT OF KIN CAN MANAGE DECENDENTS ESTATE.ESTATE.

BODY STORAGE CAPABILITIES ( SURGE CAPACITY) BODY STORAGE CAPABILITIES ( SURGE CAPACITY) FOR HOSPITALS AND FUNERAL HOMES WILL BE FOR HOSPITALS AND FUNERAL HOMES WILL BE OVERHELMED OVERHELMED

THOSE WHO DIE DURING A PI MAY NEED TO BE THOSE WHO DIE DURING A PI MAY NEED TO BE STORED FOR AN EXTENDED PERIOD OF TIME STORED FOR AN EXTENDED PERIOD OF TIME UNTIL THE MEDICAL EXAMINER IS ABLE TO UNTIL THE MEDICAL EXAMINER IS ABLE TO IDENTIFY REMAINS, DETERMINE CAUSE, MEANS IDENTIFY REMAINS, DETERMINE CAUSE, MEANS OF DEATH AND ISSUE DEATH CERTIFCIATE.OF DEATH AND ISSUE DEATH CERTIFCIATE.

ESSENTIAL SUPPLIES ( BODY BAGS, ETC) WILL BE ESSENTIAL SUPPLIES ( BODY BAGS, ETC) WILL BE IN SHORT SUPPLY AND USUALLY NOT STOCKPILED IN SHORT SUPPLY AND USUALLY NOT STOCKPILED TO MEET THE DEMAND. TO MEET THE DEMAND.

STAFFING FOR FUNERAL HOMES, HOSPITALS, MEDCIAL STAFFING FOR FUNERAL HOMES, HOSPITALS, MEDCIAL EXAMINERS OFFICE WILL AFFECT THE TIMELY PROCESSING OF EXAMINERS OFFICE WILL AFFECT THE TIMELY PROCESSING OF THE DECENDENTS. THIS INCLUDES NORMAL TRANSPORTATION THE DECENDENTS. THIS INCLUDES NORMAL TRANSPORTATION OF DECENDENTS. OF DECENDENTS.

THE ME AND LOCAL AUTHORIITIES WILL NEED TO THE ME AND LOCAL AUTHORIITIES WILL NEED TO ORGANIZE/TRAIN A SPECIAL GROUP OF “VOLUNTEERS” BEFORE ORGANIZE/TRAIN A SPECIAL GROUP OF “VOLUNTEERS” BEFORE THE INCIDENT OCCURS. SUITABLE VOLUNTEERS MAY COME THE INCIDENT OCCURS. SUITABLE VOLUNTEERS MAY COME FROM MEDCIAL SCHOOLS, INTERNSHIP PROGRAMS, FUNERAL FROM MEDCIAL SCHOOLS, INTERNSHIP PROGRAMS, FUNERAL DIRECTORS, EMBALMERS,MRC, CITIZENS CORPS. DIRECTORS, EMBALMERS,MRC, CITIZENS CORPS.

JUST IN TIME TRAINING TO INCLUDE PPE, FOR ME STAFF AND JUST IN TIME TRAINING TO INCLUDE PPE, FOR ME STAFF AND VOLUNTEERS.VOLUNTEERS.

► THE AMERCIAN CULTURE HAS STRONG BELIEFS AND THE AMERCIAN CULTURE HAS STRONG BELIEFS AND TRADATIONS REGARDING HANDLING DECENDENTS WITH TRADATIONS REGARDING HANDLING DECENDENTS WITH DIGNITY DIGNITY A PI EVENT WILL CHANGE THE FINAL DISPOSITION OF REMAINS A PI EVENT WILL CHANGE THE FINAL DISPOSITION OF REMAINS FUNERALS WILL NOT HAPPEN ( Social Distancing ) FUNERALS WILL NOT HAPPEN ( Social Distancing ) SENIOR LEADERS IN LOCAL, STATE MUST BE PREPARED TO MAKE SENIOR LEADERS IN LOCAL, STATE MUST BE PREPARED TO MAKE

PUBLIC ANNOUNCMENTS REGARDING HOW FATILITIES WILL BE PUBLIC ANNOUNCMENTS REGARDING HOW FATILITIES WILL BE HANDLED WITH FOCUS ON DIGNITY IN DEATH AND PROTECTION HANDLED WITH FOCUS ON DIGNITY IN DEATH AND PROTECTION OF THE PUBLIC’S HEALTH OF THE PUBLIC’S HEALTH

IF NOT HANDLED PROPERLYIF NOT HANDLED PROPERLY► PUBLIC DISTRUST OF THE GOVERNMENTPUBLIC DISTRUST OF THE GOVERNMENT► GOVERNMENT HINDERING INDIVDUAL CIVIL LIBERTIES GOVERNMENT HINDERING INDIVDUAL CIVIL LIBERTIES

Knox County BurdenKnox County Burden

Characteristic Moderate* Severe*

Illness 119,775 [30% of pop] 119,775 [30% of pop]

Outpatient care 59,890 [50% of ill] 59,890 [50% of ill]

Hospitalization 1,200 [1% of ill] 13,175 [11% of ill]

ICU Care 180 [15% of hosp] 1,975 [15% of hosp]

Mechanical Ventilation 90 [50% of ICU] 990 [50% of ICU]

Deaths (Case fatality rate) 240 [0.2% of ill] 2,395 [2% of ill]

KNOX COUNTY, TN BURDEN OF ILLNESS FROM INFLUENZA PANDEMIC(Based on 2006 Knox County population estimate of 399,254)

Rounding to nearest 5.

Where Do We Go From HereWhere Do We Go From Here

Begin meeting to organize our Mortuary Begin meeting to organize our Mortuary PlanPlan

Each Funeral Home should send a Each Funeral Home should send a representativerepresentative

The Knox County Medical Examiner’s The Knox County Medical Examiner’s Office will be heavily involvedOffice will be heavily involved

Consider Funeral Homes combining Consider Funeral Homes combining services as staff decline.services as staff decline.