Fatality Management during a Pandemic and Other Emergency Events

Mass fatality events can occur any day and often result from floods, tornadoes, hurricanes, multiple vehicle accidents, fires, droughts, and other natural disasters.  Mass fatalities can also occur as a result of human intervention, such as school, mall and church shootings, terrorist attacks, or a pandemic influenza outbreak. 

ADPH has completed a series of 11 conferences across the state to bring to the attention of all stakeholder organizations the need to begin now to plan to handle mass fatalities.

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County and Municipal Fatality Management Plan Template

Coroner's Fatality Management Satellite Conference - July 9, 2009

Comprehensive fatality management plans deal with the large number of decedents as a result of a pandemic.  For those who manage those bodies, this program offers information for planning consideration.  Remember, it's not a matter of if a pandemic will happen, but when.  Planning now is not a mistake.

• A County Coroner's Role in Fatality Management Planning and
  Response (2.5 MB)
• Coroner's Fatality Management Satellite Broadcast (5 MB)
• Fatality Management During a Pandemic Webcast
• Fatality Management Toolkit (1.5 MB)
• Management of Dead Bodies After Disasters:  A Field Manual for First Responders (1 MB)

Northport Conference Videos and Presentations - May 6, 2008

Video and slide presentations from the Northport conference, as well as other conferences, are available for your training and planning purposes.

The Mass Fatality Management Tabletop Exercise utilized in the Fatality Management Conferences can be modified.  Mrs. Edna Register Boone is one of the survivors on the 1918 Influenza Pandemic Survivors Share Their Stories webpage.

• Pandemic Influenza Fatality Management Operational Plan
  Cindy Lesinger
  Coordinator, Pandemic Influenza and Smallpox
  Alabama Department of Public Health
  Windows Media | RealPlayer | Slide Presentation (3 MB)
  
  
• Coroner Logistical Issues
  Bill Harris
  Lee County Coroner
  President, Alabama Coroners Association
  Chairman, Alabama Coroners Training Commission
  Windows Media | RealPlayer | Slide Presentation (1.5 MB)
  
  
• Forensic Sciences Resources
  Kenneth S. Snell, MD
  Chief State Medical Examiner
  Alabama Department of Forensic Sciences
  Windows Media | RealPlayer | Slide Presentation
  
  
• Storage and Emergency Burials
  J. Douglas Williams
  Funeral Director and Embalmer
  Team Leader, Disaster Response Team, State Mortuary Operations Team
  Coordinator, Alabama Funeral Directors Association
  Windows Media | RealPlayer | Slide Presentation
  
  
• Environmental Issues
  Pres Allinder
  Director, Bureau of Environmental Services
  Alabama Department of Public Health
  Temporary Burial Site Environmental Issues (1 MB) | Temporary Burial Site Environmental Issues Brochure
  
  
• Law Enforcement Issues
  Sergeant Andy Norris
  Public Information Officer, Department of Homeland Security
  Tuscaloosa County Sheriff's Office
  Windows Media | RealPlayer | Slide Presentation
  
  
• Alabama Emergency Management Agency Issues
  Stanley Batchelor, EMT-P, RN, MSA
  Director, Human Services Branch
  Natural Hazards Planner and Public Health Liaison
  Alabama Emergency Management Agency
  Windows Media | RealPlayer | Slide Presentation
  
  
• Pandemic Fatality Planning from the Hospital's Perspective
  Paul Abel, MT, ASCP
  Emergency Preparedness Manager, Druid City Hospital Health System
  Tuscaloosa, Alabama
  Windows Media | RealPlayer | Slide Presentation
  
  
• Emergency Medical Services System in Alabama
  Russell Crowley
  Deputy Director, Office of EMS and Trauma
  Alabama Department of Public Health
  Windows Media | RealPlayer | Slide Presentation
  
  
• Cultural and Religious Considerations During a Mass Fatality and/or Pandemic Event
  Joseph Ellington III, BS
  Director, Disease Intervention
  Area 10 Coordinator, Emergency Preparedness
  Alabama Department of Public Health
  Windows Media | RealPlayer | Slide Presentation (3 MB)
  
  
• Legal Issues
  John R. Wible
  General Counsel, Office of General Counsel
  Alabama Department of Public Health
  Windows Media | RealPlayer | Slide Presentation | Legal Issues - Text
  
  
• Fatality Management Planning at the State Level
  Alice Floyd, RN, BSN
  Nurse Supervisor, Center for Emergency Preparedness
  Alabama Department of Public Health
  Windows Media | RealPlayer | Slide Presentation (1 MB)
  

Additional Presentations

• Pandemic Fatality Planning from the Hospital's Perspective 
  Mike West, Director, Ambulance Services, Athens-Limestone Hospital
• Pandemic-Related Deaths in Institutional Settings
  Karen Ritter, Eliza Coffee Memorial Hospital
• Jefferson County Emergency Management Agency (4.5 MB)
  Michael E. Harter, MEP, Training and Exercise Officer, Jefferson County Emergency Management Agency, Birmingham, Alabama
• Law Enforcement Role and Capabilities During Pandemic Outbreak
  (3.5 MB) Captain Byron Jackson, Jefferson County Homeland Security Division, Jefferson County, Alabama
• Fatality Management:  Pandemic Deaths in Hospitals (3.5 MB)
  Donna Keith, MS, CHSP, Safety Manager, St. Vincent's Hospital, Birmingham, Alabama
• Alabama Emergency Management Agency (1.5 MB)
  David Coggins, Field Coordinator, Alabama Emergency Management Agency Region One
• Religious and Cultural Considerations During a Mass Fatality and/or Pandemic Event (6.5 MB)
  Jzyk S. Ennis, MPA, CFSP, Faculty, Funeral Service Education Department, Jefferson State Community College, Birmingham, Alabama
• Medical Examiner and Forensic Sciences Resources (1.5 MB)
  John Krolikowski, MD, Senior State Medical Examiner, Alabama Department of Forensic Sciences
• Death Registration During a Pandemic or Mass Fatality (3 MB)
  Cathy Molchan, Alabama Center for Health Statistics
• U.S. Department of Homeland Security Center for Domestic
  Preparedness (3 MB)
• Fatality Management Rolling Events (1 MB)

Additional Resources

• Mass Fatality Incident Management:  Guidance for Hospitals and Other Healthcare Entities
  Los Angeles County Department of Coroner; Department of Health Services, Emergency Medical Services Agency; and Department of Public Health, Office of Health Assessment and Epidemiology, Data Collection and Analysis Unit, August 2008.
• Appendix 1.8 - A Planning Guide for Funeral Homes and Crematorium Services, Toronto Pandemic Influenza Plan Toronto Public Health, Toronto, Ontario, Canada, March 2007.
• Guide to Services Contingency Planning:  Mortuary Affairs Search and Recovery, Air Force Handbook (22 MB) Department of the Air Force, January 2006.
• Florida Emergency Mortuary Operations Response System Field Operations Guide (FEMORS FOG, 2009) (9 MB) Florida Emergency Mortuary Operation Response System, Florida Department of Health, University of Florida, Revised May 2004.
• Operational Best Practices Regarding the Management of Human Remains and Information on the Dead by Non-Specialists for all Armed Forces and for all Humanitarian Organizations (1 MB) International Committee of the Red Cross, November 2004.
• Pandemic Influenza Simulation Exercise for General Practice - Facilitator Notes The Australian National University, June 2006.
• Mortuary Affairs Operations (2 MB) Headquarters, U.S. Department of the Army, January 2007.
• Deceased Personnel:  Care and Disposition of Remains and Disposition of Personal Effects Headquarters, U.S. Department of the Army, January 2001.
• Avian Flu Pandemic:  Tabletop Exercise after Action Report Dallas County Health and Human Services Bioterrorism and Response Division, Defenbaugh and Associates, Inc., May 2006.
• Pandemic Influenza:  Mortuary Planning Guidelines (The Barron County Model)  November 2006.
• The Infection Hazards Of Human Cadavers:  Guidelines on Precautions to be Taken with Cadavers of Those Who Have Died with a Known or Suspected Infection Health Protection Agency North West, October 2004.
• Planning for a Possible Influenza Pandemic:  A Framework for Planners Preparing to Manage Deaths Home Office, Crime Reduction and Community Safety Group, Public Order Unit, Mass Fatalities Section
• Toolkit to Assist Public Health in Conducting Preparedness Exercises Harvard School of Public Health, Center for Public Health Preparedness, 2006.
• Morgue Operations, Identification, and Command and Control of Mass Fatalities Resulting from a Pandemic Influenza Event in the United States The Fatality Management Pandemic Influenza Working Group Conference, U.S. Northern Command, Department of Health and Human Services, Joint Task Force Civil Support, March 2006.
• Scene Operations, to Include Identification, Medico-Legal Investigation Protocols, and Command and Control of Mass Fatalities Resulting from a Pandemic Influenza in the United States The Fatality Management Pandemic Influenza Working Group Conference, U.S. Northern Command, Department of Health and Human Services, Joint Task Force Civil Support, March 2006.
• Funeral Services and Final Disposition of Mass Fatalities Resulting from a Pandemic Influenza in the United States The Fatality Management Pandemic Influenza Working Group Conference, U.S. Northern Command, Department of Health and Human Services, Joint Task Force Civil Support, March 2006.
• The Provision of Family Assistance and Behavioral Health Services in the Management of Mass Fatalities Resulting from a Pandemic Influenza in the United States The Fatality Management Pandemic Influenza Working Group Conference, U.S. Northern Command, Department of Health and Human Services, Joint Task Force Civil Support, March 2006.
• "World Death Toll of a Flu Pandemic would be 62 Million:  Study Examined 1918-1919 Outbreak." The Washington Post 22 December. 2006.
• "Burial Plan Stirs Up Plague Images." The London Times.
• Possible Impacts:  Worst-Case Scenario and Opposing Ideas
• Possible Effects of a Pandemic
• "FluWrap:  Plague Pits and Mass Burials?" United Press International 4 April 2006.
• Information for Managing Pandemic Influenza Fatality Events in Virginia Virginia Department of Health, Virginia Department of Health:  Office of the Chief Medical Examiner.
• Mortuary Service and Handling of the Dead Environmental Health in Emergencies and Disasters, World Health Organization, 2002.
• Care of the Deceased during Pandemic FAQ Minnesota Department of Health, July 2006. 
• Emergency Operations Plan for Mass Fatality Municipality of Anchorage, Alaska, Office of Emergency Management, 2007.
• "Home Office Prepares for 'Mass Burials' if Avian Flu Mutates." 24dash.com 9 August 2007.
• Handling of Bodies by Funeral Directors during an Influenza Pandemic New South Wales Department of Health, 1 December 2007. 
• Guidelines for Reporting and Managing Mass Fatality Events Virginia Department of Health, Virginia Department of Health:  Office of the Chief Medical Examiner.
• "Flu Pandemic Mass Graves Planned by UK Government" Medical News Today 2 April 2006.
• Death Out of Healthcare Facility During Pandemic Influenza Event
• A Failsafe Pandemic Response Plan for State and Local Governments TheBirdFluManual.com, Grattan Woodson, MD, FACP.
• Waterloo Region Pandemic Influenza Preparedness Response WaterlooRegionPandemic.ca.
• Mortuary Affairs in Joint Operations (2.5 MB) Department of the Army, Department of the Navy, U.S. Marine Corps, Department of the Air Force, U.S. Coast Guard, Join Chiefs of Staff, 5 June 2006.
• Exercise Foghorn:  Report and Further Actions (1.5 MB) Greenwich Teaching Primary Care Trust, 4 April 2006.
• Dead Bodies and Disasters:  Principles of Mortuary Services  (1 MB) Amando Alejandro Baez, MD, MSC, EMT-P, Brigham and Women's Hospital, Harvard Medical School
• Orleans County Mass Fatality Response Plan December 2007
• ADPH Temporary Burial Site Environmental Issues
• ADPH Legal Issues
• County Mass Fatality Planning Services:  County Field Guide for the Management of Dead Bodies During an Influenza Pandemic Indiana State Department of Health, 30 May 2008.
• Guidelines for Handling Decedents Contaminated with Radioactive Materials Prepared by Charles M. Wood, Radiation Studies Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Frank DePaolo, Office of Chief Medical Examiner, New York, New York, R. Doggett Whitaker, National Funeral Director's Association
• Final Mass Fatality Planning Considerations May 2012