Let's Talk About Death: actions for employers

All UK employers and employees will be touched by the issue of death.

With 120,067 confirmed cases of Covid-19 and 16,060 deaths in UK, modelling by researchers at the University of Washington predict that Britain could suffer more than 60,000 coronavirus deaths by August.

Now is the time for employers to stop shying away from discussing the deeply taboo topic of 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 the people who are still alive.

The sensitivities of not handling COVID-related deaths well will risk mental health issues and Post Traumatic Stress Disorder (PTSD) and the serious implications of what happens 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 friends and family. The use of a ventilator is intrusive and unpleasant. It requires patients to be sedated, a tube inserted into their airway that connects to a machine while they are unable to communicate or move. Sometimes their lungs resist the machine and they have to be put in a medically induced coma.

Burial

Attitudes to death and to body disposal are culturally diverse and we are living at a time when religious rituals can’t necessarily be honoured.

Eight out of 10 people who die in the UK are cremated, with 20% opting for burial. But some faith groups – notably Muslims, Jews and Catholics – choose burial, creating additional pressure in areas where there are concentrations of those religions.

A paper on pandemic planning, published last month by the University of Huddersfield, warned that death and bereavement services were likely to be overwhelmed. Based on research carried out last year, the paper listed among key challenges: 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 which will potentially have serious consequences.

Coronavirus deaths are already putting pressure on body storage, creating backlogs at crematoria and morgues in coronavirus hotspots, with families facing a significant delay before funerals can take place and pressure mounting on mortuary space. Social distancing is limiting all but a limited number of close family and friends from attending funerals while remote grieving is the only alternative.

Impact of ‘indirect’ coronavirus deaths

A tentative estimate circulating in Whitehall suggests a six-figure death toll from a long-term lockdown, caused by a spike in suicides and domestic violence. 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.

From February to March, traffic to the website for the National Domestic Abuse Helpline has increased by 156%. Domestic abuse homicides have more than doubled during Covid-19 lockdown.

There is also a strong evidence base between unemployment and higher suicide rates. Unemployment in Britain is set to more than double in coming months, 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.

Excacebated by loneliness and social isolation, people with long and enduring mental health conditions, and particularly men, are particularly at risk.

Actions for employers

It is unlikely that death by a coronavirus pandemic will be covered by employer’s conventional bereavement policy.

Introduce protocols and guidelines in the event of COVID-19 related deaths which also address the longer-term issues for those, most importantly, who are left alive.

Using the principles of dignity, decency and respect, Business in the Community recommends that all employers should take these 3 actions:

1.   Acknowledge: Most employees will be affected by a COVID-19 death that is confirmed, suspected or COVID related. All employers have a responsibility to support those who are bereaved. 

2.    Respond: Whilst acknowledging a death and accepting what has occurred in unusual times, employers need to support employees to focus on living with the death and to support employees in looking after their wellbeing in terms of moving forward.

3.    Refer: Inform all your employees that help is available. Signpost employees to internal support or organisations who can help employees affected by bereavement.