alert - warning

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5.5 Fatality Management

Fatality management within the broader context of biological incident planning varies across SLTT jurisdictions. Three of the biggest challenges facing fatality management during a biological incident are: (1) human and animal remains may be contaminated; (2) fatalities may represent critical pieces of evidence in a law enforcement or safety investigation if the incident is suspected to be intentional; and (3) local morgues, refrigeration capability, funeral homes, and cremation facilities may be overwhelmed. Therefore, fatality management protocols should be adaptable to the specifics of the biological incident.  Such protocols should consider approaches for handling and recovery, identification and tracking, transportation and storage, embalming and cremation thruput, and disposal of remains.87 Temporary holding of fatalities at hospitals to supplement morgues may be required depending on size and scope of the biological incident.88 For example, refrigerated mortuary trailers were used during the COVID-19 pandemic when hospital morgues became overwhelmed. Additional morgue staff (i.e., embalmers, funeral directors, processors) may be needed to increase throughput at funeral homes and crematoriums.

Figure 38: Mobile morgues deployed in New York City
Figure 38: Mobile morgues deployed in New York City

SLTT planners should establish mass fatality thresholds for requiring and requesting additional support. The federal government has the ability to provide technical assistance and consultation on fatality management and mortuary affairs (discussed below).

What Will You Need to Know?

  • Who has the authority at the local and state level over fatality management - medical examiner, justice of the peace, other?
    • What are their biological response plans?
  • Based on the biological pathogen, what will be the fatality management protocol?
    • For hazardous remains?
    • For evidence?
    • For cultural or religious considerations?
  • How will you know if there are any facility capacity, workforce, or resource limitations regrading fatality management?
    • If limitations arise, what will be the recommended alternatives?


87. CDC. (n.d.). Public Health Preparedness Capabilities: National Standards for State and Local Planning Capability 5: Fatality Management. HHS.

88. National Association of Medical Examiners. (2010). Standard Operation Procedures for Mass Fatality Management.