Preparing for mass fatality events requires local, state and federal agencies to participate and collaborate at all levels within and among various agencies and organizations. The Connecticut Department of Public Health (DPH) and the Office of the Chief Medical Examiner (OCME) have developed guidelines to assist localities in planning for mass fatality events.
Mass fatalities fall into two main categories: (1) unnatural causes, such as catastrophic events of nature (hurricane, flood, earthquake), bioterrorism (use of agents such as anthrax, smallpox, Ebola) and terrorist attacks (World Trade Center, arson-related forest fires), and (2) natural causes, such as natural disease processes (pandemic influenza or Severe Acute Respiratory Syndrome (SARS). The management and disposition of all unnatural deaths come under the primary jurisdiction of Connecticut's Chief Medical Examiner. The management of natural death resulting from natural disease processes is the primary responsibility of the locality in which they occur, with the OCME providing information and guidance.
For information on mass fatality events in Connecticut, the brochure titled: Guidelines for Managing Mass Fatality Events with the State of Connecticut Office of the Chief Medical Examiner (link to copy of the brochure to print) presents an overview of the OCME's role in mass fatality events with an all hazards approach, describing how and when a locality should report deaths to the Medical Examiner, and how a locality should manage human remains during a mass fatality event. Acute care hospital planners can use the Mass Fatality Incident Planning Checklist provided below.
Planning for Pandemic Influenza Fatalities
Local authorities are currently planning how to manage an increase in natural deaths due to a pandemic influenza event in Connecticut. It is an undeniable fact that if a severe pandemic were to arrive, citizens will succumb to the disease or related secondary causes. Local hospitals, local health departments or districts, first responders, funeral directors, and many others need to prepare for managing the possibly high numbers of additional deaths during a pandemic. The Managing of Pandemic Influenza Fatality Events in Connecticut (link to copy of the brochure to print) brochure contains an overview of what localities need to plan for during a pandemic event including the signing and filing of death certificates, handling of human remains, and storage considerations. Additionally, the Department of Public Health has prepared pandemic flu death estimates derived from Connecticut DPH projections, presented by Department of Emergency Management and Homeland Security (DEMHS) Planning regions. While these numbers are estimates, they provide local authorities with an idea of how many deaths they might see in their locality and encourage collaboration with other health districts and towns to manage fatalities. While pandemic flu deaths would be natural deaths, the protocols for pronouncing the death, signing the death certificate, and handling the remains would not differ from that of seasonal flu, except that there would be higher numbers. For a review of the protocol for managing pandemic flu deaths, interested readers may review the Flowchart for In-Hospital Pandemic Flu Deaths or the Flowchart for Out-of-Hospital Pandemic Flu Deaths.
All of the files listed below are contained in the above summary, but have been separated out for your reading convenience. (These files require the free Adobe Acrobat Reader).
- Guidelines for Managing Mass Fatality Events
- The Managing of Pandemic Influenza Fatality Events
- Pandemic Flu Death Estimates by Department of Emergency Management and Homeland Security (DEMHS) Planning Region
- Flowchart for In-Hospital Pandemic Flu Deaths
- Flowchart for Out-of-Hospital Pandemic Flu Deaths
- Acute Care Hospital Mass Fatality Incident (MFI) Planning Checklist
- CFDA Pandemic Packet for the Public
- Description of Forms in CFDA Pandemic Packet
- Funeral Home Survey Template for Local Health Dept. Planning
- Sample Letter for Local Health director to Funeral Director for Planning Purposes
- CFDA Pandemic SOPs
- CFDA Pandemic Matrix