Reducing occupational exposure to SARS-CoV-2: A survey of changes in caseload and controls among medical examiner and coroners’ offices in Pennsylvania during 2020

Abstract

Like their counterparts in healthcare, workers in medical examiner and coroners’ offices are considered essential workers. The frequency and urgency of their work during the coronavirus disease 2019 (COVID-19) pandemic have only become of greater importance. Because of the increased mortality in the general population due to SARS-CoV-2, the virus that causes COVID-19, it is reasonable to assume that the workload and risk of occupational exposure to SARS-CoV-2 have increased for these workers who are required by state law to investigate deaths known or suspected to be due to a contagious disease that constitutes a public hazard. Studies investigating the impact of the COVID-19 pandemic on these workers and their operations have been limited. The objective of this study was to conduct an assessment of routine medical examiner and coroners’ office duties (e.g., infectious disease testing and decedent transport) by surveying the 67 county medical examiner and coroners’ offices in Pennsylvania to characterize how the rise in infectious disease cases from COVID-19 influenced workload and resource needs. Quantitative results demonstrated an increase in workload and use of personal protective equipment (PPE) while engineering control usage remained the same. Qualitative results revealed various challenges experienced by the offices during the pandemic including limitations in access to PPE, insufficient storage space for increased numbers of decedents, personnel shortage/burnout, and limited or no engagement at the state level for emergency response planning and implementation. These data are valuable to inform the need for additional guidance or supplies and may be used to optimize resource planning and implementation (e.g., personnel, facilities, and supplies) for both routine and surge demand scenarios.

Keywords:

• COVID-19
• decedent
• medicolegal death investigation
• personal protective equipment
• occupational safety and health
• SARS-CoV-2

Disclaimer

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention. The authors confirm that the data supporting the findings of this study are available within the article and/or its supplementary materials.

Acknowledgments

The authors would like to thank the Pennsylvania State Coroners Association for its collaboration in developing and implementing the survey. We also thank Dr. Frederic Gerr for his valuable comments and suggestions on the draft of the survey instrument. The authors are grateful to the medical examiner and coroners’ office personnel who participated in the survey and for their continued work in responding to the COVID-19 pandemic.

Additional information

Funding

This project was supported by the National Institute for Occupational Safety and Health.