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Home » The Human Element » The Logistics of Carnage: How to Deal With Huge Numbers of Dead Bodies
A convoy of Italian Army trucks is unloaded upon arrival from Bergamo carrying bodies of coronavirus victims to the cemetery of Ferrara, Italy, where they will be cremated, Saturday, March 21, 2020. The transfer was made necessary since Bergamo mortuary reached maximum capacity. For most people, the new coronavirus causes only mild or moderate symptoms. For some it can cause more severe illness, especially in older adults and people with existing health problems. (Massimo Paolone/LaPresse via AP)
A convoy of Italian Army trucks is unloaded upon arrival from Bergamo carrying bodies of coronavirus victims to the cemetery of Ferrara, Italy, where they will be cremated, Saturday, March 21, 2020. The transfer was made necessary since Bergamo mortuary reached maximum capacity. For most people, the new coronavirus causes only mild or moderate symptoms. For some it can cause more severe illness, especially in older adults and people with existing health problems. (Massimo Paolone/LaPresse via AP)

The Logistics of Carnage: How to Deal With Huge Numbers of Dead Bodies

PortandTerminal.com, March 26, 2020

WASHINGTON – How do you safely deal with huge numbers of dead bodies?

What are the logistics of it from a health standpoint? Or from an emotional one vis-a-vis the survivors? This grim question is suddenly vitally important.

We see that already, hospitals and morgues in Italy, Spain and New York City are dealing with more bodies than they were designed to cope with.

A convoy of army trucks in Italy remove scores of coffins that had been crowding overwhelmed hospitals and morgues.

Yesterday, it was reported that Elmhurst Public Hospital in Queens installed a refrigerated truck outside its emergency ward to hold the bodies of the dead.  In Bergamo, Italy, the Army has been called in to transport truckloads of coffins containing COVID19 victims to free up space from overwhelmed hospitals and morgues.

Refrigerator truck installed at the the emergency room in Elmhurst, Queens to store the Coronavirus bodies.
Refrigerator truck installed at the emergency room in Elmhurst, Queens to store the Coronavirus bodies (March 25, 2020)

According to Politico, the Department of Homeland Security has been briefed that New York City’s morgues are nearing capacity. Officials were told that morgues in the city are expected to reach capacity next week, per the briefing.

A refrigerated transport container used by shipping companies can store up to 50 bodies.

World Health Organization (WHO)

At least two city hospitals have filled up their morgues, and city officials anticipated the rest would reach capacity by the end of this week, according to the briefing. The state requested 85 refrigerated trailers from FEMA for mortuary services, along with staff, the briefing said.

What are the health risks?

According to the WHO, contrary to common belief, there is no medical evidence to suggest that large numbers of dead bodies, in themselves, cause disease or epidemics.”Human remains originating from traumatic events (natural disasters, accidents or warfare) do not represent a health hazard” they advise in a grim document titled “Disposal of dead bodies in emergency conditions”.

READ: ‘There are no funerals:’ Death in quarantine leaves nowhere to grieve

COVID19 though is a highly infectious virus and there are valid concerns that the bodies of victims who have died from it remain a danger to the living. Carefully disposing of them as quickly as is safely possible seems to be the best way forward.

During the Plague in Europe, the number of dead grew so quickly that most bodies were disposed of in mass "Plague Pits" as quickly as they could be delivered to them.
During the Plague in Europe, the number of dead grew so quickly that most bodies were disposed of in mass “Plague Pits” as quickly as they could be delivered to them.

And then there is the smell. If a corpse is not kept refrigerated it will begin to smell within 24-36 hours after death depending upon a number variables including the temperature that it is kept at.

After 3-5 days things get nasty quickly. A dead body starts to bloat and blood-containing foam leaks from the mouth and nose. 8-10 days after death — the body turns from green to red as the blood decomposes and the organs in the abdomen accumulate gas.

Finally, the WHO warns of the the “psychological trauma of the loss of loved ones and of witnessing death on a large scale.” Humanely and quickly removing the distressing sight of piles of bodies is in the best interest of our mental health.

What do we do with very large numbers of dead bodies?

New York City, 9/11. Brooks Brothers became the makeshift morgue during the first few
days of the operation. Fearing the building unstable, the morgue was moved first to the
second floor of the Burger King on Liberty. That was later changed to the
Federal Express building two blocks south down Church St. After the move this sign
had to be made because the NYFD continued to bring the body parts to the store.

There are now 1,046 COVID19 deaths in the U.S. By any measure a terrible number, but logistically something our current systems can manage.

In Italy, the global epicentre of the crisis, 7,503 people have died because of the virus. That’s about 2.5 times the number of people killed in 9/11. Again, a horrific number of lost lives, but a number that can be managed, albeit with increasing difficulty.

“We have the ability to expand pretty dramatically,” she said. “If you look back at what we did during 9/11, we have the ability to create mobile stations that allow us to house bodies if we run out of space.”

Aja Worthy-Davis, Spokesperson for the New York City Office of the Chief Medical Examiner

What happens though when the numbers of the dead reach into the tens of thousands? Or hundreds of thousands?

Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID), warned congress on March 11th that “If we are complacent and don’t do really aggressive containment and mitigation, the number could go way up…many, many millions.”

READ: Fauci to congress – “It’s going to get worse. Millions of deaths possible.”

What are the logistics of handling the number of dead bodies Dr. Fauci worries we might be looking at in the not too distant future?

The Spanish Flu pandemic in 1918-1920

Make-shift treatment ward for the sick during the Spanish Flu epidemic. Image Credit: Library of Congress

The Spanish Flu killed an estimated 50 million people globally between 1918-1920. In the United States, the Spanish Flu killed 675,000 people. Nearly 200,000 Americans died from the “Spanish Flu” in October 1918 alone, making it the deadliest month in the country’s history.

How did they manage? What did they do with all of the bodies?

We know that amidst the 1918 flu pandemic, America struggled to bury the dead. Historical records show that since cremation was an uncommon practice at the time, the sheer number of bodies overwhelmed the capacity of undertakers, gravediggers and casket makers to keep pace with the arduous task of burying the dead.

Men dig a mass grave in Philadelphia to bury victims of the Spanish Flu
Men dig a mass grave in Philadelphia to bury victims of the Spanish Flu – SOURCE/THE HISTORICAL MEDICAL LIBRARY OF THE COLLEGE OF PHYSICIANS OF PHILADELPHIA.

One historical account talks about “several hundred bodies of the dead being stacked three and four deep, covered only by dirty and blood-stained sheets” at a Philadelphia morgue designed to hold only 36. At its worst, Philadelphia was handing 1,000 new deaths a day.

Many bodies remained inside city homes for days at a time, because family members could not find undertakers or were too ill to take action.

“Some bodies were mortifying and the stench was nauseating,” stated a November 1918 report submitted to J. Willis Martin, chairman of the Philadelphia Council of National Defense. “In the rear of the building, the doors were open and bodies lying all over the floor, a spectacle for gaping curiosity seekers including young children.”

Cemeteries struggled to handle the soaring death toll. With gravediggers absent from work—either because they had contracted the flu or were afraid that they would—grieving families were sometimes forced to dig graves for their loved ones. 

Casket companies, already busy supplying coffins for the thousands of soldiers killed in World War I, could not keep up with the demand. Facing a desperate shortage in the nation’s capital, District of Columbia Commissioner Louis Brownlow hijacked two train cars filled with 270 coffins bound for Pittsburgh and rerouted them to the city hospital under armed guard. Gravediggers at Boston’s New Calvary Cemetery were spotted dumping corpses out of caskets into graves so that the coffins could be used again.

In the end, the system was overwhelmed by the massive number of bodies that the only practical solution was to dispose of many of them in mass burial pits as was common practice during the Plague. In Philadelphia, it’s reported that some victims were simply tossed into mass graves “that had been hollowed out by steam shovels”.

Is mass cremation a practical solution?

Casket being cremated
In the United States, the cremation rate is 53% and growing.

While cremation was not popular during the Spanish Flu epidemic, it is a common means of disposing of the dead today. As burial plots become increasingly expensive, the cremation rate in large towns has grown to between 70% to 90% depending on the country. In the United States, the cremation rate is 53% and growing.

There are bottlenecks with cremation though as a means to dispose of large numbers of bodies.

Currently, the law only allows one body in a cremation chamber at a time. The only exception to this is if the family specifically requests that two people be cremated together. But even then, cremation chambers being designed as they are means that this isn’t always technically possible

In the United States, there are around 1,500 crematoria. Let’s say that they were all put into service working 24/7. And for the sake of the following calculation, let’s assume that each crematorium has just one oven on average.

Cremations take time. It takes about 2 – 2.5 hours to cremate a human body.

Based upon these numbers we estimate that working non-stop, America could cremate around 10 to 12 thousand people a day. But that is an optimistic number doesn’t allow for the logistics of moving bodies from where they perish to one of the nation’s 1,500 crematoria.

Summary

In an apocalyptic scenario where America was suddenly dealing with hundreds of thousands of COVID19 dead, a combination of body disposal methods would have to be put into place.

First, refrigerated containers in the thousands would have to be put into action as they are already beginning to be, to store the dead.

Next, a method for delivering victims’ bodies to crematoria and returning their ashes to families would have to be devised. Or mobile crematorium units would have to be dispatched to where they are needed most as Russia did to dispose of their dead soldiers during the fighting in Ukraine.

And finally, current burial methods, caskets, plots and whatnot would be a luxury for only the wealthy, as the trends show them becoming already.

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