What happens when you die in New York City?

The coronavirus pandemic has wreaked havoc on New York City in more ways than one – over 15,000 people confirmed dead, nearly 200,000 people testing positive, and an economy shut down for the foreseeable future. But perhaps the most nightmarish realization of that havoc is in the reports of refrigerated trucks parked outside hospitals and funeral homes to store bodies when morgues ran out of space. In one instance, dozens of bodies were left decomposing in trucks outside a Brooklyn funeral home and in another, a refrigerated trailer was used to store bodies outside a Manhattan nursing home where almost 100 residents have died since the pandemic began.

What’s never explained in the news stories and viral videos is why, other than more deaths than usual, these bodies have accumulated. Most New Yorkers probably don’t even know what happens to one’s body after passing away at home or in a hospital. 

The pandemic has shed light on the existing processes for handling bodies of the deceased in New York City, and forced the city to come up with new measures to handle the surge in deaths over a short period of time. City & State looked into what happens to the bodies of the deceased under normal circumstances, and how that has changed because of the city’s severe coronavirus outbreak. 

Before COVID-19, what happened to bodies of the deceased in New York City?

Some of the processes for handling a dead body – going from a hospital to morgue to burial, for example – depend on the circumstances of a person’s death and whether family or friends have made arrangements. 

When a person is declared dead in a hospital and the next-of-kin have already made arrangements with a funeral home, the body will be picked up directly from the hospital and brought to the funeral home, Michael Lanotte, executive director of the New York State Funeral Directors Association, told City & State. If for some reason that transfer can’t happen immediately, or if arrangements aren’t already made, the body would be kept in the hospital’s morgue if they have one, and the funeral director would retrieve the body later from the morgue once the family has hired a funeral home. 

The body is then brought to the funeral home, where the family or relations of the decedent can meet with the funeral director to make necessary preparations, including embalming, for example. Then, Lanotte said, the body would be brought to either the cemetary or crematory for final disposition – meaning the burial, cremation or other disposition of a dead body.

What happens when a person has died at home or some place other than a hospital?

For the many cases in which someone dies not in a hospital, but at home or elsewhere, the city’s emergency responders are usually the first on the scene. If a person does not die in a medical facility, the Office of the Chief Medical Examiner – the mortuary for New York City – is always brought in to do an investigation to determine whether the person died of natural causes. Aja Worthy-Davis, a spokesperson for the Office of the Chief Medical Examiner, said that depending on the circumstances of death, that investigation might happen at the site of the death, or the body might be brought to a morgue if further investigation is required. The investigators in the Office of the Chief Medical Examiner are all nurse practitioners, and they will then sign a death certificate – which can happen on-site or later at a city morgue – and the family of the deceased would begin making arrangements with a funeral director.

If a person’s family is not on the site of the death, it falls again to the Office of the Chief Medical Examiner to reach out to the family of the deceased. Though the office largely deals with criminal cases in which there might have been foul play, they are also the ones who respond when a person has died of natural causes at home or somewhere other than a medical facility.

What happens when a decedent has no next-of-kin or a body is unidentified?

For cases in which a deceased person has no next-of-kin or a body is unidentified, the remains will typically be put into the custody of the chief medical examiner’s office. If a next-of-kin can’t be identified or the body remains unclaimed or identified, the deceased will be buried on Hart’s Island. A small island just off the Bronx, Hart’s Island houses New York City’s public cemetery, where over 1 million people have been buried. 

If a person is going to be buried on Hart’s Island, however, it is the city Department of Corrections that manages the burial. Those bodies are transferred via ferry to Hart’s Island, and bodies are buried in unmarked graves.

In early April, images of New Yorkers’ unclaimed bodies in mass graves on Hart’s Island were widely distributed online and were considered disturbing by some. 

How have these processes changed because of the coronavirus crisis?

The coronavirus pandemic upended many of the established processes and customs for handling the bodies of the deceased in New York City, largely because of the sheer number of people who have died from the coronavirus in a short span of time. As of May 15, the city reported 20,476 deaths, including 15,422 confirmed dead from the coronavirus, and 5,054 probable deaths. 

That unprecedented number of deaths over the course of a few months has led funeral homes to experience a backlog, which has, in turn, overwhelmed city and hospital morgues with bodies waiting to be picked up by funeral homes. The end result of that backlog is a desperate need for temporary storage for bodies of the deceased, including refrigerated trucks. In early April, FEMA sent refrigerated trucks to New York City to be delivered to overwhelmed hospitals.

Since some of the first reports about the use of refrigerated trucks outside hospitals, when New York City was experiencing the peak of the crisis, more long-term solutions have been devised. The Office of the Chief Medical Examiner announced earlier this month that the city has set up a “disaster morgue” at the 39th Street Pier in Brooklyn, where refrigerated trucks will be stationed permanently – at least through the worst of this crisis – as storage for dead bodies that funeral homes aren’t yet able to take in. It’s one of four temporary facilities that the office has set up since the pandemic began.

The city previously had a 15-day deadline for families to claim bodies of the deceased, but it was lifted because of the extra stresses on the system caused by the pandemic. The deadline existed before the coronavirus pandemic, but Worthy-Davis, the spokeswoman for the chief medical examiner’s office, told City & State that even before COVID-19, the office usually held on to bodies for longer than two weeks – more typically for about a month – before starting the process of burial at Hart’s Island. There are various reasons why it might take a family longer than a few days or weeks to claim the body of a loved one. A few Worthy-Davis mentioned include the need to reach relatives in other states or countries, a need to secure funds to pay for a funeral, or personal conflict within a family.

In addition to providing relief to funeral homes, the extra morgue space at the 39th Street Pier will serve as storage for bodies that haven’t been claimed yet. John D’Arienzo, a funeral director and president of the Metropolitan Funeral Directors Association, told City & State that the office of the chief medical examiner has also set up a portal that allows funeral directors to know where a particular body is at one time.

Meanwhile, the burial of indigent New Yorkers – unidentified bodies or those with no next-of-kin who have claimed the bodies – is still happening at Hart’s Island, but at five times the normal rate.

For some in this business, the crisis has served as a reminder of just how much families need to have their deceased loved ones cared for with respect. “We got swamped and weren't able to offer services at the time,” D’Arienzo, the funeral director, said of the backlog funeral homes were experiencing. “Families were so desperate, it just ignited a fire under me to make sure that we're always prepared.”