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‘I’ve never seen anything like this’: Funeral homes cope with a coronavirus surge

From left to right: Matt Tauro, Nick Turco, and John Lockhead moved the casket of a woman who died of COVID-19 to the hearse parked outside of Ruggiero Family Memorial Home.
From left to right: Matt Tauro, Nick Turco, and John Lockhead moved the casket of a woman who died of COVID-19 to the hearse parked outside of Ruggiero Family Memorial Home.Jessica Rinaldi/Globe Staff

Joe Ruggiero III pulled aside a sheet of plastic that’s making do as a temporary wall and rolled a casket into the main hallway of his East Boston funeral home.

Behind him was what his family calls the tribute lounge — a place where mourners usually gather during a wake to drink coffee, sit on comfortable stuffed chairs, and admire photos of a loved one who had died.

Now, however, it is packed with caskets — chairs moved aside, tight against the walls.

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In an average busy month last year, the Ruggiero Family Memorial Home handled 20 funerals. “As of today we’re at 71,” he said last Thursday, as April came to a close, during a brief break between his third and fourth services of the day. “I’ve never seen anything like this."

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Amid the coronavirus pandemic, funeral homes across Massachusetts have labored under unprecedented conditions — helping each other out when they can — to meet an unprecedented increase in the need for their services.

While comprehensive figures for April aren’t immediately available, throughout the state “everybody’s numbers are at least double, and in East Boston and Chelsea, they’ve tripled,” said C.R. Lyons, president of the Massachusetts Funeral Directors Association.

In mid-April, 10 calls came into Ruggerio’s in one day. That single-day demand matched the number of services his home might handle in an entire slow month last year. Nowadays the white board in the downstairs office, on which he schedules his work, is filled with notes: three funerals on a Wednesday, four on Thursday, five Friday.

And funeral homes statewide are contending with the increase in demand without a corresponding increase in staffing for funeral directors, who are trained and licensed for key tasks such as embalming and making arrangements with families.

Funeral director Joe Ruggiero Jr., the founder of his family's business, looked up at the whiteboard full of funerals for the week as he tried to figure out the next day's schedule beside his daughter, Catie, an apprentice funeral director.
Funeral director Joe Ruggiero Jr., the founder of his family's business, looked up at the whiteboard full of funerals for the week as he tried to figure out the next day's schedule beside his daughter, Catie, an apprentice funeral director. Jessica Rinaldi/Globe Staff

“There aren’t a lot of unemployed funeral directors sitting out there,” said Lyons, an owner of C.R. Lyons and Sons Funeral Directors in Danvers.

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If there were, they could probably find work. On average, about 60,000 people die in Massachusetts annually — or about 164 a day, he said.

Last Wednesday, state officials announced 252 additional confirmed coronavirus deaths, the highest daily total yet.

But at present, there is no mechanism to quickly produce new funeral directors to assist with the extra work.

“It takes a couple of years to make a funeral director,” said Barbara Kazmierczak of Worcester Funeral Inc., who added that enrollment in training programs historically isn’t expansive. “They’re small classes,” she said. “Maybe 20 if you’re lucky.”

Funeral director Joe Ruggiero III moved a body into a makeshift storage area that Ruggiero Family Memorial Home usually used as a tribute room.
Funeral director Joe Ruggiero III moved a body into a makeshift storage area that Ruggiero Family Memorial Home usually used as a tribute room. Jessica Rinaldi/Globe Staff

Kazmierczak, vice president of the state association, was a nurse before changing professions. She recalled that when she graduated from funeral director training about a dozen years ago, her class was “14 or 15.”

During the coronavirus crisis, such limitations weigh on those who run funeral homes, where owners and operators don’t have the options available to some hospitals, such as diverting staff from one department to another.

“Because we don’t have the volume of a hospital, or a per diem pool, or an agency you can call, you’ve got another concern,” Kazmierczak said.

“It’s 48 man-hours from the time you get the call to the time the burial is done. That’s a lot of work, and when you’re doubling the volume, the intensity is higher,” she added. “So it’s also making sure your staff is getting the breaks they need so they stay healthy.”

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Apprentice funeral directors Catie Ruggiero (left) and Jacqueline Brangiforte took a body from Melrose Wakefield Hospital.
Apprentice funeral directors Catie Ruggiero (left) and Jacqueline Brangiforte took a body from Melrose Wakefield Hospital. Jessica Rinaldi/Globe Staff

In the weeks since funeral homes represented by the organization began to feel the full impact of COVID-19 deaths, funeral directors have shared resources when possible, Lyons and Kazmierczak said.

In certain instances, Lyons added, that meant redistributing personal protective equipment, or PPE, when a funeral home runs short.

“About two weeks ago, a colleague said, ‘I’m nearly out of N95 masks. If anyone has any, can you please reach out?’ I had a surplus,” he said.

Funeral workers moved one casket out for a funeral as another is brought in to set up for a wake inside Ruggiero Family Memorial Home in East Boston.
Funeral workers moved one casket out for a funeral as another is brought in to set up for a wake inside Ruggiero Family Memorial Home in East Boston. Jessica Rinaldi/Globe Staff

There also have been shared discussions about how best to protect staff members who embalm those who died of COVID-19, Kazmierczak said.

And in that realm, Massachusetts funeral directors benefited from advice and warnings passed along by industry associations in places such as New York, which was hit harder and earlier. Funeral directors here did what they could to stock up on protective equipment and prepare for a sharp increase in work.

Family members of Annette Nazzaro, sat in chairs that are spread apart to maintain a social distance during her wake at the Ruggiero Family Memorial Home in East Boston.
Family members of Annette Nazzaro, sat in chairs that are spread apart to maintain a social distance during her wake at the Ruggiero Family Memorial Home in East Boston. Jessica Rinaldi/Globe Staff

The surge in Massachusetts deaths began occurring “two weeks after New York and that gave us time to prepare,” Kazmierczak said. “We’re certainly not experiencing what New York has, by the grace of God, and I’m thankful.”

Her own work has gone beyond making sure there are enough protective N95 masks on hand for key tasks, such as embalming.

Kazmierczak has been making gear to distribute to those whose duties don’t require the extra protection of N95 masks, such as valets who direct cars that gather for small services.

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She also has provided face masks to clergy or families who forget to bring theirs, and to those who work on the state organization’s staff.

Jim Leo (left), a Deacon at St. John the Evangelist Church in Winthrop stood beside the casket of a man who died of coronavirus. At right, Matt Tauro held onto roses to give out to family members at Holy Cross Cemetery for Annette Nazzaro's funeral.
Jim Leo (left), a Deacon at St. John the Evangelist Church in Winthrop stood beside the casket of a man who died of coronavirus. At right, Matt Tauro held onto roses to give out to family members at Holy Cross Cemetery for Annette Nazzaro's funeral.Jessica Rinaldi/Globe Staff

“I started sewing feverishly in March making masks,” Kazmierczak said in mid-April. “I’ve hit my hundred mark.”

Numbers tell only part of the story of what funeral directors face in a time of social distancing, a particular hardship for a profession in which comforting the bereaved is essential.

For safety reasons, funeral homes try to conduct some business by phone, e-mail, or FaceTime, but “there are some things that you can’t do at the same level online as you can in person,” Lyons said. “The sense of comfort you get from someone is so much greater in person.”

Even when they’re in the same room or at a gravesite with families, funeral directors find that coronavirus restrictions leave them “trying to maintain the best level of emotional support and empathy that you can without touching a person, and by not being within six feet, and not putting a hand on a shoulder,” Kazmierczak said.

Family members embraced as other mourners looked on from the car during the funeral service for Santos A. Rivas at Woodlawn Cemetery in Everett.
Family members embraced as other mourners looked on from the car during the funeral service for Santos A. Rivas at Woodlawn Cemetery in Everett. Jessica Rinaldi/Globe Staff

At Ruggiero’s funeral home, if more than 10 people arrive for a funeral, a line forms on the sidewalk outside as mourners wait to be admitted under the one-in, one-out policy. Inside, they sit in chairs carefully spaced several feet apart.

With so few allowed at a time, the silence and stillness of mourning during a recent funeral was all the more pronounced.

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Facial expressions are now largely hidden. If a family member begins to cry and a funeral director offers comfort, their faces remain behind masks — neither able to fully gauge nonverbal responses.

When a single family runs a funeral home for generations, there’s an added layer of intimacy as employees handle arrangements for friends and neighbors.

Ruggiero’s family lives in East Boston. His father, Joe Jr., ran the funeral home before him and had been “quasi-retired. He’s back in full swing now.”

A mourner broke down during a wake at Ruggiero Family Memorial Home in East Boston.
A mourner broke down during a wake at Ruggiero Family Memorial Home in East Boston. Jessica Rinaldi/Globe Staff

“I’m 30, my dad’s 60, my grandmother’s 80,” Ruggiero added. “One of us has interacted with someone along the way, usually.”

For now, there’s no end in sight for the additional funerals they’ll handle for those they know.

“Our staff is hanging in there,” Ruggiero said Thursday. “Last night we were out on a call at 9 o’clock at night. We’ve been getting in at 6 o’clock in the morning, and yesterday we were still working at 9 o’clock at night.”

Father Eric Bennett (left) said a funeral mass for a man who died of COVID-19. Because his family lived in Italy they weren't able to travel here for the funeral so the only other person in attendance was the funeral director Joe Ruggiero III.
Father Eric Bennett (left) said a funeral mass for a man who died of COVID-19. Because his family lived in Italy they weren't able to travel here for the funeral so the only other person in attendance was the funeral director Joe Ruggiero III. Jessica Rinaldi/Globe Staff

Bryan Marquard can be reached at bryan.marquard@globe.com. Jessica Rinaldi can be reached at jessica.rinaldi@globe.com.