How the World Has Learned to Grieve in a Pandemic

Pandemic restrictions have meant that many people have died or grieved alone. Scenes from Singapore to the United States convey a deep sense of loss and show how end-of-life rituals are being adapted.

Flavio Lo Scalzo/Reuters

Hundreds of thousands of people around the world have died amid the coronavirus pandemic, both from the disease known as COVID-19 and other ailments. Compounding the pain and loss as the death toll mounts is the inability to grieve as before—yet another wrenching disruption affecting cultures and faiths worldwide. 

In Egypt, this has meant the excruciating inability of families to carry out the Islamic custom of bathing the body before burial; in Mexico, cremations are depriving many of velorios, or wakes; and in India, no more funeral pyres on the Ganges River. Many countries have restricted the number of people who can gather together, and families have been prohibited from visiting loved ones suffering from the disease and from coming into contact with their bodies after they have died. Under state and nationwide lockdowns, many have had to grieve alone.

The gathered community is essential to the grief process and the funeral process; it’s as near a universal as we’ve got.
William Hoy, Baylor University
Woman wearing protective gloves cries during the funeral of her mother
SPAIN: Under the country’s state of emergency, only three relatives are allowed to attend burial ceremonies. Here, Maria Porcel cries during the funeral of her mother, Concepcion Molero, in El Prat de Llobregat. David Ramos/Getty Images

Like so much in this pandemic, it remains unclear how long such measures will remain and what lasting effects they may have on the bereaved and their communities. Scholars who study end-of-life rituals worldwide say grieving practices can be crucial for individuals’ mental and spiritual health.

“For those who have been bereaved, the funeral ritual is but one part of the process of acknowledging and learning to handle the grief,” says Glenys Caswell, who studies end-of-life care at the University of Nottingham.

Saying Goodbye

FRANCE: Mang Phother, who recovered after being seriously ill with COVID-19, holds his hospital bed railing. Benoit Tessier/Reuters

Hospitals and senior-care facilities in dozens of countries are closed to visitors, with family, friends, and clergy members unable to be physically present with the sick in their final moments. This is not only distressing for the family members but also for the person who is close to death. 

“Long before COVID, in my hospice work, the far and away number one fear that I heard expressed from dying patients was the fear of dying alone. And look what everybody’s doing,” says William Hoy, a clinical professor at Baylor University.

Health-care workers have sometimes held video calls between patients and their loved ones so they can be together virtually, but Hoy says that’s simply not the same as holding hands.

SPAIN: Health-care workers are often the last faces seen by those about to die. Some, such as this worker in a hospital near Barcelona, have tried to bring comfort by video conferencing with relatives. David Ramos/Getty Images

In Roman Catholic rituals, a priest usually performs last rites at a dying person’s bedside, which requires physical touch, including giving communion and anointing them with oil. But amid the pandemic, many clerics have been barred from entering health facilities. During the worst of the outbreak in hard-hit northern Italy, priests stopped saying last rites. Unable to enter patients’ rooms, some priests in the United States have given blessings from the hallway or over the phone.

ITALY: On Easter Sunday, a priest dons protective gear and gives blessings to those in intensive care in Bologna. Max Cavallari/Getty Images

In other religions, such as Hinduism and Islam, family and a faith leader may pray with the dying person, but this has been nearly impossible because of pandemic restrictions.

Preparing for the Funeral

BELGIUM: Funeral home staff disinfect the casket of a person who died of COVID-19 in Brussels. Philip Reynaers/Photo News/Getty Images

Preparation of the body is an important part of many rituals, but the World Health Organization (WHO) has said that family members and friends should not touch or kiss the bodyAnyone handling it should wear personal protective equipment, even though there is no evidence that someone who has died of COVID-19 can transmit the disease.

IRAN: Men prepare the body of a coronavirus victim for burial in the hard-hit city of Amol. Majid Saeedi/Getty Images
SPAIN (L): Workers at a funeral home in Segovia tape a casket closed. PHILIPPINES (R): Priest Rey Amancio, wearing full-body gear, maintains Catholic traditions by continuing to bless the deceased in Caloocan. Susana Vera/Reuters and Eloisa Lopez/Reuters

Bathing of the body by relatives soon after death is an essential part of Islamic tradition. Some countries, such as Egypt, have only allowed medical staff to perform the ritual, while others have limited the number of relatives who can participate and required them to wear protective gear. In Iran, volunteers have helped wash the bodies and prayed over them.

IRAN: A body is carried to a cemetery just outside Tehran. Ebrahim Noroozi/AP

In Islam, it is important to perform the burial as soon as possible, ideally within twenty-four hours after death; Jewish funerals customarily also take place within twenty-four hours. But as hospital morgues and funeral homes around the world have been overwhelmed, some families have had difficulty quickly retrieving bodies. One man in Iraq told NPR that he wasn’t able to see his father’s body for eight days.

ISRAEL: Jewish individuals who have passed in the country are traditionally buried in a cloth smock and shroud. But coronavirus victims are being wrapped in plastic. Ronen Zvulun/Reuters

In predominantly Christian countries, particularly those in Latin America, such as Mexico, families often hold velorios, or wakes, lasting up to several days to commemorate the person’s life with dozens of friends and neighbors. But some governments, including Honduras and Nicaragua, have banned these wakes and encouraged swift burials after families retrieve the bodies.

The Funeral Ceremony

BANGLADESH: People wearing protective suits pray for a man who died from the coronavirus disease at a graveyard in Dhaka. Mohammad Ponir Hossain/Reuters

Funerals allow communities far and wide to come together to support the grieving, commemorate the life of a person who has died, and form tighter bonds.

“We cannot find anywhere a group of people in any era or any culture that has allowed the grieving to go it alone. The gathered community is essential to the grief process and the funeral process; it’s as near a universal as we’ve got,” says Hoy.

BRAZIL: Women look on during a collective burial of people that have passed away due to the coronavirus disease, at the Parque Taruma Cemetery in Manaus. Bruno Kelly/Reuters

Most countries have banned large gatherings and prohibited travel, which means few family members can attend funerals in person. Travel restrictions have prevented Muslim immigrants in France and Italy from repatriating the bodies of loved ones to their home countries, and they have struggled to find local burial plots that follow Islamic tradition. The Indian city of Varanasi typically sees hundreds of Hindu worshippers daily travel to cremate their loved ones in the belief that doing so will free the dead from a cycle of rebirth. Yet it has been largely absent of its funeral pyres since India instituted its nationwide lockdown.

A lone Hindu priest performs an evening prayer at the Dashashwamedh Ghat on the banks of the Ganges river during a government-imposed nationwide lockdown
INDIA: A Hindu priest performs an evening prayer in Varanasi, on the banks of the Ganges River. Varanasi’s dozens of ghats, staircases leading down to the river, are normally crowded with pilgrims taking part in bathing or cremation ceremonies. Anand Singh/AFP/Getty Images

In Ghana, a majority-Christian country, funerals are extravagant celebrations that can last up to a week. Families of the deceased arrange live musical performances and buffets; some hire professional mourners to attend the ceremony. “Fantasy coffins” are built to resemble an object or figure that might symbolize the deceased’s profession or evoke a proverb. Now, this tradition has all but stopped as the country has barred gatherings of more than twenty-five people. Many are postponing the ceremonies in the hope they can hold them after the virus has receded.

GHANA: Reverend Ebenezer Markwei livestreams a service to worshippers in Accra. Religious leaders turned to virtual services after all religious gatherings were suspended, but many Ghanaians have resisted holding funeral ceremonies this way. Francis Kokoroko/Reuters

Some communities are finding ways to substitute the traditional funeral with new practices even amid pandemic restrictions. Churches in the United States and elsewhere have gone beyond streaming ceremonies online by holding drive-in funerals, in which people can listen to services broadcast on their car radios and watch them projected on a screen in parking lots. A funeral director in Scotland has called on residents to revive the custom of bowing when a hearse passes their home to show support for the bereaved and pay respect to the deceased.

Aerial view of a burial at the Bom Jardim cemetery, the largest public cemetery in Fortaleza, Ceara state, Brazil
BRAZIL: A burial takes place at the Bom Jardim Cemetery in Fortaleza. Many cemeteries are struggling to clear space for new graves. Jarbas Oliveira/AFP/Getty Images

In many instances, those grieving have observed government orders on social distancing. Yet tensions have flared in some cases. For example, New York City has seen confrontations between police officers and mourners. Muslim activists in Sri Lanka have protested the country’s mandatory cremation order, which violates traditional Islamic practices of burying the dead.

UNITED STATES: Hundreds of members of New York’s ultra-Orthodox Jewish community gathered for a rabbi’s funeral in April, defying the city’s lockdown. Bruce Schaff/Reuters

New Ways of Grieving

UNITED STATES: Only close relatives can attend the funeral for husband and wife Bernard and Eveyln Seckler in Sharon, Massachusetts, though the service is streamed for others watching from as far as California. David L. Ryan/Boston Globe/Getty Images

After the deceased has been laid to rest, family and friends are left to grieve. Mourning rituals can last weeks or months, and different communities are finding ways to adapt. In normal times, Jewish mourners sit shiva, a weeklong ritual during which members of the community would gather to comfort the family. Now, some families have organized Zoom shivas,” allowing many more people than could attend a typical shiva to join a video conference for two hours every day. However, because shivas normally require a minyan, or a quorum of ten people present, some Orthodox rabbis have disapproved of gatherings over Zoom.

UNITED STATES: A family in New Canaan, Connecticut, joins a Zoom shiva for an elderly relative who died amid the pandemic. Andrew Lichtenstein/Corbis/Getty Images

Many ethnically Han Chinese families remember relatives long after their deaths during the annual Qingming Festival, or Tomb-Sweeping Day. Each spring in countries such as China and Singapore, families visit their relatives’ tombs, cleaning the gravesite, praying, and giving offerings. With the festival falling amid the pandemic, governments encouraged people to avoid cemeteries. Instead, cemetery staff livestreamed their tomb-sweeping ceremonies.

CHINA: Many families hire tomb-sweeping services to clean relatives’ graves since coronavirus restrictions prevent them from visiting cemeteries. Ricardo Arduengo/Reuters

Resiliency Amid Tragedy

PUERTO RICO: Gina Claudio holds the U.S. flag that draped the casket of her husband, Mart’nez Ortiz, the first Puerto Rican police officer to die of COVID-19. Ricardo Arduengo/Reuters

People could still be coping from the pandemic’s disruptions years or even decades from now, experts say. “We are going to be sweeping up the psycho-social-spiritual pieces of this for more than a generation,” says Hoy, who points to past epidemics that similarly upended community rituals, such as the 2014–16 West African Ebola outbreak. Researchers have described long-lasting psychosocial effects on the loved ones of Ebola victims, including fear of misfortune for not paying proper respect to the deceased and resentment toward authorities.

Still, people can be surprisingly resilient in the face of tragedy, as Columbia University’s George Bonanno has written, and the ways the world adapts during such times reflect this. Sierra Leoneans altered their burial customs in the midst of their civil war in the 1990s, finding other ways to pay respect to the dead, such as carrying out a ceremony using a piece of metal in place of the deceased’s body. They turned to such alternatives again during the Ebola outbreak.

In response to COVID-19, New York’s Westchester County has erected a memorial displaying purple ribbons for each of the more than one thousand killed by the virus there. Newspapers in the United States, Italy, and elsewhere have expanded their obituary sections to honor those who have died in the pandemic.

UNITED STATES: The Boston Globe dedicates sixteen pages to obituaries in its April 19 newspaper. Brian Snyder/Reuters
RUSSIA: A woman holds flowers near a memorial for health-care workers who reportedly died in Saint Petersburg amid the pandemic. Anton Vaganov/Reuters

“Right now, the task people have is to kind of do as much as they can,” says Bonanno. “We have to go through these processes to get over the loss, and people have found creative ways to do this in the time of COVID.”

Family members of a victim of the COVID-19 coronavirus mourn during a funeral in Jakarta on March 31, 2020.
INDONESIA: Family members of a COVID-19 victim mourn during a funeral in Jakarta. Bay Ismoyo/AFP/Getty Images

Additional Resources

The U.S. Centers for Disease Control and Prevention (CDC) offers guidelines for coping with a disaster. If you are experiencing a loss or feel distressed and need help, the CDC recommends talking with a doctor, counselor, or clergy member, or calling the free, confidential Disaster Distress Hotline at 1-800-985-5990.

WhatsApp maintains a list of crisis hotlines around the world.

NPR and Kaiser Health News share guidance on how to grieve amid the coronavirus pandemic.