The Body Collectors of the Coronavirus Pandemic
As the death toll from COVID-19 rises, the funeral homes and hospital morgues of New York City are struggling to keep up.
April 22, 2020
Chris Kasler, Al Johnson, and Kim Zambito load a coffin into a hearse in the parking lot of Sherman’s Flatbush Memorial Chapel.Photographs by Sinna Nasseri for The New Yorker
The dead man’s nurse was waiting in the hallway when Kim Zambito and Al Johnson stepped off the elevator on the third floor of an apartment building in Midwood, Brooklyn. The sight of them startled her. Zambito and Johnson wore surgical masks, body-length plastic protective gowns, and thick blue gloves. A stretcher rattled behind them. The body was visible through the apartment’s open door. A long interior hallway, cluttered with cardboard boxes and shoes, led to the bathroom, where a man in a striped button-down shirt and gray cardigan was lying face down on the floor. He was seventy-one and, according to the nurse, had been having trouble breathing. Several hours had passed since she found him there, she said. His mouth was still open.
Funeral directors making house calls have to treat each new death as a potential case of covid-19. “We don’t want anything escaping his lungs when we turn him over,” Zambito said. Johnson tucked a tissue between the man’s lips and covered his face with a sheet. They gently rolled him over. Zambito peeled off one of the three pairs of gloves she was wearing, and let them fall to the floor; she then reached for her cell phone in the back pocket of her jeans. Typically, a detective from the police department is required to inspect a body in person, to rule out foul play, but all of them were busy on other calls. A police officer who was waiting downstairs had asked Zambito to take a photograph of the body instead.
Zambito sprayed everything she planned to touch with disinfectant. Because the apartment’s hallway was too narrow to accommodate the stretcher, she and Johnson slid a clear plastic pouch onto the floor of the bathroom. They angled the body into the bag and zipped it shut. With Zambito holding the legs and Johnson lifting the torso, they carried the man to the stretcher. Prior to the pandemic, Zambito later told me, she found some solace in knowing that a person’s family and friends would have another chance to say goodbye at the funeral home. “With covid victims, it feels like shit, because this is the last time anyone is going to see them,” she said. “If they’re covid-positive, we’ll have to immediately casket them. You’re walking out the door with someone’s loved one, and you’re taking them away forever.”The New Yorker’s coronavirus news coverage and analysis are free for all readers.
It was 5 p.m. on April 8th. This was the sixth body that Zambito and Johnson had picked up that day, and there were still three more retrievals to do—two house calls and a trip to Maimonides Hospital. In the first six weeks of the coronavirus outbreak in New York City, the death toll surpassed that of not just every American city but also that of many other countries worldwide. More than thirty-three New Yorkers were dying every hour from covid-19, according to Governor Andrew Cuomo. Still, the statistics only captured a part of the over-all devastation. Earlier this month, when Cuomo announced eight hundred deaths on a single day in New York City, he was relying on figures from hospitals, which only included people who had tested positive for covid-19. But, in just the first eight days of April, the office of the city medical examiner recorded 1,891 deaths in people’s homes. The day before Zambito visited the apartment in Midwood, the city’s emergency medical services logged two hundred and fifty-six home deaths across the city, compared with a rate of roughly twenty-five such deaths per day in March.
Zambito, who is twenty-nine, grew up on Staten Island. She used to tell her high-school guidance counsellors that she planned to be a mortician just to get them off her back. “It creeped them out,” she said. “But I kind of wanted to do it, too.” She went on to attend St. John’s University, which she was surprised to learn offered a bachelor’s degree in funeral-service administration. “It was, like, Oh, this actually is something I can do,” she recalled. “And then, when I saw my first dead body, I didn’t throw up.”
Zambito began her career at a trade house, which performed removals for funeral homes in New York City and New Jersey. Two years ago, she took a job in Midwood, at two funeral homes that shared an office and staff: Sherman’s Flatbush Memorial Chapel, which served a mainly Jewish clientele, and Lisovetsky Memorial Home, which catered to Russian customers. It didn’t matter to Zambito which faith or ethnicity she was dealing with; preparing people for their last rites, and helping families to find some measure of closure, she told me, was meaningful work. “It made you feel like you were doing something for someone.”
Lately, though, the job has changed. She used to pick up, at most, two bodies a day, and when she went to the hospital morgue she made a habit of offering her condolences to the family; orderlies would help her carry the body to the car. Now hospital morgues have so many bodies that they’ve been storing them outside, in refrigerated trailers, and employees are under strict orders to avoid prolonged contact with the infected corpses. Every morning around seven-thirty, Zambito arrives at work to find that six or seven new cases have been called in overnight. They have been taking her to Brooklyn, Queens, and the Bronx, and each body appears to have some connection to covid-19. “You look at a death certificate, and it might not say coronavirus,” she told me. “But you look at it and you see pneumonia or respiratory failure listed as the cause of death. Where are all the regular deaths? Where’s cancer? Where’s heart disease? All of a sudden, I’m only seeing people dying of pneumonia.”
In Midwood, Zambito and Johnson brought the body out to their van, but they couldn’t leave until a detective inspected the photo that Zambito had taken. The police officer had begun pacing the sidewalk, trying to get a detective on the phone. An hour passed. Although the unprecedented caseload had Zambito feeling more rushed than ever, increasingly, she found herself waiting aimlessly on the job. To maintain social distancing, funeral directors were no longer allowed to enter the office of the Brooklyn Medical Examiner, which meant that she often spent more than an hour sitting in a caravan of cars in the parking lot. It might be several hours before a medical investigator could find a doctor to sign a death certificate and then complete the file on the deceased. Bodies were hard to locate in the chaotic refrigeration units of beleaguered hospital morgues. And the city-wide electronic system for generating and recording death certificates, called eVital, kept freezing from overuse.
When a detective finally called back, the officer put him on speakerphone. Zambito and Johnson were sitting in the car, with the windows down. They craned their necks to listen. “You’re good to go,” the detective said. “Natural causes.”
Sherman’s Flatbush Memorial Chapel is the oldest Jewish funeral home in Brooklyn. When William Sherman founded it, in Williamsburg, in 1898, he kept a stable of horses on the premises to transport bodies. Since the late nineteen-nineties, William’s great-grandson, Joe Sherman, has owned the parlor, and it now occupies a sizable lot on Coney Island Avenue in Midwood. The building, a large, brick structure, looks vaguely like a casket, with a flat black awning and a bas-relief of a glowing flame on its façade. Two hearses sit in the parking lot. Since mid-March, when a grieving family member came in with a cough, only staff members have been allowed inside. “Our main concern now,” Sherman told me, “is protecting the living.”ADVERTISEMENT
Chris Kasler, a thickset Bay Ridge native with a heavy New York accent, has been helping to coördinate Sherman’s daily operations. He is genial and warm, with a lively sense of humor and a sober sense of professional responsibility; at fifty-four, he is a pedigreed mortician himself, the son and grandson of funeral directors. “I was born into this work,” he told me. “I grew up in a funeral home. I mean, literally.” When Kasler’s grandmother died, in 2003, at the age of ninety-nine, she was the city’s oldest licensed undertaker, and his two brothers are both certified as funeral directors. One is an E.M.T. at N.Y.U. Langone Hospital, and the other is an executive at the American Academy McAllister Institute of Funeral Service, on West Fifty-fourth Street, in Manhattan.
At Sherman’s, Kasler had set up a temporary work station on a plastic folding table in the main hallway. Death certificates sat in neat piles alongside a master calendar, on which Kasler tracked each case. Early on, the funeral home vowed not to turn away any families in mourning. But there was no way to predict such an intense volume of cases. In the past, a busy week consisted of about twelve funerals. During the first week of April, the funeral home handled more than a hundred and twenty-three bodies. Some had to be transported to cemeteries, others to crematoriums. Delays at both places—the next available appointments at the city’s crematoriums, for instance, are weeks away—led to a bottleneck. “This place is like a city morgue,” Kasler told me, “only about ten times worse.”
There wasn’t room to store all the remains. The refrigeration unit could hold up to six adult caskets and roughly four additional bodies that were to be embalmed or cremated. Kasler was rotating sets of bodies through the unit every three hours, to keep them from decomposing. He had set the air-conditioning system to its lowest level, sixty-four degrees, which was still about twenty degrees warmer than it needed to be. Two weeks earlier, Sherman’s suspended funeral services in the chapel, a large, carpeted room with polished wooden pews. Forty-six bodies were now stored inside. Some of them were in caskets, others were in orange “disaster” pouches provided by hospitals, and still more were kept in thin cardboard boxes known as cremation containers. The staff used warning labels to mark the receptacles which contained the remains of those who had died of covid-19. After a few days, a sour odor began to fill the mortuary; when the staff cracked a door to alleviate the smell, flies swarmed in.
“It’s like we’re in a war zone,” Kasler said. In one corner of the chapel, a large wooden casket sat between an orange body bag and a cardboard box. Other bodies were resting on the pews, or on stands snaking along the walls. One of them was a ninety-year-old woman, who had been wrapped temporarily in a plastic sheet, for lack of a more appropriate container, until Kasler covered her with a large white blanket. He told me, “To somebody, she’s a mother, a sister, a grandmother. I tried to keep her head straight on the pillow.”
Kasler and his co-workers were also concerned about supplies. They were running low on personal protective equipment—masks, gowns, and gloves. Each house call or hospital visit now required at least three pairs of gloves and two gowns. Zambito and the others needed to shed each item as it came into contact with a contaminated body. A standard pickup, she told me, required one set of P.P.E. to retrieve the body, followed by another set to put the body in the van, and yet another to take the body out of the van and bring it into the mortuary. Sherman had begun contacting funeral homes in other states to see if he could buy supplies from them. He was looking for disinfectant sprays and Clorox wipes. A cousin of his, in California, had ordered some of the items wholesale and arranged for them to be shipped to Sherman in New York. There was also a shortage of caskets. “They can’t make them quick enough,” Sherman told me.
In the meantime, Kasler said, “We have to wing it.” He had set up two additional tables in the hallway, including one he used exclusively for arranging cremations. The chaos of the scene inside the funeral home, he said, threatened to undermine all of the traditions that had been passed down by his father and grandmother. “The body has to be treated reverently,” he told me. “How you honor the dead is how you’re brought up.” As he was saying this, he received another call on his cell phone and excused himself. Half an hour later, he sent a text: “My nephew was just rushed to Princeton Hospital. Covid positive. Difficulty breathing.”
On April 14th, the New York City Health Department revised its count of how many New Yorkers had died of covid-19 in the previous month. Earlier estimates put the number of fatalities around seven thousand, but it now appeared that an additional three thousand people, who were never tested, had died from the virus. “What New Yorkers are interested in, and what the country is interested in, is that we have an accurate and complete count,” Dr. Oxiris Barbot, the head of the city’s health department, told the Times. “It’s part of the healing process that we’re going to have to go through.”
On Hart Island, off the coast of the Bronx, authorities have begun interring victims whose remains were either unidentified or unclaimed by family members, and city officials are searching for other places to bury the dead. There aren’t enough funeral directors to retrieve all the bodies; at one point, the city put out a call for volunteers among veterinarians and laboratory technicians “because of their familiarity with the deceased and bereaved.” Recently, when Zambito went to the Brooklyn Medical Examiner’s office to retrieve a body, she met a funeral director from Texas. He didn’t have a New York license, but the medical examiners were relieved to have someone trained in the field. “It was clear the city was in need,” he told her. “I drove over.”
Funeral homes across the city were overwhelmed. “This is a state of emergency,” Pat Marmo, a mortician in Sunset Park, told the Associated Press. “We need help.” He was telling mourners to plead with hospitals on his behalf: if the morgues could hold onto bodies for a few extra days, there might be more time for mortuaries to make space. Yet finding refrigeration units to store the remains was becoming harder, too; many companies were reluctant to rent to funeral homes in the midst of a pandemic. Funeral directors were left with little choice but to crank their air-conditioners and continue working. Like Sherman’s, one parlor in Rego Park, Queens, had converted a chapel into a “makeshift refrigerator.”VIDEO FROM THE NEW YORKERDeparting Gesture
Zambito, who was now foregoing her days off altogether, struggled to deal with the onslaught. On a recent evening, she came home to make dinner and walk her dog before setting out again to retrieve bodies from a hospital morgue until midnight. Her girlfriend, who’d just lost her job at a video-game store, helped with the stretcher, which they placed in the back of Zambito’s Honda Odyssey. A few days later, during a similar night run, she texted me, “Feeling pretty depleted.”ADVERTISEMENT
Andrew Cottone, Sherman’s other funeral director, has worked in the industry for the past thirty-one years, through the aids epidemic and historic outbreaks of hepatitis and swine flu. “Nothing even comes close to what’s going on right now,” he said. At one point, because of the volume of cases, he was unable to retrieve the body of someone who died at 8 p.m. until the following evening. And yet, for the first time in recent memory, funeral directors were no longer the only people across the city doing this work. Fifteen teams of soldiers, from the U.S. Army, the National Guard, and the Air National Guard, have been working in twelve-hour shifts, overseen by the city’s chief medical examiner; according to the Times, they were picking up more than two hundred bodies a day. Eventually, though, if a family wanted to bury or cremate a loved one, funeral directors needed to get involved. They were, in fact, the final front-line medical workers: the last necessary step between life and death.
Ordinarily, individual funeral directors could make hospital removals on their own, with body bags and a stretcher, but since the onset of the pandemic retrievals have become a two-person job. A single mistake—a fumble or a slip, a slight tear in a body bag—could be deadly. Trips to hospital morgues were the most harrowing, Cottone told me. “It used to be that you’d go into a local hospital and, if we saw seven bodies in the morgue, they’d be really busy. Now we’re seeing fifty or sixty bodies in each trailer, and hospitals have two or three trailers.”
As the death toll surged in the early weeks of the crisis, the refrigerated trucks that hospitals were using to manage the overflow quickly grew disorganized, with bodies mixed together in piles on the floor. Cottone could barely stand inside some of them. He had to shuffle in and, as carefully as possible, rifle through body bags to find the one he was looking for. “You have to open the pouch to confirm the name of the person you’re picking up on a wrist or toe tag,” he said. “You see the forearms, the hands, the fingers, the ankles. You get a look at the face.” Many of the bodies appeared to have been ravaged by covid-19. “There’s a lot of mucus discharge,” he said. “They’re bloated up. The heads and eyelids are swollen.”
In the past three weeks, hospitals have instituted sorting systems, with bodies kept on improvised structures made of milk crates and wood planks. In most places, Cottone can now walk down an aisle to locate a body, each of which has been assigned a number and a corresponding position. Yet, even under these improved conditions, he told me, those who died of covid-19 pose a particular challenge: their bodies are often much heavier, from edema, caused by their prolonged time spent on respirators. He had recently picked up a body from the morgue at Mt. Sinai Hospital, on King’s Highway, which weighed about three hundred pounds. It was on the bottom rack of the trailer, level with the floor. If he dragged the bag, he risked puncturing it. He tried lifting it from a low squat and then pulling in short bursts. Finally, with a partner’s help, he succeeded in inching the body to a waiting stretcher.
On Good Friday, Chris Kasler went to church via Zoom. An observant Lutheran, he couldn’t help but feel that he was witnessing something on a Biblical scale. “This is a plague,” he told me. “God is in control; we’re not in control.” That evening, using his daughter’s iPad, he called in to the service hosted at the Church of the Good Shepherd on Fourth Avenue, in Bay Ridge. The church was once the preferred congregation of the neighborhood’s upper-middle class; in recent years, its membership has decreased, to about seventy-five congregants, many of whom are Latino immigrants. Leading the session was Juan Carlos Ruiz, the church’s Mexican-born pastor. There were roughly a dozen people in attendance. Lines of scripture appeared on the screen in a format resembling a PowerPoint presentation, and each participant was asked to read a passage. A few of them had just recovered from covid-19 themselves.
Kasler is one of the few remaining parishioners whose family belonged to the church’s old guard. He and Ruiz became friends over a weekly church dinner called “Breaking Bread with JC”—“for Juan Carlos,” Ruiz told me. Ruiz is a co-founder of the New Sanctuary Coalition, an advocacy group that organizes in support of immigrant communities throughout the five boroughs. When he started receiving phone calls from immigrants whose family members or friends had died of covid-19, he called Kasler. None of the people whom Ruiz had been speaking with knew who to call to handle the bodies or arrange last rites.
“What do we do?” Ruiz asked.
“Send them to me,” Kasler said.
Sherman’s didn’t have the space to deal with more people, and its services, while not nearly among the most expensive in the city, were still costly. “But this isn’t about business,” Kasler told me. “This is about getting people what they need right now.” He called Gerard Lockwood, an old friend who, four decades ago, worked for Kasler’s father. Lockwood is now sixty-five, with his own funeral home and chapel, in Park Slope. He agreed to help, offering to pick up and prepare as many victims as he could.
On the afternoon of Good Friday, Lockwood spoke on the phone with a translator for a Mexican woman who was trying to bury her forty-three-year-old husband. He was charging the woman about nineteen hundred dollars, the bare minimum. She’d asked if she could give him a thousand-dollar deposit and pay the rest in installments. He agreed, but never bothered to work out a payment plan. “In many of these cases, an ambulance takes away a loved one,” he told me. “You can’t communicate with them. You can’t see them. And then, a few days later, you get a phone call saying that your loved one has died. How do you process that?” He added, “There’s going to be a lot of unresolved grief.”
Lockwood initially allowed the immediate family of the deceased to congregate in his chapel, though he limited the total number of people on the premises, including his staff and Lockwood himself, to ten. One family held a service from inside the chapel and used FaceTime to patch in other attendees. Public speaking, he told me, seemed to be harder for mourners at a remove; the speakers couldn’t gauge the reactions of their listeners. At one gathering, a relative had instructed, “You’ll know that I’m finished speaking when I say ‘I love you.’ ”
Funeral homes nationwide are experimenting with novel ways to hold services. Earlier this month, in San Antonio, one mortuary held what has been described as the world’s first “drive-in theatre” for funerals. A giant screen was erected in the parking lot. Mourners drove up to a window to view the remains, and used a microphone to record messages for the family. In Brooklyn, where even small gatherings have become untenable, Lockwood devised a quieter solution. Since people can’t come in, he calls over a friend, a Jesuit priest who lives across the street, to hold a short service in the chapel on behalf of mourning family members. “Just a few blessings and prayers,” he said. “It’s something we feel we can do for the family, and people are relieved to know that someone is looking after their loved ones even in this small way.”ADVERTISEMENT
One call he received came from a forty-nine-year-old Mexican man named Félix, who lives with his wife and daughter in East Harlem. Félix’s brother, who had lived in New York for more than a decade, contracted covid-19 in early April. He lived in Elmhurst, Queens, and worked in construction. Even with a persistent fever, Félix said, his brother was reluctant to go to the hospital, because “there’s this feeling out there that, if you get taken to a hospital in an ambulance right now, you never come back.”
By the time Félix learned the severity of his brother’s condition, he couldn’t visit him, for fear of contaminating his own family. He drove forty minutes to his brother’s apartment to leave medicine outside the door. “He texted me constantly, but never called,” Félix said. “He was too ill to talk.” A few days after Félix had made one of his deliveries, his brother texted to say that he was beginning to feel better. “He never liked to worry us,” Felix said. The next morning, around seven-thirty, his brother died, at home. A few hours later, at the recommendation of a friend, Félix was on the phone with Juan Carlos Ruiz. “Talking to him gave me strength,” Félix told me.
On April 9th, Félix travelled to Park Slope, to meet Lockwood. He asked if he could accompany his brother’s body when it was transported to the crematorium. The earliest available date was still weeks away. They agreed that Lockwood, Félix, and the pastor of Félix’s church, in Manhattan, would go together, and say a prayer in the crematorium’s parking lot. Only one of them, though—the funeral director—will be allowed inside with the body.
Two weeks ago, a refrigerated trailer was delivered to Sherman’s. It took a few more days to install fully, first because of a holiday weekend and then because of heavy rain. “You can’t have a guy in the rain walking into a thirty-two-degree box twenty-five times,” Kasler told me. The unit was now connected to a power source and fitted with a wooden ramp and interior shelves. But Sherman’s was down to its last five cremation containers. The protective pouches that Kasler and the others had used to store the victims of covid-19 were gone. They were now wrapping each body in a sheet. One morning, an assistant who was lifting a covid-19 victim from a stretcher yelped in pain. A butterfly needle from a hospital I.V., which was still in the dead man’s arm, had pierced the sheet and pricked the assistant. “It’s a pure miracle we haven’t caught it,” Kasler said.
By the time the refrigeration unit was up and running, last Tuesday afternoon, they were already in need of a second one. Sherman’s was finally starting to turn families away. Nineteen bodies were due to go out that day, for burial or cremation, which would free up space. But on Wednesday, when many cemeteries were closed for Passover, no burials were scheduled, and more than a dozen bodies had come in. That evening, Kasler and Zambito inspected the chapel and storage rooms, cross-checking the schedule for burials that week. Eighteen bodies were supposed to go out the next day, but, due to a backup at the medical examiner’s office, four of them had not yet arrived.
On April 16th, Governor Cuomo announced that hospitalizations in New York had stabilized and slightly fewer people were being admitted to the city’s intensive-care units each day. Kasler hadn’t noticed much of a difference. If anything, he told me, the previous day was the worst one yet. “We seem to be hitting our peak,” he said. Kasler was hoping the situation would stabilize at some point in May, but it was impossible to tell whether an end was in sight. While he reviewed the week’s body count, Cottone and his son, who had come in to help, were sanitizing stretchers in the parking lot. Around ten bodies were coming in that day, Kasler said. “It won’t be long before the place is unbreathable again.”