When a Raleigh man buried his mother Friday afternoon he was surrounded by close family members.

Fewer than 10 of them.

Andy Medlin watched his mother fight cancer for nearly four years before she died a week ago in the middle of the COVID-19 outbreak.

The next day, Gov. Roy Cooper ordered that there be no gatherings in the state of more than 100 people.

Not only did that put an end to entertainment events but it canceled some funerals and weddings.

By the time Medlin got to the funeral home Monday the Centers for Disease Control and Prevention had recommended gatherings remain under 50 people.

Medlin said he and his family had already decided an indoor funeral was a bad idea. So they had planned a graveside service that included anyone who wanted to attend. But it didn’t take long before he changed his mind.

“By the time I got to the cemetery, 20 minutes later, I decided that was not a good idea,” Medlin said.

He added that he didn’t want to put anyone in a position to choose between their health and paying their respects.

The family decided to do a graveside service with just immediate family members — fewer than 10 of them — and then hold a memorial service later in the year.

“I think in a way it’s actually comforting to us, given the situation, to drag it out, than to ask some people to attend,” said Medlin’s son, Andy.

Doris Medlin’s obituary reflects that decision, as do many others published this week.

Families wait or cut back on funeral service

The Medlin family worked with Renaissance Funeral Home and Cremation of Raleigh and is one of many families trying to keep people safe while paying respect to a loved one.

“We’re following the CDC’s guidelines,” said Heather Hill, director of the funeral home. “We’re finding we don’t have to enforce them.”

Hill said most families are opting to hold off on burials and services or doing smaller gatherings with memorial services scheduled for later. Hill said if a family is set on having a service Renaissance will hold up to 50 people in its large chapel and spread them out. They’ve also offered online streaming services for those who can’t attend or be invited.

Hill said many families are opting to wait because they don’t want to risk traveling or being in large groups of people.

The Medlins are one of two families over the past week that the funeral home worked with for a burial that included just immediate family members.

But Hill said even before the CDC came out with its guidelines she noticed families keeping their distance, using hand sanitizer and going to the restroom often to wash their hands.

“I’m surprised how flexible people are being,” Hill said.

Funeral homes limit services, use caution

Other funeral homes across the state have been grappling with how to handle services.

In Rockingham County, all of the funeral home owners met at Wentworth Town Hall and collectively decided to only offer private funerals, graveside services and visitations.

On Monday, Stephen Davis, executive director of the N.C. Board of Funeral Services, sent a memo to funeral homes around the state helping them figure out how to navigate burials during the coronavirus outbreak.

Davis told The News & Observer that funerals can range anywhere from a few people to thousands paying their respect to an individual.

“We’re trying to offer anything from streaming services to postponing memorial services,” Davis said. “It’s a difficult thing for them and we’re trying to be sensitive to their needs.”

Davis had offered the same guidelines that the CDC’s epidemiologist David Berendes suggested.

Berendes also said to stagger funerals, not to gather more than 10 people who are high risk and to practice good hygiene throughout the service.

Berendes offered that advice to funeral home employees during a webinar held Monday by the National Funeral Directors Association. The webinar also included Medical Officer Sarah Reagan-Steiner and Senior Environmental Health Specialist Jill Shugart, both of the CDC.

Deaths from coronavirus

The group talked with funeral home employees about how to work on the body of someone who died from coronavirus, how to hold funerals and how to perform religious rituals on the deceased.

“There are no known risks of being in the same room for a funeral or visitation with a body of someone who died from coronavirus 2019 or COVID-19,” Reagan-Steiner said.

She said burials and cremations are both permitted but local health departments can issue their own guidelines on that.

Reagan-Steiner added that people should consider not holding the deceased’s hand, touching, kissing or hugging the body.

Reagan-Steiner urged funeral home employees to work with religious and health leaders for safety in handling religious rituals. She said washing and shrouding bodies, as is done in the Muslim and Jewish faiths, is not advised.

Shugart said if families request items from the casket to be returned to them prior to burial, the funeral home should try to clean and disinfect the item as best as possible.

She said the CDC is still learning how long the coronavirus can live on surfaces but so far it has determined that it can survive 24 hours on porous surfaces such as cardboard and days on stainless steel.

Davis reminded funeral homes in a news release sent Monday afternoon to use their training for communicable diseases and blood-borne pathogens when handling a body infected with coronavirus.

There were no deaths associated with coronavirus in North Carolina through Friday. There have been nearly 12,000 reported deaths worldwide as of Saturday at noon, according to Johns Hopkins University, which is tracking the pandemic.

This story was originally published March 21, 2020 at 1:37 PM.