NYC’s “city morgue” is the Office of the Chief Medical Examiner (OCME), which luckily is the best in the world.

But they are now dealing w/ the equivalent of an ongoing 9/11. And so are hospital morgues, funeral homes & cemeteries.

Every part of this system is now backed up. 2/

A typical hospital morgue might hold 15 bodies. Those are now all full. So OCME has sent out 80 refrigerated trailers to hospitals around the city. Each trailer can hold 100 bodies. These are now mostly full too. Some hospitals have had to add a 2nd or even a 3rd trailer. 3/

Grieving families report calling as many as half a dozen funeral homes and finding none that can handle their deceased loved ones.

Cemeteries are not able to handle the number of burial requests and are turning most down. 4/

It’s not just deaths in hospitals which are up. On an average day before this crisis there were 20-25 deaths at home in NYC. Now in the midst of this pandemic the number is 200-215. *Every day*. 5/

Early on in this crisis we were able to swab people who died at home, and thus got a coronavirus reading. But those days are long gone. We simply don't have the testing capacity for the large numbers dying at home. 6/

Now only those few who had a test confirmation *before* dying are marked as victims of coronavirus on their death certificate. This almost certainly means we are undercounting the total number of victims of this pandemic. 7/

And still the number of bodies continues to increase. The freezers at OCME facilities in Manhattan and Brooklyn will soon be full. And then what? 8/

Soon we'll start “temporary interment”. This likely will be done by using a NYC park for burials (yes you read that right). Trenches will be dug for 10 caskets in a line.

It will be done in a dignified, orderly--and temporary--manner. But it will be tough for NYers to take. 9/

The goal is to avoid scenes like those in Italy, where the military was forced to collect bodies from churches and even off the streets.

OCME is going to need much more staff to achieve that goal. 10/

Thankfully the Dept. of Defense and the NY National Guard have already sent teams, and volunteer medical examiners have come from around the country. But we are going to need much more help if we're going to avoid disaster. 11/

As New York City continues to appeal to the nation for help, we need to ask not just for doctors and nurses and respiratory therapists. We also need mortuary affairs staff. This is tough to talk about and maybe tough to ask for. But we have no choice. The stakes are too high. 12/

To recap: Nothing matters more in this crisis than saving the living. But we need to face the gruesome reality that we need more resources to manage our dead as well. Or the pain of this crisis will be compounded almost beyond comprehension. 13/13