WASHINGTON COUNTY, Tenn. (WJHL) – As COVID-19 case rates seem to plateau after hitting record highs this September, a consequence of the region’s high transmissibility rates looms — death.

Compared to the last surge of COVID-related deaths, the Tri-Cities region is nowhere near a peak, so local funeral homes are bracing for a coming surge.

“I guess, these things play out over a period of weeks, and, I guess, we’re just starting into this unfortunate period where people have been in hospital for several weeks,” said President of the Dillow-Taylor Funeral Home Howard Alexander.

Ballad Health on Wednesday reported the virus is responsible for one of every three patients who have died this month. Only a week ago, it was responsible for one in every four patient deaths.

The health system reported over the past seven days it’s recorded 59 COVID-19 related deaths.

In Southwest Virginia, the death rate for September is almost three times that of the state.

Comparatively, the Virginia Department of Health reported that there have been 12 COVID-19 deaths per 100,000 people in Southwest Virginia, while Virginia is at 4.

The situation is worse in Northeast Tennessee, though the region versus state gap is less. In the past 16 days, Northeast Tennessee has had 18 deaths per 100,000 people compared to Tennessee’s 12.

Just following the previous surge in COVID-19 cases, the region saw a surge in COVID-related deaths. So much so, that Ballad Health utilized a refrigerated morgue truck.

“Back then, they were concerned that that funeral homes wouldn’t be able to respond quickly enough, and that’s when they had an 18-wheeler in the parking lot. And they actually had concerns that we might take days to get there to retrieve someone. We never got to that point,” explained Morris-Baker Funeral Home and Cremations Owner Preston McKee.

Though these numbers have not peaked, funeral directors report some differences in the COVID-related deaths they see now versus during the last surge in cases.

“The cases that we have seen here have been younger than the first one,” Alexander said.

McKee said he is also preparing for the potential of a new wave of COVID deaths.

“January was a tremendous surge for us,” McKee said. “We serve twice as many families as we normally would. Since then, the range has been within our normal operating range, what we can kind of expect from year to year and deaths are a lagging indicator.”

He said he monitors data released by both Ballad Health and the health department.

“I do notice that there are more people in the hospital, a higher percentage of them are in the ICU and on ventilators,” Mckee said. “But I do see the deaths are not as high as they were in early 2021. It is still a legitimate concern.”

He explained that safety for staff and mourners is the biggest concern.

“There were months where 25-35% of the deaths that we served were COVID positive, and then we’ve had families that came in to make arrangements, and a day later, they call us to inform us that they were COVID positive,” McKee said. “And so that becomes an area of concern for our funeral directors who just spent a couple of hours in the room with them.”

McKee said only one of his staff members is unvaccinated. All are required to wear masks, and other safety precautions have to be taken due to the fact that he only employs four licensed funeral directors, so a loss of one of them – even just for a few days – is significant.

“Based upon what the family voices their concerns, we’ll let them know what we can do to accommodate their concerns. And we’ll also have a dialogue about what we need to do to keep our staff safe because we need to be healthy, to be able to take care of other people,” McKee said.

He explained that Morris-Baker’s property has updated heating, ventilation, and air conditioning system (HVAC) to constantly keep air moving, improving ventilation. Other safety measures were also taken.

“We are very careful to make sure that we wear masks. In our arrangement conferences, we have HEPA filters in the room,” McKee said.

But beyond safety precautions, funerals now begin to differ from tradition.

“When a family comes to us, we inquire about what their needs are, as far as whether they want everyone to mask, whether they want to have to be present or not, and we customize it to their needs,” Alexander said.

He said in the spring of 2021, Dillow-Taylor offered unconventional services like drive-thru and virtual, which may see a resurgence as COVID cases linger at a peak high, but he said what they are seeing most now are families choosing a “mask-optional” version of a funeral.

McKee had some additional suggestions gleaned from the guidance offered by the Centers for Disease Control and Prevention (CDC).

“There are basic things that we would encourage — if you’re going to have an indoor service, we’d probably encourage having that be private or invitation-only to keep this scale small,” McKee said. “And then you can use webcasting as an option to involve people who either don’t feel safe to attend, who can’t travel to attend, or for whatever reason. And then if you do want to have a public service that is more open, we would encourage you to take care of the beautiful fall weather to have the service at the graveside service. That allows people the outdoor setting and allows people to kind of control their distance and all the research that I’m hearing is that outdoor is safer.”

Different options can be discussed with funeral directors, both told News Channel 11.