Recommendations for Tribal Ceremonies and Gatherings During the COVID-19 Outbreak
Tribal ceremonies such as sweat lodge, social gatherings and seasonal ceremonies, and larger gatherings such as pow wows and rodeos, are a vital part of cultural identity and common and traditional practices in tribal communities. CDC offers the following recommendations to help tribal communities, elders, and leaders decide how best to keep their communities safe and prevent the spread of COVID-19. These considerations are meant to support—not replace—tribal laws, rules, and regulations aimed at protecting the health of tribal communities.
The more people who attend a ceremony or gathering and the closer they are to one another, the higher the risk of spreading COVID-19. Also, the higher the level of community transmission in the area where the gathering is held, the higher the risk of COVID-19 spreading.
You can take steps now to protect tribal community members from getting sick before, during, and after participation in tribal ceremonies or other gatherings, such as sweats, birthday parties, pow wows, rodeos, and funerals.
Preventing the spread of COVID-19 is especially important for tribal community members who may be at higher risk for severe illness, such as tribal elders and people with underlying medical conditions.
What is done today can affect seven generations. The risk of COVID-19 spreading at events and gatherings, including tribal seasonal ceremonies and gatherings, increases as follows:
Tribal ceremonies or gatherings are conducted virtually (for example, by communicating online, or by video conferencing or telephone), if traditions allow.
Small, in-person ceremonies or gatherings are held. Gatherings take place outside or in larger structures with good air flow. No food is served at ceremonies or gatherings. Tribal members remain at least 6 feet (or about two arm lengths) away from others, wear masks, and do not share or touch the same items.
Medium-sized, in-person ceremonies or gatherings are adapted to allow tribal members to remain at least 6 feet apart. Tribal members are encouraged to wear masks. Food is served in pre-packaged boxes with disposable utensils.
Large, in-person ceremonies or gatherings are held where it is difficult for tribal members to remain at least 6 feet apart because of the increased number of participants based on the venue size. Tribal members share or touch the same items. Food is served “potluck” or family style. Tribal members attending the ceremony or gathering come from multiple tribal communities or from outside the local geographic area.
Tribal elders and leaders can consider postponing, rescheduling, or canceling in-person tribal ceremonies or gatherings. Hold virtual tribal ceremonies or gatherings (for example, by communicating online, or by video conferencing or telephone) or hold them at another time, as tribal traditions allow.
If tribal elders and leaders decide to proceed with holding an in-person tribal ceremony or cultural gathering, CDC offers the following suggestions to consider, in the context of tribal traditions:
- As traditions allow, limit the size of ceremonies or gatherings.
- Hold events in a large, well-ventilated area or outdoors, as circumstances and traditions allow.
- Encourage tribal members to stay at least 6 feet, or two arm lengths, away from others who don’t share the same household.
- Provide ample seating or viewing areas.
- Provide physical guides, such as tape to mark floors or walkways and signs on walls, to ensure that tribal members remain at least 6 feet apart in lines and at other times.
- Encourage the use of masks, especially when it is difficult to stay at least 6 feet away from others.
- Promote healthy hygiene practices.
- Encourage tribal members to wash their hands often with soap and water for at least 20 seconds. If soap and water are not available, use hand sanitizer that contains at least 60% alcohol.
- Provide adequate supplies to support healthy hygiene behaviors, including soap, clean water, hand sanitizer with at least 60% alcohol, tissues, and no-touch trash cans.
- Stay home if you are a sick person or have had close contact with someone who is sick with COVID-19.
- Increase cleaning and disinfection and limit use of shared items.
- Clean and disinfect frequently touched surfaces at least daily and clean shared items between uses, if possible.
- Consider limiting the sharing of frequently touched items that are passed or shared among tribal members if traditions allow.
- Ensure safe and correct use and storage of disinfectants, including storing products securely away from children.
- Consider not serving food or changing how food is served.
- Avoid buffet or family-style meals, if possible. Have tribal members bring their own meals as feasible or serve meals on individual plates.
- Use disposable eating and serving utensils (for example, plastic forks, spoons, and knives; and paper dishes and cups). If disposable items are not feasible or desirable, ensure that all non-disposable utensils are handled with gloves and washed with dish detergent and hot water or in a dishwasher. Individuals should wash their hands after removing their gloves or after directly handling used food service items.
- Avoid sharing food, containers, and utensils.
- Consider posting signs in highly visible locations (for example, at entrances or in restrooms) that promote everyday protective measures and describe how to stop the spread of germs by properly washing hands and properly wearing a mask.
COVID-19 and Funerals
How can communities plan for an increase in the number of deaths?
Tribes have asked for guidance to help them plan for increased deaths from COVID-19. While an increase in deaths may be a very difficult topic to discuss and plan for, tribal leaders have resources to help:
Tribal leaders can help prevent the spread of COVID-19 by doing the following:
- Postpone large events, including celebrations such as funerals, weddings, baptisms, and holiday gatherings.
- Limit gatherings to a small number (less than 10) of family and friends and ensure physical distancing and hand washing.
Am I at risk if I go to a family gathering, traditional event, ceremony, or funeral for someone who just died from COVID-19?
There is currently no known risk associated with being in the same room at a funeral or visitation service with the body of someone who died of COVID-19.
Anyone who is sick should stay home. These actions help prevent people from getting sick and help stop the spread of the virus.
Also, tribal leaders can help. While each tribe has its own traditions regarding death rituals and funerals (including family feeds, giveaways, and commemorative gatherings), it is important for leaders to determine ways for immediate family members to take part while making sure that
- Vulnerable populations are protected.
- Everyone practices frequent hand washing (hand hygiene) and physical distancing (keep 6 feet of space or greater between people of different households).
- Gatherings are limited to 10 or fewer people.
CDC recommends wearing masks in public settings where physical distancing is difficult to maintain. This is especially important in communities where the spread of COVID-19 is on the rise. So, if you do go to a funeral or gathering, wear a mask. But also try to keep about 6 feet from others who are present. You can find more information about using a mask.
Do not place masks on children younger than 2 years old. Also, don’t place a mask on anyone who has trouble breathing or who is unconscious or unable to remove the mask without help.
What are the most important things to remember about COVID-19 American Indian/Alaskan Native funeral services or other gatherings?
For Tribal Leaders:
- Authorized COVID-19 vaccines can help protect you from COVID-19. Educate your community about getting a COVID-19 vaccine as soon as they can.
- To maximize protection from the Delta variant and prevent possibly spreading it to others, people who are fully vaccinated should wear a mask indoors in public if you are in an area of substantial or high transmission.
- Educate your community about who is at higher risk of getting very sick, such as tribal elders and those with diabetes or serious heart or lung conditions.
- Limit the number of people at a gathering to 10 or fewer.
- Clean and disinfect where these activities are held.
- Provide plenty of handwashing sinks with soap and water or ensure there is hand sanitizer with at least 60% alcohol for all.
- Avoid close contact with people who are sick.
- Stay home and do not engage in burial and funeral practices if you are sick.
- Practice physical distancing by putting at least 6 feet of distance between yourself and other people.
More information on large gatherings and events.
Am I at risk if I touched someone who died of COVID-19 after they passed away?
You should avoid touching the body of someone who has died of COVID-19 before the body is prepared for viewing.
Though we are still learning more about how COVID-19 spreads, it may be possible that you could get COVID-19 by touching the body of someone who has died of COVID-19. After the body has been prepared for viewing there may be less of a chance of the virus spreading from certain types of touching, such as holding the hand or hugging. But you should avoid other activities, such as kissing, washing, and shrouding before and during body preparation. After any contact with the body, be sure to wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol.
How can I protect myself when preparing the body of someone who died from COVID-19?
If washing the body, shrouding, or other important religious or cultural practices are observed in a specific tribal community, families are encouraged to consider this guidance and work with their cultural and religious leaders and funeral home staff on how to reduce their exposure as much as possible.
If you participate in these activities, wear disposable gloves (nitrile, latex, or rubber). And you may need added equipment (called personal protective equipment, or PPE). For example, you may need the following:
- Disposable, waterproof isolation gown
- Face shield or goggles
Following preparation of the body, remove PPE and throw away. Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
Shower after completing body preparation activities. If you did not wear any personal protective equipment while preparing the body, wash your clothes in the warmest setting possible and dry them completely.
How do you transport the body of someone who has died from COVID-19?
Follow these steps if you are involved in transporting the body of someone who died from COVID-19:
- If the body of a tribal member needs to be moved, wear disposable gloves and contain the body in a body bag, an impermeable shroud, or another impermeable covering that does not allow body fluids to leak from the enclosure. The virus that causes COVID-19 is not thought to be carried by blood (bloodborne), but leaked fluids could cause exposure to pathogens.
- If a body bag is used to contain the body, disinfect the outside of the bag with an EPA-approved disinfectant for emerging viral pathogensexternal icon. Follow the manufacturer’s instructions for cleaning and disinfection products including concentration, application method, and contact time.
- Following transport of the body, carefully remove your gloves and immediately wash your hands with soap and water for 20 seconds. If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
Are there any special requirements for burying or cremating people who die from COVID-19?
People who died from COVID-19 can be buried or cremated. But check for any additional tribal, state, local, or territorial requirements that may dictate the handling and disposition of the body of individuals who have passed from certain infectious diseases.
What do funeral home workers need to know about handling deceased who had COVID-19?
- Tribal traditional practitioners and family members handling of body should follow the precautions outlined for funeral home workers.
- Products with EPA-approved emerging viral pathogens claimspdf iconexternal icon are expected to be effective against the virus that causes COVID-19 based on data for harder to kill viruses.
- After removal of PPE, perform hand hygiene by washing your hands with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol.
How do you protect yourself after body preparation?
After the body has been prepared for viewing and burial, clean surfaces using EPA-approved products in accordance with the manufacturer’s instructions for all cleaning and disinfection products (such as concentration, application method, and contact time).
What resources are available for burial of American Indian/Native Alaskan veterans?
Spouses and families of American Indian/Alaska Native veterans may be eligible for burial assistance. Burial benefits can include opening and closing of the grave, perpetual care, a government headstone or marker, a burial flag, and a Presidential Certificate—at no cost to the family. Some veterans may also be eligible to receive money to help cover the cost (burial allowances).
The National Cemetery Administration oversees burial benefits. This office is under the Department of Veterans Affairs (VA), Veterans Benefits Administration. The VA can be contacted at the following phone numbers:
- For burial, survivors’ pension, or other benefits: 1-877-294-6380
- For the status of VA headstones and markers: 1-800-697-6947
- For obtaining bereavement counseling: 1-202-461-6530
- For telecommunications devices for the Deaf and Hard of Hearing services, dial 711.
- Burial Benefitsexternal icon
- VA Survivors and Burial Benefits pdf iconexternal icon