New York City is storing bodies in refrigerated trucks and burying them on Hart Island as morgues and hospitals fill up. When COVID-19 makes its ugly presence felt in rural counties here in upstate, where will the bodies be stored?

It’s one of a number of nightmarish, keep-you-awake-at-night concerns that county officials have shared with Stephen Acquario, the executive director of the New York State Association of Counties. He says that counties have had to adapt quickly to changing circumstances.

“We went from ‘this thing is nothing’ to ‘this is community wide’ in a few short weeks,” explains Acquario of upstate counties. “It’s was like a four-alarm fire trying to figure this out. It took us days to interpret these laws.”

Not only will every upstate county take a severe revenue hit as sales and motel and hotel occupancy taxes slow to a trickle, but they are, at the same time, expected to step into the breach.

The good news is that counties have roadmap.

After 9/11, the state, New York City and 57 counties created an emergency activation plan called the NYS Mass Fatality Management Resource Guide. It’s designed to supplement each county’s emergency planning operation. The manual was updated after 14 people were killed in a 2009 mass shooting in Binghamton and again after 20 people died in the limousine crash in Schoharie County.

One of the most pressing logistical concerns for counties is where to store bodies if the worst comes to pass.

Counties employ the coroners who pronounce the body dead as well as medical examiners who perform an autopsy if one is needed (although not all counties have medical examiners; some rural counties will contract with an ME’s office in a separate county to save money).

The body is then sent to a funeral home which works with the decedent’s family on arrangements. The final step in this process is burial or cremation.

If there’s a delay in any part of this process, rural counties, which have no capacity to store bodies, could be in trouble if they haven’t prepared.  

According to Scott Schmidt, Orleans County coroner and the president of the NYS Association of County Coroners and Medical Examiners, his home county has a morgue capacity of two. As a courtesy, Medina Hospital allows the county to use its two-drawer morgue.

Even without the pressure of a pandemic, those two drawers are sometimes not enough. Recently, the Orleans County legislature followed the protocols established in the Mass Fatality Management Resource Guide, and took steps to increase its storage capacity: it authorized the leasing of a refrigerated tractor trailer truck to temporarily hold remains.

Some other grim but welcome news: upstate hockey rinks could act as temporary morgues if needed.

Regarding hospitals, equipment and testing, NYSAC’s Acquario said county leaders are concerned about all of the above.

“If testing can only be done at hospitals,” Acquario asks, “and we don’t have a hospital, where do we go? Are people going to have to travel hours to get tested?”

Rep. Elise Stefanik echoed his concerns.

“According to data from the New York State COVID-19 tracker, NY-21 counties have only received 1.67% of total tests statewide – this is unacceptable,” said Stefanik in a statement released Monday.

A related worry that county executives from the Finger Lakes, Catskills and North Country have shared with Acquario can be summed up in two words: second homeowners.

There’s a fear that downstaters carrying the virus will travel to rural communities and infect the populous while clearing grocery store shelves and using up scarce hospital bed space.

“I called Airbnb and asked them to stop renting. They said no,” Acquario says.