Image copyright Getty Images Image caption The health risk has given rise to funerals at a distance

As the coronavirus crisis escalates the US’s health protection agency has urged mourners to change drastically the way they say goodbye to loved ones - by live-streaming their funerals.

In a webinar with the National Funeral Directors Association and funeral homes across the US, the Centers for Disease Control and Prevention (CDC) said funerals should be limited to a small number of mourners physically present, and streamed online for everyone else.

This is not because of a risk of being infected from a deceased person whose cause of death was coronavirus-related - the CDC said there was no evidence to suggest this was possible.

Instead, it is so people can adhere to “social distancing” advice, not just in the US, but in countries around the world.

Dr David Berendes, an epidemiologist at CDC, told the webinar: “As you think about planning for the event, limit the number of people if possible, use live-streaming options and perhaps have only immediately family on hand.”

The CDC had earlier recommended limiting gatherings to no more than 50 people, while US President Donald Trump said gatherings should be no larger than 10 people.

This is particularly crucial for events where many guests are considered vulnerable, either because they’re over 70 years old or because of underlying health conditions.

But even before this directive, funeral homes in the US had already started offering to live-stream their services - sometimes out of last-minute necessity.

One funeral director in Syracuse, New York, told a local news site that a pastor had carried out a service over webcam, when travel bans in the state prevented him from holding it in person.

And the US is far from the first country to change funeral arrangements.

In the UK, some funeral homes have pre-empted any official directives by offering live-streaming services. One funeral director in North Yorkshire told the BBC that although he offered the service before, he would now waive the usual £62 fee.

In Ireland, mourners have been ordered not to kiss the bodies of their deceased loved ones, while the Irish Association of Funeral Directors went a step further and suggested all services should be postponed.

Image copyright AFP Image caption Bergamo: Burials of coronavirus victims take place quickly in Italy

But perhaps the most stringent measures are in Italy, the new epicentre of the virus, where funeral services have been banned altogether - restricted instead to a simple blessing.

‘It makes you feel powerless’

By Mark Lowen, BBC News, Rome

In Italy, the silent killer is stealing lives – and deaths.

Coronavirus fatalities in Italy have soared to more than 2,000, the vast majority in small towns in the north that are struggling to cope with the sudden surge in bodies. Some crematoria are operating 24 hours a day and mortuaries are being used to store coffins. And then there are the quarantine restrictions.

On 26 February, Miriam Casali’s mother, Giuseppina, fell ill from the virus while on holiday in Genoa. Miriam, living in the town of Castiglione d’Adda, in the locked-down "red zone", was unable to leave. After five days, she and her son were given special permission to travel to Genoa. But on the morning of 3 March, as they prepared to go, Giuseppina died.

“What hurts the most is that I couldn’t get to her,” Miriam tells me. “It makes you feel powerless. There's nothing you can do. It’s devastating. Surreal.”

Under the restrictions, funerals are banned, to limit public gatherings. When the body of Giuseppina was brought back, a quick burial was held with a simple blessing from the priest.

“If she had died in a different way, it would have been easier to accept,” Miriam tells me, by video phone from her home. “She must have felt abandoned and there was nothing I could do. I’m never going to get over this.”

Regardless of faith, culture or tradition, funeral and memorial services are a crucial time for grieving, catharsis and collective remembrance.

Media playback is unsupported on your device Media caption It's not something you have to "get over"

So how can people cope emotionally when these are fundamentally changed?

Lianna Champ, a grief counsellor and funeral director based in the UK, anticipates that “the way we grieve is going to be completely changed because of the coronavirus”.

“We have to have a process of closure, of rituals, especially when we’re grieving - it requires an intimacy with those we share our lives with and those we love,” she told the BBC.

“But I think physical distance from the actual funeral service could actually become quite normal for us moving forward. We’ve got to adjust to this new way of thinking and being. The world has changed, society has changed - and we need to realise that when something like the coronavirus hits the world, we need to change not just our everyday lives, but how we die as well.”

If you’re grieving and unable to attend a loved one’s funeral in person, Ms Champ recommended that you “reach out to people and be honest in your communication, in sharing with people how you feel”.

“As human beings we need intimacy,” she said. “And if the coronavirus forces us onto our phones and emails then that’s how it will have to be - but we need to reach out to others and be there for each other.”