How dying and mourning have changed around the world amid coronavirus pandemic

Xavier Delarue, an actor and former professional basketball player from France, is still processing the circumstances surrounding his father’s death from the novel coronavirus. Above all, he is wondering what more he could have done.

He last saw his father, Fred-Louis, a 68-year-old retired police officer originally from Guadeloupe, at his nursing home in Tremblay, a small city just outside of Paris, early in March.

“I was told like everybody else that we cannot visit him because of possible contamination,” Delarue told ABC News, although he managed to secure a visitation. It was 15 days before President Emmanuel Macron announced a sweeping lockdown on French life to quell the spread of COVID-19.

“I never thought it was the last time I would see my dad. He was full of projects, he smiled, he sang, he laughed,” Delarue said of his father, who had early-onset Alzheimer's. “I was the last one of my family to see him.”

He received three phone calls on March 29, informing him that his father’s condition was deteriorating "out of the blue." The next morning, he was told that his father had died.

“Everything went so fast. I insisted like crazy to get permission to come to say goodbye,” he said. “When I entered in his room with my wife, he was in a sealed bag. I could not see him.”

At the nursing home, Delarue saw three other coffins that day. And, like so many others in France and elsewhere, he was denied the chance for a proper funeral.

“He was cremated without ceremony ... It was a total absence of humanity,” Delarue said. “I can't grieve my father right now. It's impossible."

Delarue's story and his feelings of grief, isolation and helplessness mirror so many others in the pandemic, which has now caused over 250,000 deaths worldwide.

It is not just life that has changed as we know it as a result of lockdowns and other social distancing strictures. According to experts specializing in grief and religious leaders around the globe, COVID-19 is changing both how we die and how society wants us to mourn our dead.

The loss of tradition

Just like in the U.S., social distancing measures have severely impacted how many people can attend funerals around the world, and the types of services that can be held.

In France, funeral ceremonies are limited to 20 people, and family members are permitted one last chance to see the body before it is placed into the coffin at a distance of 3 feet. Delarue, however, never saw his father’s face again, as the body was sealed in a bag to prevent potential infection.

Families also have the option of placing bodies in an airtight coffin for six months after the death – but there are no guarantees social distancing measures will be different to permit for traditional wakes and funerals.

Msgr. Denis Jachiet, the Auxiliary Bishop of Paris, told ABC News that mourners and religious people alike must find ways to “express our faith in a different way.”

“As a priest, who is helping my parishioners, yes, I can feel anxiety and confusion and a real loss of certainty regarding these funerals,” he said. “It’s a unique moment.”

Variations of Delarue’s story, while unique to him, are being played out across the globe. In Algeria, Belaid Medjkan, says he has lost two friends in the space of a short time to coronavirus. The first, as is now policy in Algeria, had a funeral with just close family attending.

But just two weeks ago, when he found out about the death of his second friend, he couldn’t stay away.

“I knew and worked with my friend for decades,” he told ABC News. “I could not stop myself from going to express my sincere condolences to her family. It was impossible. My friends told me not to go, that it could be dangerous. But this time I could not.”

He drove outside his native Algiers to the seaside village of Ain-Benian, and on the way he thought of her and the life she had led, he said.

The ceremony took place outdoors, with her family and a few neighbors in attendance, and he greeted them at a distance, he said.

Normally the ceremony, in line with Islamic tradition, is far more expansive – but in this case the funeral only lasted 30 minutes, with one imam reciting a prayer for her death.

“That was all,” he said. “In Algeria, it's a moral obligation to express our condolences to say goodbye and to honor the life of our friend. [The new restrictions in place] goes against our tradition but we have to follow the rules.”

In Algeria, only two-three family members can now attend services whereas before, it would be hundreds. Family and friends cannot visit the dying and services, generally held before midday prayer are now held at all hours. And finally, instead of singing, the imam now offers only a short prayer.

Social distancing has prevented Algerians from driving across the country to express their condolences in this way, which Medjkan describes as a “moral obligation.”

Before the pandemic, different groups would perform rituals during the funeral ceremony, with extensive reading from the Quran, and men and women singing in order to honor the dead, according to Ali Himeur, head of the COVID-19 crisis unit in the village of Ath Vou Yahi, in the Atlas Mountains of the region of Kabylie.

“Population health is now a priority rather than our customs,” he told ABC News. “It's very sad, but we need to protect our people… Before it was hundreds of people coming from different villages and cities. All of this is over now.”

Adaptation in the time of social distancing

Similar changes are taking place in other parts of the world. In India, home to 1.3 billion people, local media have reported that some of the dead have been buried without coffins

Drive-through funerals have been reported in Madrid, while in the U.S. new safety precautions mean that family and friends have been restricted to watching funeral services on a screen, or from a car at a distance.

In the early stages of the pandemic, social distancing measures were particularly felt in Israel, as in the Jewish tradition there is “a great importance to the burial ceremony and to the preparation of the dead for burial,” Rabbi Yakov Roja, based in Tel-Aviv, told ABC News. Prior to burial, bodies must be washed, dressed in a ceremonial cloth and accompanied to the grave by a “Minian” – a group of 10 men.

But in these extraordinary times, these rituals have been tested. Bodies are now prepared by special teams wearing personal protective equipment (PPE), after which bodies are wrapped in a double nylon sheath, he said. Regulations do permit the “Minian” to attend if they adhere to social distancing, but at some funerals they do not attend as many family members themselves stay away from funerals “due to concerns for personal safety,” he said.

Families are also supposed to sit “shiva,” a period of seven days to mourn the diseased at the home of the dead, he said, but “the custom has been deeply altered.”

“Instead of coming in person, people used WhatsApp, phone and internet,” he said. Despite the community’s attempt to adapt, however, “any deviation from the ritual is considered in the Jewish tradition as an insult of the dead and his family,” Roja said. However, even in Israel, people have been forced to adapt to the new situation.

“In spite of the social distancing regulations the community offered support from a distance as much as possible,” he said. The public has accepted limitations “because ultimately, that too is complying with the commandment calling to keep safe and healthy,” he added.

‘Layers of loss’

Such changes have fundamentally altered how we immediately mourn the dead, which “can be traumatic,” according to Nancy Berns, professor of sociology at Drake University in Des Moines, Iowa, and author of "Closure," a book about grieving.

"What is important to understand, is when you are expecting to be able to use your traditional rituals, whatever those are for your family, and then you can't use those, then that in itself can feel like a loss," she told ABC News.

In general, Burns said, the pandemic is adding extra “layers of loss” to the grieving individual, meaning, like Delarue, we are left searching for answers to more questions than we would in ordinary times.

"There are additional losses that are going to be there for people,” she said. “It's not just losing an individual, a loved one in your life, and grieving the loss of that person. But grieving the loss of those times that you thought you would have when they were dying or being able to show the sacred rituals [associated] with that time, and being able to give them a send-off.”

As well as experiencing many forms of loss at once, there is a risk, in the absence of usual rituals, for the bereaved to feel “imaginary guilt,” according to Boris Cyrulnik, a French neuropsychiatrist and ethologist.

“Each human being, each culture chose its mourning ritual, but the principle is always the same: not letting a body of someone we love [to] rotting,” he said. “We still love someone who is not here, we know he died but we still love him.”

When we are denied the chance to show that, thus making aspects of grieving “impossible,” there is a risk that we “will punish ourselves with punitive behavior.”

What to know about Coronavirus:

• How it started and how to protect yourself: Coronavirus explained
• What to do if you have symptoms: Coronavirus symptoms
• Tracking the spread in the US and Worldwide: Coronavirus map

Despite the challenges, in the long term, there may be an opportunity –- to help reconfigure our support for the bereaved, not just in the immediate aftermath of a death, but the crucial months and years ahead.

"I think that in many cultures the death rituals and grieving rituals really center around that immediate time after a death,” Berns told ABC News. “So what the pandemic might help us see too...is stretching out that support: continuing to stay in touch with people for the weeks and months after a death.

"And then when people can get together [after lockdown] - having memorial services, having celebrations of life, coming together - it will be interesting to see if that stretches out the support that people see, whether we're talking about a pandemic or not."

But for Delarue, the immediate path forward is rife with uncertainty.

“I can't grieve my father right now,” he said. “It's impossible. Him and I will have a last journey together. I will bring him back to Guadeloupe, for a real ceremony.

"I want us to be dressed in white," he added. "I want to honor my father. I want to take care of him.”

For Medgkan, he said he can find some comfort in that he did all he could, with the means available, to mourn his lost friend.

“The soul belongs to God,” he said. “I am telling myself that. Her soul will return to its creator even without the full rituals."