Managing Biomedical Waste During the COVID-19 Pandemic: Challenges and Solutions, Study Guides, Projects, Research of Environmental Science

Download Managing Biomedical Waste During the COVID-19 Pandemic: Challenges and Solutions and more Study Guides, Projects, Research Environmental Science in PDF only on Docsity! Assignment Topic SOLID WASTE GENERATION AND IT’S MANAGEMENT DURING THE COVID-19 PANDEMIC IN INDIA SUBJECT: AECC-EVS SUBJECT CODE: 72182801 SRI AUROBINDO COLLEGE (EVENING) UNIVERSITY OF DELHI (APRIL-JULY 2022 SESSION) SUBMITTED BY NAME-SWATI MEHER ROLL NO.20/3090 B.A (HONS.) PSYCHOLOGY (II-SEM) SRI AUROBINDO COLLEGE EVENING, UNIVERSITY OF DELHI WASTE GENERATION AND IT’S MANAGEMENT DURING THE COVID- 19 PANDEMIC IN INDIA Swati Meher | Applied Psychology Hon. | Roll no. 21/3090 EVS ASSIGNMENT PAGE 1 Introduction Basic waste management services were available in only 27% of health-care facilities in the least developed countries even before the coronavirus disease 2019 (COVID-19) pandemic hit the global population. By the time COVID-19 was declared a pandemic, cities around the world reported an increase of nearly five times in medical waste generation. This volume increase can be attributed to the increased use of personal protective equipment (PPE) globally. The outbreak of the novel coronavirus has not only exposed the poor health-care infrastructure in countries and the lack of preparedness to battle a pandemic but also loopholes in their waste management process. Existing evidence points toward contact, droplet, and airborne as well as environmental spread from fomites and fecal– oral routes of transmission of COVID-19. Only 15% of the affected have severe life- threatening pneumonia in COVID-19, while in the rest of the cases, the patient might be asymptomatic or may present with mild (common cold) or moderate forms of illness.5 Waste generated by patients in hospitals and the waste from households with COVID-19–infected patients can all be contaminated with blood, body fluids, or droplets. Sewage and waste water generated from these sources can also be considered contaminated with the COVID-19 virus. To control the spread of COVID-19, the use of masks and PPEs, disposables, sanitizing liquids, and disinfectants has also increased. All these methods of precaution lead to an increased waste production and, as we all know, irresponsible waste management has led to disasters previously. As of the last week of December 2020, nearly 78 million people worldwide were diagnosed with COVID-19 and more than 1,727,000 had died.7 The number of COVID-19 cases is still on the rise; any further outbreaks due to improperly handled waste will just increase the problem. In this article, the authors have tried to present a comprehensive review of the national and international scenario and of all national and international guidelines on solid waste and biomedical waste (BMW) management during the COVID-19 pandemic. While India is fighting with coronavirus threat, there is one more aspect that needs our attention which is the biomedical waste generated from the hospitals and laboratories, for instance. Not all if it hazardous, but even the smaller amount of hazardous waste is enough to spread the virus and hinder our fight against corona. Many researches are going on nowadays to obtain more and more information about the virus. Recent researches have shown that the virus can stay activated on plastic surfaces, cardboard, and even in the air for a varying duration. This survival property in activated form makes it even more formidable and can cause an outbreak through biomedical waste coming out from hospitals after dealing with a coronavirus patient. Hence, biomedical waste must be handled very carefully and should be treated properly in a way it does not encounter anybody in any way before it gets treated or placed in a safe place until the virus is deactivated from the waste. After the treatment, there are methods discussed in the later section which can be used to dispose of different kinds of waste. Also, various wastes need to be pretreated or disinfected before disposing of. The problem in India is not only confined to the pretreatment or disposing of the wastes but some challenges need to be addressed to make the whole process easier and faster. The Challenges are, for example, proper segregation of the waste, which is not commonly practiced in India, know- how of handling the waste at the staff level, proper disinfection of waste, lack of PPEs to collection staff, etc. The proper solutions to the challenges have been mentioned in the later part of this paper. These solutions are meant to mitigate the burden on our management system and to strengthen the fight against this contagious disease. PAGE 4 NOVEL CORONA VIRUS DISEASE 2019 (n COVID 19) AND ITS IMPACT ON WASTE Coronavirus belongs to the family of the Coronaviridae in the order of Nidovirales. This Coronaviridae family has a subfamily called Orthocoronavirinae which includes the alphacoronavirus, beta coronavirus, gamma-coronavirus, and deltacoronavirus . The two viruses namely SARS coronavirus (SARS-CoV)and MERS coronavirus (MERS-CoV) belong to the beta coronavirus family emerged in 2002 and 2012 respectively and had the deadly effects on human beings as they cross barrier among species . The current lethal coronavirus resembles these SARS- CoV and MERS-CoV and hence belongs to the beta family of the coronavirus. Researches have shown that this novel flu-like coronavirus is about 82% identical to the SARS-CoV and also called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) . The effect of this SARS-CoV- 2 was first seen in the Wuhan city of China at the end of 2019 and spread almost in all countries of the world and declared pandemic by World Health Organization (WHO). India has also become the victim of this deadly virus as there are 182,143 confirmed cases and 5,164 Deaths so far as on date 31 May 2020 and the effect is exponentially increasing and there is no registered vaccine for the disease till date. As per the epidemiological studies, there are three conditions for the spread of the virus infection source, transmission route and susceptibility. The mode of the infection may be a person to person close contact, personal contacts to the infected surfaces, and the waste generated from the curing of the infected person. The waste generated from healthcare centers, quarantine centers, and quarantine homes is of great concern for the authorities working on impact mitigation of the COVID19. If this waste mix with general waste and handle without extra precautionary measures then infected waste may lead to community spread of the virus and cause severe harm to human beings. Several pieces of research have been conducted on the infection spread due to waste and it has been found out that the virus can sustain on the surfaces of the material for a specific period. The table shows the period of the virus on different surfaces. Therefore, it is an important consideration to be taken in action in storage, collection, handling, transporting, and disposing of such waste effectively and efficiently. The virus can be cleaned with the common disinfectants used at home Surfaces Survival Period Plastic 2-3 days Hard, shiny and stainless steel 2-3 days Copper. < 4 hours Cardboard < 24 hours Air < 3 hours WHO has categorized COVID-19 into risk group 2 in bio-hazard level.Kempf et al, in 2020, showed that the COVID-19 virus remains infectious for up to 72 hours on plastic and metal surfaces, up to 24 hours on cardboard, and for 4 hours on copper.The COVID-19 virus can remain suspended in aerosol for more than 3 hours. Research has shown that both asymptomatic and symptomatic patients can shed the virus in feces even after they’re declared cured. PAGE 5 Categories of medical waste as per WHO Waste category Descriptions Hazardous waste Infectious waste Waste contaminated with blood, body fluid, or any other material with the potential to carry bacteria, virus, fungi, or parasites Pathological waste Human anatomical tissue, fetuses, organs, body fluids Microbiological waste Bacterial and viral culture, stock, used media, quality control reagents, serological enzymes and equipment used in microbiological laboratories Pharmaceutical waste Expired or unused drugs Cytotoxic waste Cytotoxic drugs Chemical waste Laboratory reagents, solvents, cleaning agents Radioactive waste Radioactive isotopes, urine and excreta of patients treated with radioactive isotopes Nonhazardous waste General waste Cardboards, plastic, and thermocol packaging material, paper, kitchen waste Waste generated in 2020 in each state PAGE 6 2. No proper training is provided to staff and sanitary workers to handle the general waste, generating during COVID-19. 3. Irregular/ lack of supply of PPEs and disinfectants to the collection staff may increase the chances of them getting infected. 4. Appropriate usage and removal of the PPEs among sanitary worker, otherwise infection can be spread among workers. 5. Maintaining the social distancing as per the guidelines at collection centers as well as treatment plants. 6. Wastewater discharging from the health care facilities may have the virus, therefore operators or staff employed at the treatment plant of the wastewater may at the high risk of infection. 7. Staff associated with the sludge disposal or handling from the wastewater treatment also has chances of getting contaminated. 8. Due to lack of the door to door collecting staff from residential areas in many parts of the country, the one-point collection is prevailing there, and hence increasing the infection risk because of the residents gathering at a point. 9. Separate vehicles for collecting the COVID-19 waste from homes/quarantine centers to Common Biomedical Management Waste Treatment Facility and the arrangement of chemicals to disinfectant these vehicles. 10. If these vehicles are used for collecting Medical waste without disinfection, there is a chance of spreading the virus. 11. Towns and villages have not proper monitoring review and verification systems. 12. Waste treatment plant operators/staff are also at great risk. Regular training to the operators to handle the waste is also a challenging issue. Some of the solution may include 1. Domestic Hazardous Waste (DHW) should be kept in yellow bags provided by ULBs and it should not be mixed to other general waste at the time of storing by households and collection by the collection authority. 2. The yellow bag containing the DHW should be checked properly before usage so that it cannot be leaked, and it should be away from the reach of children and pets. 3. Especially masks, gloves, and other PPEs generated from home quarantine should be kept idle in paper bags for a minimum period of 72 hours before disposal of the same as general waste or before handling to the sanitary worker. 4. A request of identifying arrangement for the collection of DHW (both wet and dry waste generated as home quarantine ) to the Urban Local Bodies associated to solid waste management and this waste should not be dumped near the locality or water body or in open areas. PAGE 9 5. There should be a separate team to collect COVID19 waste. 6. Only handover this waste to the authorized collector at the doorsteps, if this system of the collection exists, and if not then deposition centers for the yellow bags have been established. 7. If an alternate arrangement if available and then contact the Common Biomedical Management Waste Treatment Facility operator and hand over your waste at your doorstep. 8. People generating DHW (as a result of the home quarantine) have any problem in handling the waste must contact to ULBs officials. 9. Urban Local Bodies should provide the yellow bags and other facilities to the people operating Quarantine Camp and to caretakers of homecare. 10. Sanitary workers should wear PPEs and sanitize it regularly and should not touch anything (fleet/ waste buckets, even plastics, cardboard, and steel, etc.) with bare hands. 11. Doctors and other health workers should sanitize tools using for curing patients. 12. Adequate PPEs and removing procedures should also be provided for the workers in the waste processing plant. 13. People and the sanitary worker should maintain a proper distance of minimum 6 feet from the each other. 14. If anyone has got the symptoms of COVID19 then stay away from other people and work and inform the concerned people or supervisor of work. 15. The health care service provider and the sanitary worker should remove PPEs as per the protocol and wash hands, mouth, eyes, nose, etc. thoroughly. 16. Vehicles designated for collecting this waste should be regularly sanitized with sodium hypochlorite and other good disinfectants. 17. When you come out from outside should wash hands and face properly and shoes must be kept outside. 18. There should be a daily check-up before and after commissioning the work of staff working in a hospital or associated with the collective work or working in the waste processing units. India’s response to Covid-19 waste India BMW management rules, 2016, and amendments 2018, 2019, are comprehensive rules made under the WHO core principles. Furthermore, the Kayakalp initiative of the Government of India was appreciated by WHO. Central Pollution Control Board (CPCB) of India brought out specific guidelines for the handling, treatment, and disposal of waste generated during treatment, diagnosis, and quarantine of COVID-19 patients on March 18, 2020. These guidelines were revised on March 25, 2020 (revision 1), followed by revisions on April 18, 2020 (revision 2), June 10, 2020 (revision 3), and July 17, 2020 (revision 4).These guidelines for the management of waste generated during the diagnostics and treatment of COVID-19–suspected or–confirmed patients are required to be PAGE 10 followed by stakeholders in addition to the existing practices under BMW management rules, 2016, as amended. For COVID-19 waste, use of separate COVID-19 waste-labeled, color-coded, and foot-operated bins and trolley were advised. Use of double-layered bags for collection and transport is advised to prevent spillage or leaking. (Color categories of BMW as per BMW management rules, 2016, amendments 2018, 2019, and CPCB guidelines 2020 ) To reduce bulk meticulous segregation of general waste from BMW and reducing the use of disposables is advised. General waste generated in hospitals and isolation centers has to be segregated into wet and dry waste, which reduces the waste marked for incineration or landfills remarkably.The COVID-19 isolation/quarantine homes also need to follow the BMW guidelines as per BMW management rules, 2016, as amended. General waste (kitchen waste, tetra packs, cardboard boxes) have to be discarded as general waste. Used masks, gloves, and COVID-19 patients’ blood- or body fluid– contaminated swabs from home quarantine or isolation centers should be treated as BMW and need to be collected in nonchlorinated yellow bags. PPEs, hazmat suits, and face shields should be collected in red bags. The wet and dry waste bags need to be sprayed with 1% sodium hypochlorite before being handed over to the designated waste collectors.The Indian government has further widened the regulation to include mortuaries, crematoriums, and graveyards in these COVID-19 waste management rules. PPEs, masks, and bags from these places also need to be considered BMW; if they are from health-care workers (HCWs), they can be collected in red/yellow bags, and if from the general public, they can be collected in the municipal blue bin and handed over to the municipality/local governing bodies. The only point further advised to the public was to use reusable masks and discard only after 72 hours storage and mutilation. Effluent treatment plants were advised not to recirculate the treated water for any purpose. Use of PPE at all levels of waste handling is advised. Regular training sessions are being conducted for all workers and supervisors involved in BMW management. For effective communication, exclusive manpower and use of modern technology (mobile applications, barcoding, GPS tracking) has been made mandatory. PAGE 11