The world will be drowning in medical waste in 2020 due to the corona virus (COVID-19) and this mounting medical waste from COVID-19 emphasizes the need for a sustainable waste management strategy. Spreading of COVID-19 pandemic throughout the country on a large scale will lead to the generation of waste of use and throw items required to combat the spread of the virus. Properly managed disposal of these items is highly important not only to save the environment but also the people. There is a need to manage waste generated during treatment of COVID-19 in healthcare facilities across the country, including quarantine sites. Waste of medical and other items like masks, PPE, testing kits, sanitizer containers etc. all need to be discarded after their use and this will put a pressure on their proper disposal. Government agencies are always issuing regulatory and safety guidelines monitoring the outbreak of COVID-19 (formally known as novel corona virus, 2019-nCoV) and particular developments have been made in infection control related to the proper management of medical waste generated during treatment of patients infected with the virus.
Guidelines to residents
First of all the residents should comply with the following tips to help manage waste during the COVID-19 curfew.
• Reduce the amount of waste generated by consuming only what is needed.
• Soiled baby pampers and used wipes should be stored separately and treated with disinfectant to reduce odor.
• All waste to be collected should be placed in tightly sealed plastic bags.
• Cardboard boxes and small plastic water bottles are to be flattened to reduce volume.
• Rinse all used cans, bottles, eggshells and other similar waste before discarding in the trash bin to help reduce odor and prevent flies.
Waste management during COVID -19
Strict guidelines have been issued that medical waste generated in the treatment of COVID-19 patients and patients under investigation (PUIs) is managed in accordance with routine procedures. There are no additional packaging or transportation requirements for regulated medical waste or sharps. These guidelines are based on current knowledge on COVID-19 and existing practices in management of infectious waste generated in hospitals while treating viral and other contagious diseases like HIV, H1N1, etc. The proper packaging guidelines for regulated medical waste and sharps are:
• Specific guidelines are required to be followed by all, including isolation wards, quarantine centers, sample collection centers, laboratories, ULBs and common biomedical waste treatment and disposal facilities. The guidelines should be updated as per the need arises.
• Generators are responsible for packaging waste for transport to treatment facilities. Improperly packaged containers or damaged containers will be denied pickup or returned to the generator.
• Consider operation of common bio-medical waste treatment and disposal facility.
• Maintain separate record of waste generated from COVID-19 isolation wards. Biomedical waste collected in isolation wards should be lifted directly from wards.
• Closed bags must not be visible once a secondary container (box or reusable tub) is closed.
• Collect and store biomedical waste separately prior to handing over the same to common bio-medical waste treatment and disposal facility.
• Each bag must be hand tied by gathering and twisting the neck of the bag and using a tie or hand knot to secure the bag, and each container must be securely closed.
• Reusable sharps containers should not be packaged in containers but rather placed on the racks for standard processing.
• The (inner and outer) surface of containers/bins/trolleys used for storage of COVID-19 waste should be disinfected with 1 per cent sodium hypochlorite solution daily.
• Use a dedicated collection bin labeled as ‘COVID-19’ to store COVID-19 waste and keep separately in temporary storage room prior to handing over to authorized disposal staff.
• Use dedicated trolleys and collection bins in COVID-19 isolation wards.
• Using double layered bags, mandatory labeling and color coded bins for the management of waste generated during the diagnostics and treatment of suspected and confirmed COVID-19 patients are part of the guidelines
• If possible, put a disposable set of gloves, on a daily basis, in direct contact with workers’ skin, before wearing usual work gloves.
• Make sure that there are disinfectants and hand sanitizers available in each and every vehicle.
• Frequent hand-washing and increased cleaning in workers’ facilities is a must.
• Drivers and collectors should avoid contact with residents and employees from serviced business.
Health and safety precautions for waste workers
Accordingly, there is a need to ensure the health and safety precautions of waste workers as they are one of the most important sanitary barriers to keep cities and people safe from several diseases, including COVID-19. Current scientific research has not provided evidence that waste management is a vector for the transmission of SARS-CoV2 virus, but considering waste workers are everyday on the streets despite isolation and quarantine measures that are taken for the whole population, additional measures should be considered as the following:
• Strict adherence to enhanced hygiene norms, including frequent change and cleaning of PPE and professional clothing; replacing professional gloves in the event of breakage or any incident of potential contamination; sanitizing regularly facilities, vehicle cabins and other equipment. An important measure here is to make sure that where masks are usually worn, the workers are removing masks and gloves without getting in contact with them. This means using correct techniques for putting the mask on and taking it off.
• Adaptation (as much as possible and considering the particularities of the waste collection systems) of the behavior in order to avoid contamination between workers in teams like strict respect of the distance between people, limiting as few as possible workers in the same area (control room, canteens, changing rooms) and all precautionary measures helping at preserving health of workers in safe occupational conditions.
• Direct contact (without gloves) with bins or bags should be avoided in any case. Uniforms should be daily changed or cleaned – cleaning of work clothes and shoes is minimizing the possibility of dispersing the virus and limiting its transmission.