New Delhi: India’s fight against its piles of garbage intensified in 2020, a year that will go down in history as the year of the COVID-19 pandemic. With the Coronavirus outbreak still raging, one of the other major fallouts has been the surge in hazardous bio-medical waste. According to the Central Pollution Control Board (CPCB), the average quantity of COVID-19 related bio-medical waste generation was about 162 tonnes per day (TPD) for the month of November 2020. This quantity is in addition to the regular bio-medical waste generation of about 610 TPD per day (approximately). In the last six months, between June to November, India produced 28,468.85 tonnes of COVID-19 related bio-medical waste. As the year 2020 comes to an end, we look back at the lessons to learn from the COVID-19 pandemic in the field of waste management and the strategies that need to be adopted in 2021 as the pandemic continues.
COVID-19 Related Bio-medical Waste And Its Disposal
Any waste generated during the diagnosis, treatment, immunisation, research pertaining thereto, production or testing of biologicals is called bio-medical waste. In view of COVID-19, bio-medical waste can be personal protective equipment (PPE) including goggles, face shield; mask; gloves; laboratory waste. As per the Guidelines for Quarantine Facility COVID-19 issued by the Ministry of Housing and Urban Affairs, bio-medical waste is to be bifurcated in four streams:
1. Eye protection goggles, plastic vials, recyclable materials like pens, plastic water bottles and bed sheets are to be kept in red bins. The collected waste is to be disinfected through autoclave or microwave or hydroclave and sent for recycling.
2. Sharp waste including metals is to be discarded in white bins. For the treatment, sterilisation is to be followed by shredding or container mutilation or encapsulation.
3. Glassware, tube light, CFL bulbs, LED used in quarantine facility are to be kept separately in a cardboard box marked blue. The waste is to be disinfected and sent for recycling.
4. Used personal protective equipment (PPE), mask, gloves, shoe covers, head covers, disposable bed sheets, and PPE with spill is to be discarded in a yellow bin and incinerated or buried in deep pits.
Guidelines for disposal of COVID-19 waste also applies to COVID-19 patients quarantining at home. Used masks, gloves, tissues, swabs contaminated with blood or body fluids of COVID-19 patients, including used syringes, medicines, are to be treated as bio-medical waste and collected in a yellow bag provided by the urban local body (ULB).
Masks and gloves used by persons other than COVID-19 patients should be cut and kept in paper bags for a minimum of 72 hours prior to disposal.
COVID-19 Pandemic And The Challenge Of Bio-medical Waste Management
Talking to NDTV about the challenges posed by the COVID-19 pandemic in the management of bio-medical waste, Swati Sambyal, a Delhi-based waste management expert, asserted there has been an increase in the levels of bio-medical waste generation, based on the CPCB reports. She added,
Segregation is a major concern and lack of systems that support segregation is another. Secondly, awareness on effective waste management at the household level is extremely poor; people have been giving a lot of their mixed household waste in the designated yellow bag meant for COVID-19 waste. Cities that have heavily centralised waste management systems have more challenges over cities with decentralised resource management systems.
Ms Sambyal further called for implementation of a third bin for hazardous waste; effective segregated collection of municipal solid waste and bio-medical waste at the household level. Segregation of waste is crucial as it reduces the amount of hazardous waste generated from quarantine homes to be dealt as bio-medical waste.
Further elaborating on the issues pertaining to bio-medical waste management, Sourabh Manuja, Fellow, Centre for Waste Management, Environment & Waste Management Division at The Energy and Resources Institute (TERI), listed two major points. He said,
The focus of waste management strategies should be on waste reduction but we don’t see much implementation of models that showcase waste reduction from medical institutions. At a city level, domestic hazardous waste management and bio-medical waste management are equally important. Cities lack implementation of appropriate strategies to collect and manage this hazardous waste, stringent monitoring, review and verifications are required.
Learnings From COVID-19
The roadblocks in the way of efficient bio-medical waste management have brought in some lessons for both the individuals and government. Sharing the key lessons the COVID-19 pandemic has taught, Ms Sambyal said,
Firstly, apart from hospitals and clinics, households’ bio-medical waste management is the need of the hour and appropriate systems need to be created to support this with at least a two to three year action plan. Secondly, in smaller towns, there are not sufficient bio-medical waste management facilities, need to upscale the same. Thirdly, masks and personal protective equipment (PPEs) are a new normal, however, usage of single-use masks and other PPE equipment should be restricted to frontline staff.
Ms Sambyal noted that many Common Bio-medical Waste Treatment Facilities (CBWTFs), especially in cities with high COVID-19 case load are running over capacity and have no space to take in more waste. This means, India needs to focus on capacity building and upgrading existing facilities.
As per the latest CPCB report for November, 2020, around 198 CBWTFs are involved in the treatment and disposal of COVID-19 biomedical waste across the country. But, some states are generating a huge amount of COVID-19 related bio-medical waste like Kerala generated 600 tonnes in November 2020 and has only one CBWTF the capacity of which is not adequate, suggests CPCB report.
In addition to this, Mr Manuja stressed on awareness and said,
Cities need appropriate training and capacity building along with the infrastructure to manage the bio-medical waste they generate, including domestic hazardous waste.
Stepping Into 2021 With A Hope For Efficient Bio-medical Waste Management
With the start of 2021, India’s COVID-19 vaccination programme that focusses at 30 crore people in phase 1 will begin which will result in increased bio-medical waste in the form of vaccination vials. Mr Manuja alerted that the challenge will come up in rural areas and said,
We need appropriate guidance, training and monitoring for our practitioners to handle the discarded bottles and syringes, which may be generated in a phased manner.
Both Ms Sambyal and Mr Manuja said that India has a robust policy for bio-medical waste management but its implementation is always a challenging aspect. Contrary to this, Dr Lata Ghanshamnani, Ophthalmologist and co-founder of NGO RNisarg Foundation, which looks in education and awareness and management of all kinds of waste, did suggest a couple of policy level changes. Dr Ghanshamnani suggested waste audit for every healthcare establishment. She added,
Waste audit should be linked to patient footfalls and surgical and inpatient records. Acknowledge and encourage establishments practising greener and sustainable policies. Bring in extended producer responsibility (EPR), a policy approach under which producers are given a significant responsibility for the collection and treatment of post-consumer products, in pharmaceutical and medical equipment industry at the earliest.
Mr Manuja suggested better coordination between governments and added,
State and local governments will have to work cohesively with centre to manage bio-medical waste generated (along with a strong political will). For policies to be implemented by urban local bodies, it requires clear local bye laws, with penal mechanism; prior training and capacity building of its employees; involvement of stakeholders while formulating and implementing policies at the city level.
Talking about what more the government can do to strengthen waste management, Mr Manuja said,
The government will also have to make sure that bio-medical waste management capacities at levels of each district are sufficient. Entrepreneurs should be promoted to invest under public-private-partnership and come up with more treatment units, meeting environmental norms.
As per the experts, policies are in place, but they need to be enforced strictly and the gaps need to be filled. While signing off, Dr Ghanshamnani, said,
Healthy introspection is the need of the hour. Ignoring the past and not taking lessons from it will be the biggest mistake. Hence, grassroot level study into the subject is currently the most essential step.
NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.
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