1.33 billion People, a Pandemic, and Biomedical
Waste
When the
world is faced with a pandemic, it is only natural that there is a spike in the
demand and hence the production of medical equipment, medicines, and related
services. And more the production and consumption, more is the waste generated.
The management and disposal of
biomedical waste are to be done according to
Bio-Medical Waste Management (BMWM) Rules 2016, under the provision of the
Environmental Protection Act (EPA) 1986. The waste is to be segregated at
source, color-coded, and transported to common bio-medical waste treatment
facilities (CBWTFs) where they undergo treatment such as incineration,
autoclaving, microwaving (to disinfect), etc. Now the question is, is India equipped
to deal with the surge of biomedical and plastic waste in this COVID era? To
put things into perspective, as of 2018, India has 200 CBWTF in operation
across 28 states, the remaining 7 do not have CBTWFs. This has not led to any
significant problems as of now as the states with no CBTWF have low occurrence
of cases. These facilities are not evenly distributed across all states and
union territories and are struggling to handle the waste generated from 733
districts across India. It is to be noted that, the flattening of the cases
curve, does not imply a flattening of the BMW curve. That is, the BMW generated
does not cease to exist, the moment new cases stop occurring. This is clear
from the fact that in Wuhan, China, long after the incident cases curve flat
lined, CBWTFs are running at maximum capacity to dispose the waste that was
generated but stored during the peak of the pandemic.
Typical to
the Indian scenario, there is no shortage of policy framework to tackle this
surge in BMW, all issues arise from lack of proper implementation. Central
Pollution Control Board (CPCB) has released detailed guidelines to be followed
while handling, treatment, and disposal of waste generated during treatment/
diagnosis/ quarantine of COVID – 19 patients, which includes measures to be
taken in, isolation wards, sample collection centers, and testing laboratories,
and in quarantine camps and homecare for suspected patients. WHO, International
Solid Waste Association (ISWA), and many other bodies have also released guidelines
for the same. There is also the case of conflicting guidelines being issued by
CPCB and State PCBs, as seen in Maharashtra. There should be effective
communication between the concerned authorities and the people at the
implementation end.
From used
tissue paper, to facemasks, to sanitizer bottles, most homes have seen an
increase in waste generated. This is especially true for houses with
quarantined persons. The CPCB guidelines specifically ask such homes to store
their biomedical waste in yellow bags which would be collected by CBWTF
personnel. But then, lack of source segregation of waste has always been a
major concern in the solid waste management scenario in our country.
Maharashtra PCB data shows large fluctuation of total BMW generated, and the
officials feel that it could be due to improper segregation at source. Such
cases mean that, contaminated BMW could be steadily finding its way into
regular municipal solid waste, and eventually our landfills, putting the
sanitation workers, the large informal sector involved in waste collection and
communities living near landfills in the path of direct risk of contracting the
virus. We have seen first-hand what improper disposal of medical waste can do
in the incidence of Hepatitis B outbreak in Gujarat in 2009, where 240 were
infected. The use of recycled and unsterilized syringes and injection needles were
cited as the means of transmission of the infection by health department
officials.
ISWA
guidelines highlight the need to train the municipal workers who collect waste
from residences on regular disinfection, and following social distancing in the
workplace. It also emphasizes that the vehicle needs to be disinfected often.
But in reality, the sanitation workers face a dearth of Personal Protective Equipment
(PPE) and inadequate training. The general public understood the gravity of the
situation when the son of a sanitation worker tested positive in Coimbatore.
Many states
are ramping up their BMW disposal capacity by adding new small scale plants,
incinerators etc., but will this be enough to cater to the rapidly rising needs
especially considering the unsettling reports that state that India has not yet
approached the peak. Like China, we could also consider opting for compact, on
site treatment machines, which grinds down and sterilizes waste, making it less
risky to transport to treatment facilities. The National Green Tribunal and
CPCB have been reiterating the need for source segregation of waste over the
past many years, perhaps it is time the general population starts paying heed
to their words.
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