BIOMEDICAL WASTE MANAGEMENT DURING COVID PANDEMIC

THE BIG PICTURE : BIOMEDICAL WASTE MANAGEMENT DURING COVID PANDEMIC

CONTEXT:

The second wave of the Covid-19 pandemic has posed numerous challenges before India on multiple fronts –health, economy and also the environment.
Data suggests the average quantity of COVID-19 related biomedical waste generation during May, 2021- the ongoing month- is about 203 Tonnes Per Day.
The peak generation of about 250 Tonnes Per Day was reported on May 10th.
The earlier peak generation in the year 2020 was in the range of 180 – 220 Tonnes Per Day.
National Green Tribunal (NGT) has recently directed various authorities to ensure compliance from the biomedical waste management facilities in the country.

NGT DIRECTION:

Central Level: The Central Pollution Control Board (CPCB) to ensure strict compliance of biomedical waste management rules and scientific disposal of the waste.
State Level: The Chief Secretaries of all the States/UTs to oversee compliance and ensure that authorisation is secured by every health care facility in their respective jurisdiction.
District Level: The District Magistrates in accordance with the District Environmental Plans.
Groundwater Contamination: While permitting deep burials, it may be ensured that groundwater contamination does not take place.
Segregation: Ensure that hazardous bio-medical waste is not mixed with the general waste.

WHAT IS BIOMEDICAL WASTE (BMW)?

The Biomedical Waste Management Rules, 2016, define biomedical waste as “any waste that is generated during the diagnosis, treatment or immunisation of human beings or animals or research activities pertaining thereto or in the production or testing of biological or in health camps.”
Therefore, broadly, any waste generated from treating patients comes under the ambit of biomedical waste.
India produced approximately 600 tonnes of Biomedical waste per day before the coronavirus first hit.
However, ever since COVID-19 showed up on our shores, the amount of biomedical waste produced in India has increased exponentially. This is mainly due to two factors:
Medical facilities themselves are producing far more biomedical waste as they battle the virus.
Due to the strategy of home quarantining of COVID-19 positive patients, a major part of affected household waste has now become biomedical waste.

BIO-MEDICAL WASTE & ITS IMPACT:

Improper management of Bio-medical waste can have both direct and indirect health consequences for health personnel, community members and the environment.
Indirect consequences in the form of toxic emissions from inadequate burning of medical waste.
The most serious effect of biomedical waste is on seas as bio-medical waste discharged into the waters that could be consumed by ocean life creatures.
Toxins would interject into the food chain and eventually reach humans who consume sea creatures.
Human exposure to such toxins can stunt human growth development and cause birth defects.
Poor infection control can lead to nosocomial infections in patients particularly HIV, Hepatitis B & C.
Poor waste management encourages unscrupulous persons to recycle disposables and disposed drugs for repacking and reselling.
Development of resistant strains of microorganisms.
Improper segregation of biomedical waste and different medical waste streams from the point of origin can trigger a domino-like effect on the environment that incurs dangers to people, animals, or soil and water sources.
Environmental hazards associated with improper healthcare waste management can contaminate the air through dangerous airborne particles.

CONCERNS IN BMW MANAGEMENT:

States are not following the CPCB guidelines on Covid-19 related waste.
In some states, improper segregation of waste has been reported from Covid-19 facilities and quarantine homes.
The rise in residential biomedical waste and its collection without adhering to safety protocols could also trigger a surge in caseload.
Without proper scientific management of such waste, it can potentially affect patients and can affect the concerned workers and professionals.

STATUS IN INDIA:

The biomedical waste generated during treatment and diagnosis of COVID-19 patients is required to be treated and disposed in scientific manner and in line with provisions under Biomedical Waste Management Rules, 2016.
CPCB has prepared guidelines for “Handling, treatment and disposal of waste generated during treatment, diagnosis and quarantine of COVID-19 Patient”.
As reported by State Boards, about 198 Common Biomedical Waste Treatment and disposal Facilities are involved in treatment & disposal of biomedical waste.
CPCB has developed a waste tracking application namely ‘COVID19BWM’ for tracking and accounting of COVID-19 biomedical waste.
There is gradual increase in quantity of COVID BWM generation since February, 2021.
Trend of average monthly generation of COVID-19 biomedical waste is shown in chart below:

Of the 203 tonnes per day of waste in May, Kerala accounted for highest followed by Gujarat, Maharashtra and Delhi.
The disposal of the waste was done through nearly 198 common biomedical waste treatment facilities across the States. Maharashtra had the highest number of such facilities followed by Karnataka and Gujarat.

CPCB GUIDELINES:

Used PPEs, masks, head cover, shoe cover etc. generated from COVID-19 isolation wards at Healthcare Facilities shall be segregated and sent to Common Facilities for disposal as per Bio-medical Waste Management Rules, 2016.
However, those generated in Common Households, Commercial Establishments, Institutions, etc., are required to store separately for minimum 72 hours for disposal along with solid waste after cutting or shredding.
People in home quarantine should segregate their COVID-19 related waste into a yellow bag so that it can go for incineration.
Similarly, healthcare establishments need to segregate the waste into four streams (red, white, yellow and blue) as per the Guidelines for Quarantine Facility COVID-19 issued by the Ministry of Housing and Urban Affairs.
A separate record should be maintained for BMW generated from COVID-19 related activities, and the same should be reported to the pollution control board.
There should be dedicated vehicles for the transportation of BMW, and it should be sanitized after every trip.
BMW generated from COVID-19 related activities should be strictly disposed of within 24 h.
All the persons involved in the handling of BMW (COVID-19) should be given the required training and personal protective equipment.

SALIENT FEATURES OF BMW MANAGEMENT RULES, 2016

The ambit of the rules has been expanded to include vaccination camps, blood donation camps, surgical camps or any other healthcare activity
Phase-out the use of chlorinated plastic bags, gloves and blood bags within two years
Pre-treatment of the laboratory waste, microbiological waste, blood samples and blood bags through disinfection or sterilisation on-site in the manner as prescribed by WHO or NACO
Provide training to all its health care workers and immunise all health workers regularly
Establish a Bar-Code System for bags or containers containing bio-medical waste for disposal
Report major accidents
Existing incinerators to achieve the standards for retention time in secondary chamber and Dioxin and Furans within two years
Bio-medical waste has been classified in to 4 categories instead 10 to improve the segregation of waste at source
Procedure to get authorisation simplified. Automatic authorisation for bedded hospitals. The validity of authorization synchronised with validity of consent orders for Bedded HCFs. One time Authorisation for Non-bedded HCFs.
The new rules prescribe more stringent standards for incinerator to reduce the emission of pollutants in environment. Inclusion of emissions limits for Dioxin and furans
State Government to provide land for setting up common bio-medical waste treatment and disposal facility
No occupier shall establish on-site treatment and disposal facility, if a service of `common bio-medical waste treatment facility is available at a distance of seventy-five kilometer.
Operator of a common bio-medical waste treatment and disposal facility to ensure the timely collection of bio-medical waste.

WAY FORWARD:

As a short-term solution, India could increase its biomedical waste incineration capacity by employing mobile incinerators, as was done in Wuhan.
In the long term, it is important that biomedical waste treatment infrastructure be increased proportionally to the amount of such waste being generated in the country.
Additionally, massive awareness campaigns regarding the need for proper segregation of waste must be carried out in every single ward in the county periodically.
Where waste is not going to incinerators, deep burial systems should be properly maintained as per protocols taking all due precautions.
The government should set up recycling plants across the country (as envisaged under the Smart cities project) under the Public-Private Partnership (PPP) Model.
Coherency in rules is need of the hour.
Start-ups and Small and Medium Enterprises (SMEs) need to be incentivised for offering solutions for waste segregation and treatment.
There should be constant and regular monitoring by the CPCB/SPCBs, States/UTs and Centre.

https://youtu.be/WSuR-NUUFEE

https://vikaspedia.in/energy/environment/waste-management/bio-medical-waste-management/bio-medical-waste-management-rules

https://cpcb.nic.in/uploads/Projects/Bio-Medical-Waste/COVID19_Waste_Management_status_Jan_May_2021.pdf

https://pib.gov.in/PressReleasePage.aspx?PRID=1657061

https://www.thehindu.com/news/national/coronavirus-india-witnesses-surge-in-covid-19-related-biomedical-waste/article34563675.ece

https://vidhilegalpolicy.in/blog/biomedical-waste-in-india-has-increased-exponentially-as-a-result-of-covid-19/

https://cpcb.nic.in/uploads/Projects/Bio-Medical-Waste/BMW-GUIDELINES-COVID_1.pdf

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