Review on distribution, fate, and management of potentially toxic elements in incinerated medical wastes.

Medical wastes include all solid and liquid wastes that are produced during the treatment, diagnosis, and immunisation of animals and humans. A significant proportion of medical waste is infectious, hazardous, radioactive, and contains potentially toxic elements (PTEs) (i.e., heavy metal (loids)). PTEs, including arsenic (As), cadmium (Cd), lead (Pb) and mercury (Hg), are mostly present in plastic, syringes, rubber, adhesive plaster, battery wastes of medical facilities in elemental form, as well as oxides, chlorides, and sulfates. Incineration and sterilisation are the most common technologies adopted for the safe management and disposal of medical wastes, which are primarily aimed at eliminating deadly pathogens. The ash materials derived from the incineration of hazardous medical wastes are generally disposed of in landfills after the solidification/stabilisation (S/S) process. In contrast, the ash materials derived from nonhazardous wastes are applied to the soil as a source of nutrients and soil amendment. The release of PTEs from medical waste ash material from landfill sites and soil application can result in ecotoxicity. The present study is a review paper that aims to critically review the dynamisms of PTEs in various environmental media after medical waste disposal, the environmental and health implications of their poor management, and the common misconceptions regarding medical waste.

Multifaceted Impact of Lockdown During COVID-19 on Food Security and Smallholder Agricultural Systems Review and Meta-Analysis: SARS-CoV-2 and Enveloped Virus Detection in Feces and Wastewater

Summary One of the most serious pandemic situations created in history over the past 100?years due to an outbreak of the novel disease COVID-19 (coronavirus disease-19), in which, the entire population worldwide is experiencing lockdown and all activities have been disrupted. The first case of COVID-19 or coronavirus disease in India was reported on 30 January 2020. In this paper, we have reported a case study to address the question of how the lockdown ensuing from the outbreak of COVID-19 in India is affecting the economy of the Indian farmers. The cumulative report of the number of confirmed cases along with those of recoveries and deaths reported per day from 30 January 2020 to 21 April 2020 (80?days) was used for this analysis. The Ministry of Health and Family Welfare, Government of India, has confirmed that a total of 15?300 active cases of COVID-19 and 592 deaths have been reported in India till 21 April 2020. Different agro-farming societies and farmers' groups have informed that the production of cereals and pulses during the Rabi season (2019?2020) is high owing to a relatively longer period of cold weather. While the Indian government has ensured an adequate supply of all essentials, sporadic incidences of panic involving rapid purchase of goods and groceries by the population have been observed. However, farmers in all states of India cannot avail facilities such as accessibility to market yards, ease of procuring inputs, and selling of their produced goods equally. Comparatively, these facilities were found to be better in the state of Uttar Pradesh and the region of Bundelkhand, although a crisis in disposing summer vegetables such as cucurbits was witnessed in Bundelkhand. Detection and quantification of viruses supplies key information on their spread and allows risk assessment for public health. In wastewater, existing detection methods have been focusing on non-enveloped enteric viruses due to enveloped virus transmission, such as coronaviruses, by the fecal-oral route being less likely. Since the beginning of the SARS-CoV-2 pandemic, interest and importance of enveloped virus detection in wastewater has increased. Here, quantitative studies on SARS-CoV-2 occurrence in feces and raw wastewater and other enveloped viruses via quantitative real-time reverse transcription polymerase chain reaction (RT-qPCR) during the early stage of the pandemic until April 2021 are reviewed, including statistical evaluation of the positive detection rate and efficiency throughout the detection process involving concentration, extraction, and amplification stages. Optimized and aligned sampling protocols and concentration methods for enveloped viruses, along with SARS-CoV-2 surrogates, in wastewater environments may improve low and variable recovery rates providing increased detection efficiency and comparable data on viral load measured across different studies.

Training community health workers for the COVID-19 response, India.

OBJECTIVE: To report experiences in Bihar, India's most densely populated state, with a state government programme to train community health workers (CHWs) to combat the coronavirus disease 2019 (COVID-19) pandemic in the state's predominantly rural population of 128 million. METHODS: In May 2021, during the second wave of the COVID-19 pandemic in India, the Bihari government initiated a 1-day COVID-19 training programme for rural, unaccredited CHWs who had recently completed a community health education course from the National Institute of Open Schooling. The use of primary health centre buildings and doctors to deliver COVID-19 training and the existence of certification data on CHWs who participated in the community health education course streamlined implementation and minimized costs. After COVID-19 training, CHWs were paid as first responders and COVID-19 treatment workers by the Bihari government. FINDINGS: Overall, 15 000 CHWs in Bihar completed the COVID-19 training programme in 2021 and a further 30 000 were enrolled. A survey of CHWs carried out after COVID-19 training had started found that 80% (81/102) were satisfied with training and felt they were receiving information from reliable sources. CONCLUSION: The training and mobilization of a team of CHWs helped ease pressure on a stressed, rural, health-care system in Bihar and improved its preparedness for future COVID-19 outbreaks. The success of the training programme illustrates how local initiatives can help address gaps in the health workforce and extend the reach of public health care into rural areas, in addition to improving COVID-19 responses.