War on waste: Challenges and experiences in COVID-19 waste management.

COVID-19 has posed formidable challenges including overwhelming bio-medical waste. Guidelines have been rapidly changing along with mounting pressure of waste generation. These challenges were managed by smart re-engineering of structure and processes for desired outcomes. Dedicated staff in PPE with appropriate training were deployed to collect waste using dedicated trolleys. A dedicated route plan was drawn with a dedicated lift meant for COVID-19. A new temporary holding area was created. Dedicated trucks with requisite labels were deployed to transport COVID-19 waste to CBWTF. Communication challenge was addressed through timely circulars, which were further reinforced and reiterated during various on-going training programs.Before the onset of COVID-19 pandemic Bio-Medical Waste generated was 1.93kg/Bed/Day and currently the quantum of COVID-19 biomedical waste generated is 7.76Kg/COVID Bed/Day. Daily COVID-19 waste generation data is maintained and uploaded in an android Application. Till date none of the worker handling COVID-19 waste has acquired Healthcare associated COVID-19 infection which reflects on the soundness of the new system and the infection control practices in the Institute. A responsive leadership harmonizing with a robust communication and training system has augmented timely re-engineering of structure and processes for better outcomes in the war on waste.

Knowledge, Attitude and Practice of Personnel Involved in Bio Medical Waste Handling about COVID-19 & Its Bio-Medical Waste Management: A Descriptive Analysis.

Background: The COVID-19 pandemic has led to an increased amount of biomedical waste, worsening the already strained biomedical waste management system in India. As biomedical waste handlers are the core of biomedical waste handling, their knowledge, attitude, and practices regarding sorting, segregation, transport, and storage of the waste are of prime concern. This study aims to evaluate the knowledge, attitude and practices of personnel involved in biomedical waste handling about COVID-19 and its biomedical waste management at All India Institute of Medical Sciences Mangalagiri. Design: Cross-sectional survey. Setting: AIIMS Mangalagiri and common bio-medical waste treatment facility at Guntur. Participants- Personnel involved in bio-medical waste handling Methodology: The study enrolled a total of 139 participants from December 2020 to January 2021. A convenient sampling technique was used and a questionnaire was administered by face-to-face interview. Results: The study showed that half of the participants had favorable knowledge about bio-medical waste management (average score 5.08 and range 1-9). Two-thirds of the respondents felt that handling COVID-19 waste is necessary to contain the infection. Conversely, the practices regarding COVID-19 and its biomedical waste management were not in conformity with attitudes and knowledge. Fewer participants knew the exact sequence of donning (15.80%) and doffing (31.70%). Majority of participants (72.7%) desired a hands-on training for handling biomedical waste. Conclusion: Participants have good knowledge and attitudes regarding COVID-19 bio-medical waste management, but are not adhering to it. This explains the need for comprehensive training programs for all those involved in bio-medical waste management of COVID-19.

Management of COVID-19 waste

The COVID-19 Pandemic has greatly influenced waste management sector due to large-scale patient care, diagnosis, treatment and isolation. COVID-19 waste could comprise of both municipal waste as well as bio-medical waste depending on the source of its generation. Such waste could be potentially infected with the virus. If not managed and treated scientifically, the risk of secondary transmission of the virus increases. The existing waste management systems are not designed to handle such surge of waste and therefore, safe handling and disposal of such waste is viewed as one of the biggest challenges. There could be multiple sources of COVID-19 waste, which includes hospitals, COVID-19 wards, testing centers, laboratories, home quarantine, temporary medical establishments, ambulances, graveyards and commercial establishments. Guidelines and procedures for management of the COVID-19 waste have been prescribed by WHO and by governments by countries across the globe. Selection of appropriate technology to treat and dispose potentially infectious COVID-19 waste is critical but depends on economic, environmental and social factors of a country or region. Looking at the quantum of waste that would be generated from the used PPEs, it is quite apparent that the existing waste management systems are going to be overburdened. The pandemic is also going to adversely impact the waste recycling sector, including the informal sector. To minimize the risk of transmission of the virus through sewage, proper treatment followed by disinfection is necessary. An ideal waste management policy during this pandemic should safely tackle the waste generated such that there are no chances of transmission due to the waste, ensure that the waste causes least possible damage to the environment, and strive to achieve sustainable development goals (SDGs) and other international obligations. © 2022 Elsevier Inc. All rights reserved.

The intricate association of COVID-19 pandemic with ecological issues.

This critical narrative review is intended to emphasize the comprehensive ecological issues related to the evolution of the novel coronavirus, the environmental factors associated with the disease progress, and the impact the pandemic is having on the environment. Approximately 60% of the emerging infectious disease of the last century (including deadly viruses like HIV, Ebola, Influenza, coronavirus strains like SARS, MERS) are linked to zoonotic spillover. Therefore, to escape the emergence of newer cross-species infections, proper precautionary measures should be taken. Every country has specific rules to deal with the biomedical waste produced in hospitals. But the COVID-19 pandemic has posed a unique global challenge due to the overwhelming amount of biomedical waste generated from dedicated COVID hospitals, diagnostic facilities, quarantine centers, and home quarantine facilities. Moreover, inappropriate disposal of masks by the general public may contaminate the environment turning it into a potential health hazard. Therefore, strict adherence to Biomedical Waste Management Guidelines for proper disposal of masks and other medical waste by all concerned is a must. Lockdown has brought about tremendous improvement in conditions of the world's atmosphere, hydrosphere, and biosphere. Dramatic improvement in air quality index, decrease in water, and noise pollution are some of the positive aspects of lockdown. However, these effects are temporary. But these teach an important lesson to the world to take some permanent measures to bring down greenhouse gases and other toxic emissions. Some harmful effects of lockdown are illegal deforestation, wildlife trafficking, encroachment of reserved areas etc.

COVID 19 Pandemic and biomedical waste management practices in healthcare system.

The whole world was shaken with the pandemic of Coronavirus Disease (COVID-19) in end of the year 2019. Due to its novel origin, it was required to follow all precautions possible. Dealing with the massive amount of infectious healthcare waste became an enormous challenge. This review identifies the impacts of the pandemic on biomedical waste management. This systematic review was made by using keywords "biomedical waste" and "COVID 19" in open access databases like PubMed, Science Direct, Scopus, Google Scholers etc. 2124 articles downloaded and 765 found duplicate and 634 not related to the topic. after scrutiny with inclusion criteria 102 articles were considered to analyze the practices related to biomedical waste management during pandemic using PRISMA guideline.. The COVID-19 waste segregation, collection, storage, transportation, and disposal are a big challenge with all stakeholders. In order to control the virus spread, strict monitoring of the complete waste management cycle is required. Adoption of appropriate guidelines is paramount to worker safety and containment of infection. Sustainable recycling methods are needed to deal with the ever-increasing plastic waste resulting from mandatory personal protective equipment (PPE) usage. The situation also demands a rethinking of the healthcare system. Overall, there was an increase in BMW generation, and municipal waste had increased globally. Pandemic preparedness requires a global public health strategy and long-term investments. This will be vital for making a robust community capable enough to fight against any public health pressures in the future, as well as the pandemic tremors. Systematized efforts from all stakeholders, at all levels, not only refines epidemic preparation but also helps to attain a sustainable development of health for a healthier future.

Prioritization of factors and selection of best business practice from bio-medical waste generated using best–worst method

Purpose: Hospital activities restore health and save lives;yet they produce infectious waste that might harm people and the environment if not handled carefully. The sudden increase in bio-medical waste (BMW) generation was caused due to the outbreak of Coronavirus disease (COVID-19) at the beginning of year 2020. There is a huge potential of businesses from BMW generated in the developing economies. The document destruction process would prove to be beneficial in determining the strategies and policies for the business from BMW. Therefore, the purpose of this study was to identify and evaluate the factors that influence the business prospects from BMW in developing economies. Design/methodology/approach: The study focuses on identifying 18 factors based on an extensive literature review, questionnaire, theoretical foundations and interviews with experts in the context of developing economies. These factors are categorized into four groups namely “Culture, education and microeconomics”, “Infrastructure, social provision, and technology”, “Policy and institution” and “Integrated waste management system”. Consequently, these factors are prioritized to assist the decision-maker in comprehending the most critical aspects of accomplishing the best business practices. A framework based on the Best–Worst Method (BWM) is applied to evaluate and determine the significance of each identified factor. Findings: The major contribution of this paper is to identify key factors that are responsible for successful implementation of the business practices from the generated BMW. The study also explains their nature, significance and inter-relationship among them using BWM. Current study applied a distinctive modeling approach to examine the contextual relationship among the key factors and to rank them as per their importance. The findings of the study suggest that “Setup for collection and segregation is the best alternative for business from BMW produced”. Originality/value: The paper also presents strategies, which can be adopted as a guiding step by the decision-makers to formulate policies for the effective business practice from BMW. This research is expected to stimulate future applications of the BWM to facilitate long-term decision-making. © 2022, Emerald Publishing Limited.

Virtual Methodology for Household Waste Characterization During The Pandemic in An Urban District of Peru: Citizen Science for Waste Management.

The Covid-19 pandemic has caused the alteration of many aspects of the solid waste management chain, such as variations in the waste composition, generation and disposal. Various studies have examined these changes with analysis of integrated waste management strategies; qualitative studies on perceived variations and statistical evaluations based on waste collected or disposed in landfills. Despite this information there is a need for updated data on waste generation and composition, especially in developing countries. The objective of this article is to develop a data sampling and analytical approach for the collection of data on household waste generation and composition during the pandemic; and, in addition, estimate the daily generation of masks in the study area. The proposed methodology is based on the principles of citizen science and utilizes virtual tools to contact participants, and for the training and collection of information. The study participants collected the information, installed segregation bins in their homes and trained their relatives in waste segregation. The article presents the results of the application of the methodology in an urban district of Lima (Peru) in August 2020. The results suggest an apparent decrease in household waste per capita and a slight increase in plastics composition in the study area. It is estimated that each participant generates 0.124 masks per day and 0.085 pairs of gloves per day. The method developed and results presented can be used as a tool for public awareness and training on household waste characterization and segregation. Furthermore it can provide the necessary evidence to inform policy directives in response household waste issues and Covid-19 restrictions.

Recent advances and applications of polymeric materials in healthcare sector and COVID-19 management.

The coronavirus disease pandemic is considered at its worst and all nations are collectively fighting to improve global public health. In this outlook, polymers and their related materials (including plastics) are the primary sources in the manufacturing of medical and personal protective equipment. Plastics can be mass-produced, economical, and sterilized, which makes them an inevitable material in the medical and healthcare sector. Along with plastics, antibacterial and antiviral coatings, polymeric nanomaterials and nanocomposites, and functional polymers have become excellent materials for COIVD-19. This review centres on the applications of polymer materials in managing the COVID-19 outbreak. Moreover, the utilization of plastics with its healthcare applications are reviewed. Apart from this, major challenges and future directions of these materials have also been discussed. This review will help aspiring researchers to develop the basic understanding of polymeric materials currently employed in medical sector.

Application of ArcGIS and QFD-based model for site selection for bio-medical waste disposal.

With the increasing formalisation of the health sector in India, the bio-medical waste (BMW) disposal regulations are getting stringent and its implementation is being enforced strictly. The coronavirus disease 2019 (COVID-19) created a healthcare crisis because of the highly contagious nature of the novel virus. Measures employed for the prevention and management of COVID-19 resulted in the generation of an unprecedented amount of BMW in Indian medical history. This BMW needs to be disposed of safely at a suitable site to prevent secondary infection and the potential spread of the virus in the environment. The selection of an appropriate site for BMW disposal requires comparing a wide range of social, economic and environmental factors corresponding to different site locations, which makes it a multi-criteria decision-making (MCDM) problem. This study aims to solve the BMW site selection problems using a quality function deployment-based model that can consider both the subjective and the objective criteria, and evaluate them as per the user's requirements. The proposed model is applied to evaluate the suitability of waste disposal sites in the city of Bilaspur in Chhattisgarh, India. At first, eight possible locations for BMW disposal are identified, while utilising geographical information system (GIS). Consequently, the developed model is applied to evaluate the identified sites, taking 18 relevant criteria into consideration. A software prototype is developed in Visual BASIC 6 to automate the entire decision-making process, further adding to the novelty of the work.

Redefining bio medical waste management during COVID- 19 in india: A way forward.

India is ranked 120 among 165 nations with respect to sustainable development and critically suffers from insufficient waste treatment provisions and amenities. And the abrupt occurrence of the COVID-19 virus has aggravated the issue of managing of medical waste in India, manifolds. As a result, the safe disposal of a huge volume of hazardous medical waste has become a top priority. This conceptual study evaluates India's management of medical waste during the COVID-19 pandemic. Additionally, this article aims to highlight the inadequacies in India's implementation of the BMW 2016 standards by a synthesis of multiple agency reports (government and non-government) and data obtained directly from the Central Pollution Control Board (CPCB). The findings indicate that India is well behind in terms of COVID-19 waste management and requires comprehensive monitoring and implementation systems to enable the achievement of SDGs related to environmental health.

Assessment of bio-medical waste before and during the emergency of novel Coronavirus disease pandemic in India: A gap analysis.

Considering the widespread transmission of Coronavirus disease (COVID-19) globally, India is also facing the same crisis. As India already has inadequate waste treatment facilities, and the sudden outbreak of the COVID-19 virus has led to significant growth of Bio-medical waste (BMW), consequently safe disposal of a large quantity of waste has become a more serious concern. This study provides a comprehensive assessment of BMW of India before and during the COVID-19 pandemic. Additionally, this article highlights the gaps in the implementation of BMW rules in India. This study uses various government and non-government organizations, reports and data specifically from the Central Pollution Control Board (CPCB). The finding of the study demonstrated that most of the States/Union Territories (UTs) of India are lacking in terms of COVID-19 waste management. India has generated over 32,996 mt of COVID-19 waste between June and December 2020. During this period, Maharashtra (789.99 mt/month) is highest average generator of COVID-19 waste, followed by Kerala (459.86 mt/month), Gujarat (434.87 mt/month), Tamil Nadu (427.23 mt/month), Uttar Pradesh (371.39 mt/month), Delhi (358.83 mt/month) and West Bengal (303.15 mt/month), and others respectively. We draw attention to the fact that many gaps were identified with compliance of BMW management rules. For example, out of all 35 States/UTs, health care facilitates (HCFs), only eight states received authorization as per BMW management rules. Moreover, the government strictly restricted the practice of deep burials; however, 23 States/UTs are still using the deep burial methods for BMW disposal. The present research suggests that those States/UTs generated on an average of 100 mt/month COVID-19 waste in the last 7 months (June-December 2020) should be considered as a high priority state. These states need special attention to implement BMW rules and should upgrade their BMW treatment capacity.

Compromising situation of India's bio-medical waste incineration units during pandemic outbreak of COVID-19: Associated environmental-health impacts and mitigation measures.

COVID-19 induced pandemic situations have put the bio-medical waste (BMW) management system, of the world, to test. Sudden influx, of COVID-infected patients, in health-care facilities, has increased the generation of yellow category BMW (Y-BMW) and put substantial burden on the BMW-incineration units of India. This study presents the compromising situation of the BMW-incineration units of India, in the wake of COVID-19 pandemic, from 21st March 2020 to 31st August 2020. This analysis revealed that on an average each COVID-infected patient in India generates approximately 3.41 kg/d of BMW and average proportion of Y-BMW in it is 50.44%. Further, it was observed that on 13th July 2020, the total Y-BMW, generated by both the normal and COVID-infected patients, fully utilized the BMW-incineration capacity of India. Also, it was made evident that, during the study period, BMW-incineration emitted several pollutants and their concentration was in the order: NOx > CO > SOx > PM > HCl > Cd > Pb > Hg > PCBs > Ni > Cr > Be > As. Subsequently, life time cancer risk assessment depicted that with hazard quotient >10-6, Cd may induce carcinogenic health impacts on both the adults and children of India. Therefore, to mitigate the environmental-health impacts associated with the incineration of BMW, evaluation of various options, viz., alternative technologies, substitution of raw materials and separate treatment of specific wastes, was also done. It is expected that the findings of this study may encourage the global auditory comprising scientific community and authorities to adopt alternate BMW-management strategies during the pandemic.

Disinfection technology and strategies for COVID-19 hospital and bio-medical waste management.

The isolation wards, institutional quarantine centers, and home quarantine are generating a huge amount of bio-medical waste (BMW) worldwide since the outbreak of novel coronavirus disease-2019 (COVID-19). The personal protective equipment, testing kits, surgical facemasks, and nitrile gloves are the major contributors to waste volume. Discharge of a new category of BMW (COVID-waste) is of great global concern to public health and environmental sustainability if handled inappropriately. It may cause exponential spreading of this fatal disease as waste acts as a vector for SARS-CoV-2, which survives up to 7 days on COVID-waste (like facemasks). Proper disposal of COVID-waste is therefore immediately requires to lower the threat of pandemic spread and for sustainable management of the environmental hazards. Henceforth, in the present article, disinfection technologies for handling COVID-waste from its separate collection to various physical and chemical treatment steps have been reviewed. Furthermore, policy briefs on the global initiatives for COVID-waste management including the applications of different disinfection techniques have also been discussed with some potential examples effectively applied to reduce both health and environmental risks. This article can be of great significance to the strategy development for preventing/controlling the pandemic of similar episodes in the future.