The pandemic is also an environmental crisis

The COVID pandemic is not just a public health crisis. It is also environmental. After more than 430 million reported cases of the disease worldwide, the pandemic has generated huge amounts of medical waste in the form of test kits, gloves, masks, syringes and other products that people in clinics and hospitals use once then shoot. .

A recent report by the World Health Organization found the problem to be global, but extreme in poorer countries where much of the rubbish is simply burned in open pits and decrepit incinerators with no controls. Pollution.

According to WHO estimates, between March 2020 and November 2021, 87,000 tons of personal protective equipment and other medical products were shipped to countries like the Democratic Republic of Congo and Bangladesh. Most of these materials were used and then thrown away. But the WHO estimate only takes into account shipments delivered by the United Nations and its partner groups, not the huge amounts of material that countries obtain from other sources, according to Ute Pieper, an independent consulting engineer at Berlin, which advises countries on medical waste management.

Medical waste was a big problem before the pandemic

Many healthcare facilities were unable to safely manage waste before the disease exploded across the planet, and the sheer scale of the pandemic has only compounded a serious problem. “The pandemic is exposing inadequacies in global healthcare waste management systems that have long awaited an overhaul,” says Ruth Stringer, international science and policy coordinator for Health Care Without Harm, an international nongovernmental organization that develops health care waste management programs. ecological sustainability for hospitals and clinics. She was an advisor for the WHO report.

Ideally, most medical waste, COVID-related or not, would be sterilized and then recycled. But for this to happen, waste must be broken down into its various components, which is a capability that many countries do not have. “One of the biggest problems we face is that waste is not separated in the hospital ward,” says Amos Gborie, director of the Division of Environmental and Occupational Health at the National Institute of Public Health of the Liberia. “So good management becomes a problem.”

Waste packaged in Liberia often ends up in small, poorly controlled incinerators that do not meet international standards, a common situation throughout the developing world. Emissions from incinerators are rich in toxic pollutants and the ashes themselves are also dangerous.

Chemicals like dioxins and furans, which the US Environmental Protection Agency classifies as “probable human carcinogens,” permeate the plumes. Its levels can be “hundreds of times higher than those recommended for air emissions,” says Stringer. “And levels of dioxins and furans, up to 13 times above European Union limits, have also been documented in chicken eggs near medical waste incinerators.”

Chickens and their eggs absorb these fat-soluble toxins and concentrate the chemicals in large quantities, making the eggs dangerous for people who eat them.

Special measures must be taken

Some countries are now experimenting with ways to separate medical waste for safer recycling and disposal. Hospitals in Liberia, for example, have recently started implementing color-coded bins in an effort to sort waste.

Health Care Without Harm promotes needle-cutting devices that prevent needle stick injuries. “Without the needle, all vaccine waste, including vials and packaging, is fully recyclable,” Stringer says. “We can make this waste disappear.”

Autoclaves that steam sterilize medical waste offer more recycling opportunities, and manufacturers can design products with recycling in mind. Masks, for example, have metal nose clips, polypropylene filters and elastic headbands. Integrated in the same product, these components are not recyclable. But if they can be separated, the pieces can be reused in many ways.

Pieper adds that another important goal is to prevent the overuse of certain protective gear, especially gloves, which account for a large portion of medical waste globally. Healthcare workers in minimal-risk settings, such as those administering vaccines, often wear gloves out of habit or fear of infection, although “most evidence indicates that the primary route of transmission is through by the particles. [superficies contaminadas] Pieper said. According to WHO guidelines, gloves may only be necessary when caring for sick COVID patients.

Beyond minimizing material use and promoting recycling, the main environmental benefits “would come from the elimination of small-scale incinerators,” says Pieper. Located in small hospitals or clinics, these devices are often made from bricks and other local materials and provide inexpensive options for waste disposal. But they also break down frequently, releasing toxic chemicals into the air.

Pieper says putting trash in these incinerators can be “no different from open burning.” To overcome this problem, Gborie says her department recently assembled a team that collects waste from healthcare facilities in Monrovia, Liberia, and then delivers it to a centralized disposal facility. Liberian officials are also beginning to collect fees from private hospitals “to pay for managing the waste they generate”, says Gborie.

Stringer welcomes these changes. “Now is the time to focus on creating systems that are safe, climate-smart and environmentally sustainable,” he said. “We have technical solutions, and what is needed is the resource and the political will to implement them.”

By Charles Schmidt. Articles in English

Leave a Comment