COVID-19 fallout: Rising bio-medical waste poses fresh challenge

With the second wave of COVID-19 creating havoc in India, along with the rise in the number of cases, the country has an unlikely menace at hand - the rising pile of Bio-medical wastes.

The quantity of Bio-medical wastes generated per day in the country has almost doubled from 7.22 lakh kg in pre-Covid times to nearly 14 lakh kg now, according to the Indian Medical Association (IMA).

J A Jayalal, president of the IMA, told Moneycontrol: “Overall Bio-medical wastes produced in the country would have almost doubled to around 13 to 14 lakh kg now. If you investigate generation of per-bed Bio-medical wastes, it may have increased to around 400 grams per day.”

Before the COVID outbreak, per-bed Bio-medical wastes were to the tune of 250 grams per day.

Due to the rise in quantity, sources indicated that in several states, authorities are facing a crisis in dealing with such rising wastes.

However, when contacted, a senior official of the Central Pollution Control Board (CPCB) said that the situation is currently manageable. However, in some places like Mumbai and Pune, Bio-medical wastes are either sent to hazardous waste treatment units and in certain parts of rural India, for deep burial.

According to figures shared by CPCB, on May 10, Bio-medical wastes produced only due to COVID in the country touched 230 tonnes per day, crossing 220 tonnes per day during the same time last year.

This is in addition to the non-COVID Bio-medical wastes to the tune of around 600 tonnes per day. “Despite a huge rise in the number of cases, Bio-medical wastes due to COVID have not increased due to better segregation this year. Last year during the same time, food wastes generated from hospitals were also part of the Bio-medical waste numbers, this time food wastes are treated separately,” said the CPCB official.

What is Bio-medical waste?

According to IMA, Bio-medical waste means any sewage which is generated during the diagnosis, treatment or immunization of human beings or animals, or in research activities.

This includes infected sharps and wastes with infectious, hazardous, radioactive, or genotoxic characteristics, which if inadequately treated and managed, can have an adverse impact on the environment and public health.

Based on the current practice in India, the management of Bio-medical wastes begins at the bedside of the patient with the effluent being categorised, segregated, and disposed of in different containers.

The categories of wastes include Yellow (post-operated body parts, caps, masks, pathological wastes, bedding, placenta, plaster of Paris etc) and Red (syringe, IV Sets, catheters, gloves, urine bags, blood bags, dialysis kits etc), White and Blue.

Methods of treating Bio-medical wastes

Common methods of treatment and disposal of Bio-medical waste are by incineration or plasma (by burning) pyrolysis (heating in the absence of oxygen) and deep-burial for Yellow Category waste; autoclaving/microwaving/chemical disinfection for Red Category waste; sterilization and shredding, disinfection followed by burial in concrete pit through foundry/encapsulation for White Category sharps waste; and washing, disinfection followed by recycling for Blue Category glass waste.

Based on current government guidelines, Bio-medical waste generated from the hospitals must be treated and disposed of by Common Bio-medical Waste Treatment and Disposal Facility (CBWTF). In case there is no common facility within the reach of a healthcare facility, then such healthcare facility should install a captive treatment and disposal facility.

According to the government data, India had 200 authorized CBWTFs in 28 States in 2020 for environmentally safe disposal of biomedical waste.

The remaining seven states - Goa, Andaman Nicobar, Arunachal Pradesh, Lakshadweep, Mizoram, Nagaland, and Sikkim - do not have CBWTFs.

Apart from common facilities, there are 12,296 captive treatment and disposal facilities installed by healthcare facilities. Every healthcare facility, both bedded and non-bedded, is required to take authorization from the concerned State Pollution Control Board/Pollution Control Committee (SPCB/PCC) for management of Bio-medical waste.

As per official government data for 2018, 2,60,889 healthcare facilities were generating about 608 tonnes per day of Bio-medical Waste, out of which 528 tonnes was treated and disposed of through either CBWTF or captive disposal facility.

The current crisis of rising wastes

According to industry experts, Bio-medical wastes are rising daily after the second COVID wave.

In the government sector alone, the number of available beds has increased from 631,222 in April 2020 to 760,100, as of January 2021. Including the private sector, the total number of beds would be around 30-35 lakh across the country.

“This rise in the number of beds, along with the increase in occupancy rate, has also contributed to the increase in the number of Bio-medical wastes,” said Jayalal.

The occupancy level has increased from 50-60 per cent before COVID to almost 90 per cent now in several states.

Pavan Choudary, chairman of the Medical Technology Association of India, said that there is a spike in the use of personal protective equipment (PPE) kits, sanitisers, masks, breathing circuits etc, that has led to the doubling of Bio-medical wastes in the country.

“At this point, we will not be able to quantify the rise in Bio-medical wastes. However, we are handling unprecedented quantities now, which is a huge task for companies, government and for the health sector in itself,” said Ashok K Agarwal, president of the Indian Society of Hospital Waste Management.