Dr Ravinder K Gupta, Abhay Singh
Waste is easier produced than handled. With the advent of the industrial era it has also marked the beginning of the era of production of tremendous amount of waste. Waste is commonly described as anything that is left after use or is no longer in a useable condition and needs disposal, but it is very simple to define waste than to deal with the waste. Dealing with waste becomes even more difficult when it comes to handling it at an individual level, though at an institutional level we find an array of management guidelines to be followed but at a household/individual level many find it difficult to manage and moreover due to the lack of knowledge about hazards related to the waste they tend to dispose it in a wrong manner.This topic of waste disposal and management finds even more relevance today amidst the coronavirus pandemic because of the enormous amount of health care associated waste being produced both at the institution as well as the household level and more importantly the waste being produced is potentially infectious and can cause a serious threat to the current fight against the virus. The waste includes used masks , head cover/cap, shoe-cover, disposable linen gown, PPEs , goggles, face-shield, splash proof apron, plastic covers, gloves etc . The simple analogy that can be drawn is that waste due to infected patient of COVID-19 produces 15 times more waste than an average hospitalised patient (As of today more than 6.8 million people are infected with numbers still increasing). Nowadays due to the pandemic the waste from donned off masks and other PPE material has increased enormously and its disposal should ideally be treated separately from other household waste.
The face mask has emerged as the most important weapon in our arsenal against the novel coronavirus (SARS-CoV-2) in addition to hand-washing and social distancing. Masks can help stop the spread of corona virus not just from those infected , but also by preventing the wearer from contracting the virus from other carriers during the COVID 19 outbreak.
Nowadays every body is wearing masks. The masks are of varied nature .Center for Disease Control (CDC) is additionally advising the use of simple cloth face coverings to slow the spread of the virus . One can find used masks , gloves or other protective kits being littered here and there like we see polythene plastic bags or used diapers or sanitary pads . The littering of these items is not only an environmental hazard but source of infection. Many times, the stray dogs are picking up these items and spreading it here and there. Handling of the gloves ,masks and other protective kits like face shields or goggles after use need to be addressed properly in this time because when it comes to the use of these things most know to use them, many know how to use them, few know how to remove them but only a few know how to dispose them. Even if we have the knowledge about the first three parts it will not make a huge difference if we do not know how to deal with the fourth part.
COVID-19 Isolation Wards / Test Centres and Laboratories: Used masks have to be discarded and collected in separate ‘yellow colour coded plastic bags’ (suitable for biomedical waste collection). They have to be handed over to the waste collector engaged by common biomedical waste treatment facility (CBWTF) operator at the doorstep and should be incinerated.
Quarantined homes or other households: Used masks should be kept in a paper bag for a minimum of 72 hours prior to their disposal as general waste. This must be done in accordance with the Solid Waste Management Rules, 2016. It is also advised to cut the masks prior to disposal to prevent their reuse.
Further, wrap and keep in a closed bin before handing the mask over to the sanitary worker. This waste must be treated as domestic hazardous waste and should be incinerated.
The Union Ministry of Health and Family Welfare have indicated that the masks used by patients / care givers / close contacts during home care should be disinfected using ordinary bleach solution (five per cent) or sodium hypochlorite solution (one per cent) and then disposed of either by burning or deep burial.
From containment zones / hotspots and sealed regions (ie red and orange zones): Used masks and other PPEs should be disposed and collected separately by the waste collectors and have to be incinerated or buried at a depth of at least 10 feet from the Earth’s surface in order to prevent infection. Also, the sanitation staff have to be advised not to mix waste from these hotspots / containment and sealed zones with the other localities.
For people in low risk areas, masks need to be tightly packed in bags and disposed of as nonrecyclable garbage. People who have symptoms like cough and fever are asked to spray disinfectant on the mask and seal the mask in a bag before discarding.This is important in context to the topic of COVID-19 as the spread of the virus is via surface contact aided by the survival of the virus on the surfaces for a long time and infection can spread easily by ineffective disposal of them both.The home made masks can be reused after proper washing and drying.
At homes when disposing gloves, they must be turned inside out. As for masks, it is advised people to pour boiling water on it before disposing them separately. The virus may live on such infected protective gear for at least three hours. Also, it is inappropriate to mix contaminated masks with household waste. The mixture of polluted masks and recyclable waste may cause a potential danger to rubbish collectors when they put hands in the waste bins to collect recyclable items.Worse, if someone just throws a used mask on the street, someone might pick it up, or worse try to collect them to sell second-hand.Special trash cans should be set up in communities as centralized disposal points for the used masks of residents.
If no special garbage bins are available, residents could spray disinfectant on both sides of their used masks and fold them up before putting them into a sealed plastic bag in the dustbin.A label ‘COVID-19 Waste’ to be pasted on these items also. The (inner and outer) surface of containers/bins/trolleys used for storage of COVID-19 waste should be disinfected with 1 per cent sodium hypochlorite solution daily.
At institutional levels or quarantine centres used PPEs such as goggles, face-shield, splash proof apron, plastic coverall, hazmat suit, nitrile gloves are collected into Red bag while used masks head cover/cap, shoe-cover, disposable linen gown, non-plastic or semi-plastic coverall in Yellow bags.
The communities need to dispose their used napkins, tissues, empty sanitizer bottles in a separate bag, to ensure the safety of municipal workers and ragpickers. It will also ensure that the cycle of garbage collection and plastic recycling don’t get affected. The Government should also provide safety kits to municipal workers urgently and educate them on how to handle household waste during the outbreak, to help in halting the chain of transmission.
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