Does COVID 19 really contributes world climate and environment?

While globe battles against the Covid-19 pandemic few good news are reported about climate benefits from this crisis. Top news are headlined as: “Enjoy Pure Sky”, “Cleaner Air”, “The World Has Started Breath Again” …etc.

All news is true 
and truly contributes to our mental health as a sparkle of positive in the flood of negative information we are fed on a daily basis. But will these climate benefit lasts longer? Unfortunately, no without special measures global community need to consider to deal with a medical/paramedical waste the crisis generates and it keeps and keeps on…
 
Medical waste and by-products cover a diverse range of materials, as the following list illustrates:
 
•Infectious waste: waste contaminated with blood and other bodily fluids (e.g. from discarded diagnostic samples),cultures and stocks of infectious agents from laboratory work (e.g. waste from autopsies and infected animals from laboratories), or waste from patients with infections (e.g. swabs, bandages and disposable medical devices);
•Pathological waste: human tissues, organs or fluids, body parts and contaminated animal carcasses;
•Sharps waste: syringes, needles, disposable scalpels and blades, etc.;
•Chemical waste: for example solvents and reagents used for laboratory preparations, disinfectants, sterilants and heavy metals contained in medical devices (e.g. mercury in broken thermometers) and batteries;
•Pharmaceutical waste: expired, unused and contaminated drugs and vaccines;
•Cyctotoxic waste: waste containing substances with genotoxic properties (i.e. highly hazardous substances that are, mutagenic, teratogenic or carcinogenic), such as cytotoxic drugs used in cancer treatment and their metabolites;
•Radioactive waste: such as products contaminated by radionuclides including radioactive diagnostic material or radiotherapeutic materials; and
•Non-hazardous or general waste: waste that does not pose any particular biological, chemical, radioactive or physical hazard.
 
The major sources of health-care waste are:

•Hospitals and other health facilities
•Laboratories and research centres
•Mortuary and autopsy centres
•Animal research and testing laboratories
•Blood banks and collection services
•Nursing homes for the elderly
 
Of the total amount of waste generated by health-care activities, about 85% is general, non-hazardous waste. The remaining 15% is considered hazardous material that may be infectious, toxic or radioactive. On average countries generate up to 0.5 kg of hazardous waste per hospital bed per day and 3 kg of non-hazardous waste1 that means: one COVID-19 infected patient generates 73.5 kg of waste if the patient is hospitalized for 21 days as recommended by EU Healthcare Guideline.2 As so, 80 000 tons of medical waste is generated globally up now just from the hospitalized Covid-19 infected patients
 
Medical waste generated from the hospitalized patients is not an end of the story. Masked and gloved people add even higher risk and threats to environment and of course a way back to human health again. Watchful people, advised from media, are using disposable masks, gloves and antiseptic napkins few times in a day. If we assume that only 10% of global population are using those solutions once in a day, means that 35 000 tons of those consumables are wasted everyday globally. Masks are produced from chemically designed synthetics materials which persists in environment for ages. Few types of gloves are sold nowadays: Latex, Nitrile and vinyl. Latex and nitrile gloves are produced from biodegradable materials (obtained from the incision of the bark of rubber trees) but vinyl is made from pure synthetic materials as disposable masks. Does not matter type and production materials, both masks and gloves goes to unsorted/mixed waste bins following to EU regulation.3 All 27 EU member countries have in country capacity to safely incinerate unsorted waste and recover an energy from it but not all other 180 countries can afford safe disposable and treatment of medical/paramedical waste. 
 
 
Georgia lacks proper incineration facilities to deal with medical waste and the country does not have mixed waste incineration facility at all.   As so, Health-care waste contains potentially harmful microorganisms that can infect hospital patients, health workers and the general public in the country. Other potential hazards may include drug-resistant microorganisms which spread from health facilities and landfill into the environment.
 
Improper treatment and disposal of healthcare and paramedic waste may pose health risks indirectly through the release of pathogens and toxic pollutants into the environment.
 
•The disposal of untreated health care wastes in landfills can lead to the contamination of drinking, surface, and ground waters if those landfills are not properly constructed.
•The treatment of health care wastes with chemical disinfectants can result in the release of chemical substances into the environment if those substances are not handled, stored and disposed in an environmentally sound manner.
•Incineration of waste has been widely practised, but inadequate incineration or the incineration of unsuitable materials results in the release of pollutants into the air and in the generation of ash residue. Incinerated materials containing or treated with chlorine can generate dioxins and furans, which are human carcinogens and have been associated with a range of adverse health effects. Incineration of heavy metals or materials with high metal content (in particular lead, mercury and cadmium) can lead to the spread of toxic metals in the environment.
•Only modern incinerators operating at 850-1100 °C and fitted with special gas-cleaning equipment are able to comply with the international emission standards for dioxins and furans.
•Alternatives to incineration such as autoclaving, microwaving, steam treatment integrated with internal mixing, which minimize the formation and release of chemicals or hazardous emissions should be given consideration in settings where there are sufficient resources to operate and maintain such systems and dispose of the treated waste.
 
Lack of awareness about the health hazards related to health-care waste, inadequate training in proper waste management, absence of waste management and disposal systems, insufficient financial and human resources and the low priority given to the topic are the most common problems connected with health-care waste in Georgia.
 
The management of health-care waste requires increased attention and diligence to avoid adverse health outcomes associated with poor practice, including exposure to infectious agents and toxic substances.
 
Key elements in improving health-care waste management are:
 
•Promoting practices that reduce the volume of wastes generated and ensure proposer waste segregation;
•Developing strategies and systems along with strong oversight and regulation to incrementally improve waste segregation, destruction and disposal practices with the ultimate aim of meeting national and international standards;
•Where feasible, favouring the safe and environmentally sound treatment of hazardous health care wastes (e,g, by autoclaving, microwaving, steam treatment integrated with internal mixing, and chemical treatment) over medical waste incineration;
•Building a comprehensive system, addressing responsibilities,resource allocation,handling and disposal. This is a long-term process, sustained by gradual improvements;
•Raising awareness of the risks related to health-care waste, and of safe practices; and
•Selecting safe and environmentally-friendly management options, to protect people from hazards when collecting, handling, storing, transporting, treating or disposing of waste.
 
To make the summary, open burning, disposing and incineration of health care/paramedical wastes like it does in Georgia can, under some circumstances, result in the emission of dioxins, furans, and in particular matter causing microbial outbreak. Measures to ensure the safe and environmentally sound management of health care wastes can prevent adverse health and environmental impacts from such waste including the unintended release of chemical or biological hazards, including drug-resistantmicroorganisms, into the environment thus protecting the health of patients, health workers, and the general public.
 
To conclude, Covid 19 not only contributes huge amount of medical/paramedical waste generation but as side effect it threats well-functioning waste management systems introduced at developed countries and commercial levels:  
 
•In the U.S., some cities have limited recycling programs as officials worry about the risk of spreading the virus in recycling centers. In particularly hard-hit European nations, waste disposal options have been rolled back. Italy has banned infected residents from sorting their waste at all. 
•Industry has seized the opportunity to overturn disposable bag bans, despite the fact that environmental experts say single-use plastics can still harbor viruses and bacteria.
•Businesses that once encouraged consumers to bring their own bags or containers have increasingly switched to single-use packaging. In early March, Starbucks announced a temporary ban on using reusable cups.
•Consumers stuck at home, and people increasingly shop online and order meals to be delivered, which come with a lot of packaging.
•Sewage treatment plants are asked to strengthen their disinfection routines to prevent coronavirus from spreading through sewage, mostly through increased use of chlorine. Some amount of that toxic chemical has found its way into the nation’s drinking water
•Crisis motivates human phycology to create a storage of primary consumptions what logically tends to increase a food waste.



1United Nations’ World Health Organization Research https://www.who.int/news-room/fact-sheets/detail/health-care-waste
2Directive 2011/24/EU applies to healthcare provided in a private hospital or by a private healthcare provider
3Directive 2008/98/EC sets the basic concepts and definitions related to waste management, such as definitions of waste, recycling, recovery

14.04.2020

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