Tens of thousands of tonnes of extra medical waste from the response to the COVID-19 pandemic have put enormous pressure on healthcare waste management systems around the world, threatening human and environmental health and revealing a deep need to improve waste management practices, according to a new WHO report.
WHO’s global analysis of health waste related to COVID-19: status, effects and recommendations bases its estimates on the approximately 87,000 tonnes of personal protective equipment (PPE) purchased between March 2020 and November 2021 and sent to supporting countries’ urgent need for COVID- 19 response through a joint UN emergency initiative. Most of this equipment is expected to end up as waste.
The authors note that this is only an initial indication of the extent of the COVID-19 waste problem. It does not take into account any of the COVID-19 products purchased outside the initiative or waste generated by the public as disposable medical masks.
They point out that over 140 million test kits with the potential to generate 2,600 tonnes of non-infectious waste (mainly plastic) and 731,000 liters of chemical waste (equivalent to a third of an Olympic-sized swimming pool) have been dispatched, while over 8 billion doses of vaccine has been administered globally, producing 144,000 tonnes of additional waste in the form of syringes, needles and safety boxes.
As the UN and the countries struggled with the immediate task of securing and quality assuring supplies of PPE, less attention and resources were devoted to the safe and sustainable management of COVID-19 related health waste.
“It is absolutely vital to provide healthcare professionals with the right PPE,” said Dr. Michael Ryan, CEO, WHO Health Emergencies Program. “But it is also important to ensure that it can be used safely without affecting the surrounding environment.”
This means having effective management systems in place, including guidance to healthcare professionals on what to do with PPE and healthcare products after they have been used.
Today, 30% of healthcare facilities (60% in the least developed countries) are not equipped to handle existing waste loads, let alone the extra COVID-19 load. This potentially exposes healthcare professionals to needle stick injuries, burns and pathogenic microorganisms, while affecting communities living near poorly managed landfills and landfills, through polluted air from burning waste, poor water quality or disease-carrying pests.
“COVID-19 has forced the world to reckon with the gaps and the neglected aspects of the waste stream, and how we produce, use and dispose of our health resources, from cradle to grave,” said Dr. Maria Neira, Director of Environment, Climate. Change and health at the WHO.
“Significant changes at all levels, from the global to the hospital floor, in how we manage the health waste stream is a fundamental requirement for climate-smart health systems, which many countries committed to at the recent UN climate conference, and, of course, a healthy improvement from COVID-19 and preparedness for other health emergencies in the future. “
The report sets out a set of recommendations to integrate better, safer and more environmentally sustainable waste practices into the current COVID-19 response and future pandemic preparedness efforts, highlighting stories from countries and organizations that have put into practice in the spirit of “building back better” .
Recommendations include the use of environmentally friendly packaging and shipping, safe and recyclable PPE (eg gloves and medical masks), recyclable or biodegradable materials; investment in non-combustible waste treatment technologies such as autoclaves; reverse logistics to support centralized processing and investment in the recycling sector to ensure that materials such as plastics can have a different life.
The COVID-19 waste challenge and the increasing urgency of tackling environmental sustainability provide an opportunity to strengthen systems to safely and sustainably reduce and manage health waste. This can be through strong national policies and regulations, regular monitoring and reporting and increased accountability, support for behavior change and workforce development, and increased budgets and funding.
“A systemic change in how the healthcare system handles its waste will include greater and systematic control and better procurement practices,” said Dr. Anne Woolridge, Chair of the Health Care Waste Working Group, International Solid Waste Association (ISWA).
“There is a growing understanding that health investments must take into account environmental and climate implications, as well as a greater awareness of the co-benefits of action. For example, safe and rational use of PPE will not only reduce environmental damage from waste, it will also save money, reduce potential supply shortages and further support infection prevention by changing behavior. “
The analysis comes at a time when the healthcare sector is under increasing pressure to reduce its CO2 footprint and minimize the amount of waste sent to the landfill – partly due to the great concern about the spread of plastic waste and its impact on water , food systems and human and ecosystem health.
This report was led by the WHO’s Department of Water, Sanitation, Hygiene and Health in collaboration with the following WHO teams: Infection prevention and control, emergencies, medical equipment and vaccinations. Technical input was provided by WHO partners, Health Care without Harm, United Nations Development Program (UNDP), Global Fund and International Solid Waste Association (ISWA), a global, independent, non-profit association working in the public interest to promote and develop sustainable waste and resource management in the transition to a circular economy.
Quotes from partners:
“Waste management is an integral part of the supply chain as a result of the use and expiration of health products. Inadequate and inappropriate handling of health waste can have serious consequences for public health and the environment and can have a significant impact on human and planetary health ”.
Dr. Mandeep Dhaliwal, Director of HIV Health and Development, UNDP
“In the light of COVID-19, sustainable waste management from healthcare is more important than ever to protect communities, healthcare professionals and the planet and prevent pollution”
Ruth Stringer, Science and Policy Coordinator, Health Care Without Harm.