Home quarantine raises queries on proper disposal of biomedical waste

Home quarantine raises queries on proper disposal of biomedical waste

By Sambit Dash

THE Covid-19 pandemic has thrown up challenges which have never been faced before. Ever since the World Health Organisation has declared coronavirus as global pandemic, quarantining of Covid-19 positive patients and those susceptible began in right earnest in India.
While an ‘infectious disease’ has prompted strict infection control measures in hospitals, focus should be on such measures in quarantined homes or containment areas. Though biomedical waste management has had a decent run in India, household biomedical waste management has been neglected. A neglect that could come to bite in times of this pandemic.
Odisha, which has been at the forefront of the fight against Covid-19 and has embarked on various initiatives, would do well to add a vertical in its waste management practices, and well beyond this pandemic, address the management of household biomedical waste.
Biomedical Waste (Management and Handling) Rule 1998 was implemented by the Ministry of
Environment and Forests, Government of India which is applicable to those who generate, collect, receive, store, dispose, treat or handle BMW in any manner. While these set of laws largely deal with clinical establishments and one can debate the success or the lack of its handling, it is noteworthy that these biomedical waste rules do not mention or govern household biomedical waste.
The Government has, however, taken cognizance of this gap during this pandemic. On March 25, the
Central Pollution Control Board issued guidelines on handling waste from quarantined homes.
Yellow bags are to be used for collection of household biomedical waste and trained and authorised staff, in full protective uniform, are to collect it.

Risks aplenty

Imagine an individual, an elderly or an immobilised patient, who has tested positive for Covid-19 and uses adult diapers. Or he is a diabetic and takes insulin injections. How would that diaper or the needle be disposed of? There are numerous such items that pose a risk of spreading the virus. While public at large have been sensitised about coronavirus spread, it also applies to everyday life. The same diapers, insulin pens, blood-stained cotton, used condoms, old medicines and the likes pose many risks.
We currently mix these biomedical waste with regular waste and they end up in landfills. It is no secret that people who handle these wastes in India lack protective equipment and the risk of health hazard from needle stick injuries and other infections like Hepatitis remains. This is the situation all over the country and Odisha is no different. So much so that a few years ago the Orissa High Court issued notices to all Government and private medical colleges for violating biomedical waste management rules.

The road ahead

While the first step post-pandemic is to fix the existing biomedical waste management gaps, this
opportunity should be used by Odisha as well as the entire country to add another vertical to the existing system, that of household biomedical waste.
With increased life span, increased access to healthcare facilities and an overall improvement in living standards of people in the last two decades, the generation of household biomedical waste has increased. It is thus imperative that it should be separated and segregated from other wastes and treated.
While dry and wet waste segregation have had mixed response in cities where it is carried, there is a need to create a different setup for household biomedical waste. The increased awareness regarding health during Covid-19 can be used to sensitise people about it. To be effective, it has to be taken to the community level.
The initial infrastructure needs to be provided by local governments. Collection boxes or bins need to be placed at smaller units, be it apartment or streets. Since biomedical waste generation is not to the tune of volume as that of other waste, the collection need not be on a daily basis. But it would be important to have personnel adhering to safety standards in collecting it.
The next question is that of handling of that waste. There would broadly be two ways to go about it. Incinerators and disinfectant units at local levels can be created, which could be built through PPP mode.
The other strategy would be to channelise these biomedical waste to existing infrastructure, which would require a great deal of planning at micro level. The processing of biomedical waste from households can also be monetised by recycling lot of these waste items.

Opportunity in the crisis

While Covid-19 pandemic is a tough situation for governments and health agencies to handle, it also provides an opportunity to set right things that have long been neglected. Household biomedical waste management is one such area. A massive infectious disease outbreak has put the spotlight on infection control at various levels. While a small headway has been made vis-à-vis quarantined homes, focus should be on the management of this kind of biomedical waste. And the focus should remain well beyond the pandemic.

__ The author is Senior Grade Lecturer, Department of Biochemistry, Melaka Manipal Medical College (Manipal Campus). He comments on public policy, healthcare and issues of social interest. He tweets at @sambit_dash

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