Doc discusses medical waste

Dr Margaret Montgomery, from the World Health Organisation (WHO), discusses medical waste that has been generated during the Coronavirus (Covid-19) pandemic.
She explains how medical waste can impact one’s health and what can be done to reduce it.

Vismita Gupta-Smith: Describe for us what this medical waste is that has been generated during the pandemic.

Dr Montgomery: Medical waste is all the waste that results from vaccinations, from testing for the Covid-19, as well as for caring for patients in healthcare facilities and homes.
So this is vaccine needles, vials, testing reagents, testing swabs, as well as all the personal protective equipment that health workers are using, such as masks and aprons, as well as carers and the patients themselves.
In terms of the scale, it’s massive.
We’ve all seen discarded masks on the streets, and in 2020 alone, 4.5 trillion additional disposable masks were thrown away by the public, resulting in six million extra tons of waste.
In our own analysis, looking at the extra waste loads at healthcare facilities, we found that it increased by up to four times during this pandemic and in facilities that didn’t segregate their healthcare waste, the increase was 10 times greater, which really shows that segregation is very important because only 20 per cent of healthcare waste is infectious and hazardous and requires extra care and treatment.
At the same time, we know that one in three care facilities globally before the pandemic lacked ways to safely segregate and treat waste.
On the sub-Saharan continent, this is two in three health care facilities.
So we have the combined double burden of already weak systems for waste management, coupled by the fact that health workers are extremely overburdened with increased patient loads and can’t manage the existing waste, let alone extra waste.

Vismita Gupta-Smith: As you described, medical waste is not a new problem. Tell us about the health impact, the impact on our health, as well as our planet’s health of this medical waste.

Dr Montgomery: There’s many adverse impacts from unsafely managed and treated healthcare waste, so needle-stick injuries cause many hepatitis B and C infections every year.
There’s also other infectious pathogens that are spread through bandages and other infectious waste, some of which are not treatable through existing antimicrobials.
There’s also all the dangers that are involved with burning waste and in particular plastic can lead to the release of dioxins and pure ends, which are carcinogenic and can harm not only those working in healthcare facilities, but those vulnerable communities that surround where healthcare waste is being burned.
Lastly, there’s a lot we don’t know about plastics and the environment, and increasingly we’re finding that micro-plastics are showing up in our waterways and our food systems. These are all concerns about healthcare waste.

Vismita Gupta-Smith: The scale of this problem seems huge. What can we do as individuals to reduce this medical waste?

Dr Montgomery: There’s three main things the public can do.
The first is to become aware and take it as your personal responsibility to understand the amount of waste you’re generating and how you can reduce those volumes to begin with.
So, for example, gloves are not needed in many situations. So reducing things that aren’t needed can reduce volumes of waste. The second is to be a conscious consumer and actively seek high quality, reusable personal protective equipment (PPE).
In particular in high income countries increasingly, we’re finding that very high quality reusable masks are available and those would be preferred.
In places where high quality, reusable masks are not available and disposables are the only option it is also important to think about recycling these masks, and increasingly we’re finding that recycled masks are being put to use to make roads and other building materials.
Lastly, the packaging. It’s important to try to seek products that use more ecological packaging and paper-based packaging instead of plastics.
I want to emphasise that the government also has important role by creating and implementing strong healthcare waste policies that are backed by regular budgets and financing in supporting the recycling sector so all that waste that is not infectious can be put to other uses. Lastly, in investing in high quality, locally manufactured PPE, which not only can reduce carbon emissions from transporting goods long distances, but can also help fulfill commitments that were recently made around low carbon and sustainable health systems. So in short, we can no longer afford to ignore the impact on the environment.
The good news is it’s possible to prevent and protect against Covid-19 and then environment, and I call on each of you to do your part. – WHO