HEALTHCARE SOLID WASTE

MANAGEMENT STRATEGY DURING

COVID PANDEMIC

PROJECT
By

MAYAN YADAV

SCHOOL OF INFRASTRUCTURE
INDIAN INSTITUTE OF TECHNOLOGY BHUBANESWAR
BHUBANESWAR -751013, ODISHA

NOVEMBER, 2021
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 HEALTHCARE SOLID WASTE
MANAGEMENT STRATEGY DURING
COVID PANDEMIC

B-TECH PROJECT REPORT

(Part- 1)
Submitted in the partial fulfilment for the
Requirements of the degree of

BACHELOR OF TECHNOLOGY
In

CIVIL ENGINEERING
Submitted By:-

MAYAN YADAV
Roll No 18CE02032
Under the Guidance of

Dr.Remya Neelancherry

SCHOOL OF INFRASTRUCTURE
INDIAN INSTITUTE OF TECHNOLOGY BHUBANESWAR
BHUBANESWAR -751013, ODISHA

NOVEMBER, 2021

3
4
 INDIAN INSITUTE OF TECHNOLOGY BHUBANESWAR

CANDIDATE’S DECLARATION

We hereby certify that the work which is being presented in the project entitled “Healthcare

Solid Waste Management Strategy During COVID Pandemic”, in the partial fulfillment

of the requirement for the award of the Degree of Bachelor of Technology in Civil

Engineering and submitted in the School of Infrastructure, Indian Institute of Technology

Bhubaneswar, is an authentic record of my own work carried out during a period from May

2021 to November 2021 under the supervision of

Dr. Remya Neelancherry, IIT Bhubaneswar.

The matter presented in the project has not been submitted by me for the award of any degree

of this or any other Institute/ University

MAYAN YADAV (18CE02032)

This is to certify that the above statement made by the candidates is correct to the best of our

knowledge.

Signature of Supervisor (S) Signature of H.O.S.

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 ABSTRACT
Since the outbreak of novel coronavirus (COVID-19), hospitals, quarantine centres, isolation
wards and home quarantine are producing a huge volume of bio-medical waste (BMW)
globally. The personal protective equipment, testing kits, surgical facemasks, and gloves are
contributing the major proportion of waste. Dispensation of new category of BMW (COVID-
waste) is of great global concern to public health and ecological sustainability if handled
inappropriately. It may cause rampant escalation of this lethal disease as waste acts as a
vector for COVID virus, which survives up to 7 days on COVID-waste. Proper disposal of
COVID-waste is therefore the need of the hour to lower the threat of pandemic spread.
Henceforth, in the present article of ‘healthcare waste management strategies’ from waste
classification & separate collection to various physical and chemical treatment steps have
been reviewed. Furthermore, Indian strategy and downsides with multiple lacunas which
needs imperative attention has been extensively discussed. Finally, measures and innovative
interventions, which if effectively adopted can be boon for COVID scourge. This article can
be of great significance to the strategy development for preventing/controlling the pandemic
of similar episodes in the future.

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 ACKNOWLEDGEMENT
I would like to express my sincere thanks to my guide Dr. Remya Neelancherry,
for her continuous guidance throughout the course of this project. Her immense
knowledge and experience has motivated me throughout the project.

I am grateful to her for providing me with this opportunity of gaining

invaluable learnings and for her constant encouragement and support.

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 Content
Page no.
Candidate's Declaration 5
Abstract 7
Acknowledgement 9
Content 11
List of Figures 13
List of Tables 15

CHAPTERS
1. Introduction……………………………………………………….. 17
1.1 Classification of healthcare waste 18
1.1.1 Volume of healthcare waste generation 19
1.1.2 Raw materials associated with COVID healthcare waste 20
1.2 Waste segregation 21
1.3 Waste Transportation 23
1.4 Healthcare solid waste treatment 23
1.4.1 Incineration 23
1.4.2 Pyrolysis……………………………………………… 24
1.4.3 Autoclaving 25
1.4.4 Microwave 25
1.4.5 chemical disinfection 26
1.4.6 Landfilling 27
1.4.7 Ultraviolet(UV) Light 28

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2. Indian scenario……………………………………………………. 29
2.1 Key Findings……………………………………………… 29
2.2 Challenges and gaps in BMW management in India 31
2.3 Measures 33
2.3.1 Waste Recycling 34
2.3.2 Possible innovative solutions 35
2.3.3 Learnings from China 36
2.3.4 Future prospects 36

Forthcoming Works 37
References 39

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 LIST OF FIGURES

Figure. No. Details of Figure Page No.

1.1 BMW/hospital waste generation to disinfection 17

And disposal practices

1.2 COVID specific landfilling 28

2.1 Guidelines & Directions by CPCB for COVID-19 30

BMW management

2.2 Mask, Hand gloves, PPE kits dumped carelessly on roadside 32

2.3 Fibre of Banana tree used to make Mask 35

2.4 Brick 2.0 made up of Recycled PPE 35

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 LIST OF TABLES

Table No. Details of Table Page No.

1.1 Classification of different types of medical waste 18

1.2 Properties of Healthcare Waste 19

1.3 Average waste generation rates by type of facility 19

1.4 Back-calculation results for four layer pavement system 20

1.5 Healthcare Materials, Their constituents, use, storage and Treatment 21

1.6 Colour coding of biomedical waste segregation disposing 22

2.1 Top & bottom Ten COVID-19 waste generator states/UTs 30

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 CHAPTER 1
INTRODUCTION
Healthcare waste constitutes the waste generated by medical laboratories, healthcare, and
biomedical research facilities. Improper treatment of this waste poses severe risks of disease
transmission to waste pickers, health workers, patients, and the community through exposure
to infectious agents. Poor management of the waste emits deleterious and harmful
contaminants into society. However, contamination of highly contagious agents like the
COVID-19 virus has created enormous instability in healthcare waste handling and
subsequent recycling due to the quantity of the waste generated and its infectious nature.

Figure 1.1: BMW/hospital waste generation to disinfection and disposal practices

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1.1 Classification of healthcare waste

Table 1.1: Classification of different types of medical waste

Out of these healthcare wastes, 15% are considered as hazardous (Infectious waste,
Pathological waste, Sharps Pharmaceutical waste, Genotoxic waste, Chemical waste,
Radioactive waste) and 85% as non-hazardous (Paper and cardboard, Packaging, Food
waste, Aerosols (spray)). And it is expected that the hazardous waste component may
increase further because of COVID-19 waste from medical sectors.

In addition to material constituents, an understanding about the properties of healthcare

waste is required to select suitable options for managing healthcare waste, identifying
treatment technologies, and setting necessary parameters for operation of treatment systems.
The moisture content, heating value, percentage of combustible materials, and bulk densities
of healthcare waste in general conditions are summarised below:-

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 Table 1.2: Properties of Healthcare Waste

1.1.1 Volume of healthcare waste generation

The average healthcare waste generation rates by type of medical facility under normal
conditions are shown in Table below. According to this information, the highest generation of
healthcare waste happens in maternity centres and hospitals.

Table 1.3: Average waste generation rates by type of facility

The peak growth rate of hazardous medical waste (approximately 240.0 t per day) in Wuhan
(China) has surpassed the maximum daily incineration capacity (49.0 t per day) from its
typical generating quantity of 40.0 t per day. According to published estimates, the volume of
hazardous waste in Hubei Province, China, increased by 600 percent during the pandemic
period. According to Bridges, Southeast Asian countries could face an additional 1000 tonnes
of hazardous waste every day. The daily hazardous medical waste in Manila, Philippines, has
reached 280 t, while in Jakarta, it has reached 212 t. According to the equation below, each
infected person is expected to produce around 3.40 kg of hazardous medical waste per day.

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Table 1.4: Estimated COVID-19 hazardous waste volume for some selected countries

1.1.2 Raw materials associated with COVID healthcare waste and their impacts &
effects

Each month of the epidemic, the WHO estimates that 76 million gloves, 89 million medical
masks, and 1.6 million medical goggles will be required.
More precisely, PPE kits, are made using various raw materials. Patrício et al. reported that
plastics are the most preferred raw material used in the healthcare sector owing to their
availability, flexibility, and lightweightedness. Various types of plastic are used in the
production of PPEs which are polyethylene terephthalate (PET), high-, low-, and linear-low-
density polyethylene (HDPE, LDPE, and LLDPE), polyethylene (PE), polyvinyl chloride
(PVC), polystyrene (PS) & polypropylene (PP). The coverall used are made from non-woven
cloth, which feels like cloth but is actually made of PP. Masks are made of non-woven

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materials containing PP and PE. These materials disintegrate into small micro-plastic
pieces. Various PPEs end up as ocean plastics debris, and as per estimation, most of the
debris reached into the ocean as end plastic.
Among the healthcare materials, gloves, masks, coverall/gowns/aprons, and head and shoe
covers are single-use and discarded with proper guidelines. The goggles and face shield are
also single-use but may be reused depending on the raw material quality and disinfection
property (either decontaminated or not). Another PPE, i.e., gloves, also fall in single-use
plastics and pose a substantial danger to the environment. During the pandemic, PPE kit used
in hospitals and isolation centres should be collected and disposed of according to biomedical
waste management (BMW) rules, as shown in Table 1.5.

Table 1.5: Healthcare Materials, Their constituents, use, storage and Treatment

1.2 Waste segregation

The segregation of biological waste from solid waste is a critical stage in COVID19 waste
management. In order to alleviate the strain on incinerators built to burn BMW.
It includes the classification and separation of various forms of waste at the place of origin.
As a result, if recyclable waste is segregated from other non-hazardous waste in an efficient
manner, waste will be reduced greatly. To segregate infectious waste, carefully labelled
containers with the type and weight of the waste are utilised. Infectious waste is typically
stored in double-layer plastic bags, plastic-lined cardboard boxes, or other leak-proof
containers that meet specific performance requirements, followed by sharps and fluid

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elimination. Color-coding is used to make it easier to distinguish between different forms of
waste. In most nations, infectious waste is usually contained in red or yellow bags

Table 1.6: Colour coding of biomedical waste segregation disposing (source: CPCB)

Appropriate measures should be taken to establish the optimum placement and labelling of
these containers to improve segregation efficiency and avoid improper container use. In
regions where both types of waste are produced, it is common to install general trash
containers alongside infectious waste containers, resulting in effective and better segregation.
It's also a good idea to have a sufficient number of waste bins. In places where several
containers are located, posters with illustration schemes for appropriate segregation are
occasionally mounted to walls; these might serve as reminders to health workers about the
objectives of utilizing specific containers for specific waste.
Secondary leak-proof containers are preferred to prevent leakage from primary containers
during transportation.
1.3 Waste transportation
In-house transport and storage

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  On-site transportation should take place during off-peak hours.
 Use Established routes to prevent patient and staff exposure and to reduce the loaded
carts passage through patient’s and other clean areas.
 Regular transportation routes and collection times should be reliable and consistent.
 Infectious waste should not be collected at the same time as general waste or with the
same trolley.
 Storage should be kept away from patients and the general public, as well as properly
ventilated and inaccessible to vertebrate pests.
 Transport personnel should wear appropriate personal protective equipment, such as
gloves, strong and closed shoes, overalls, and masks.
Transportation to offsite treatment
 Provide regular and expanded waste collection services.
 appointed healthcare waste service provider should be specialised and licensed
 grant temporary license to competent waste management service provider
 Provide and instruct proper use of PPE to collection staff
 direct transportation to the treatment or duly authorized disposal site
 Maintain social distance and keep windows open of collection vehicle, transfer
station, etc.
 Disinfect collection vehicle
 OSH (collection workers)
 Adapt collection vehicle to transport healthcare waste safely
 For waste tracking, use a vehicle with GPS; barcoding systems for bag/containers
containing HCW; label vehicles with ‘Biohazard’ or ‘Cytotoxic’ symbols
 collection vehicles loading area should be non-absorbent & capable of being sealed,
and separated from driver’s cabin

1.4 Healthcare solid waste treatment during COVID 19 pandemic:

1.4.1. Disinfection using incineration

 Incineration is extensively used in developing countries because it is simple,
safe, and effective way of disposing medical waste
 reduces volume of hospital waste by 85 to 90%
 Those Biomedical waste are incinerated, which are incapable of recycling and
non-reusable and should not be disposed in landfills.
 High-temperature range between 800 °C to 1200 °C>>in presence of oxygen
 COVID-waste are incinerated at temperature > 1100 °C
 Completely kills the pathogen and burns up to 90% organic matters.
 possibilities of survival of pathogens is high in case of incomplete burning
 Occasionally, Depending on the volume reduction of COVID-waste, residual
mass is re-incinerated with a fresh charge
 incineration process cannot be utilized to dispose radioactive waste

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  COVID19 waste demands the development of municipal solid waste
incinerator for disposal of medical waste
 After combustion of BMW, a significant volume of bottom ash is produced
that could be disposed in sanitary landfills
 despite toxic emissions and bottom ash being major challenges, it is the best
available medical waste disposal method that could give on-site solution
 Problems linked with incineration can be corrected by installing end-of-pipe
treatment (such as bag filters, wet scrubbers, fixed bed adsorption system)

pros
completely destructs COVID-19 hazardous waste
operation technique is Simple with ∼90.0 % volume
reduction of waste
During incineration process, a large quantity of heat
energy is also released that could be used to generate
electricity
No post treatment needed for final disposal
cons
incomplete combustion and improper
management ,leads to release of several
toxic pollutants like dioxin and furans
High energy requirement
Nitrogen oxides, and range multiple
volatile substances (e.g. metals, halogenic
acids, products after incomplete
combustion)
emission of carcinogens
Particulate matter, and solid residues in
the form of ashes, which are toxic
flue-gas treatment facility also needs to
installed with incineration facility that
creates overhead costs for the operator.

1.4.2 Pyrolysis
 In comparison to incineration, this is a more technologically sound technique
 thermal decomposition of organic waste occurs at high-temperature ranging
from 400 to 700 °C in the absence of oxygen
 Although it is generally used in industries for charcoal and fuel production
from agricultural waste, waste rubbers, tyres, biomass and plastics, it can also
act as the most dependable disinfection technique for biomedical wastes
 Pyrolysis is a valuable method of disposing of PPEs because it is suggested
that the PPE kits can be repurposed for the production of biofuel.

Pros Cons
complete destruction of hazardous waste Specific requirement needed to be defined
along with toxins (i.e. dioxin, furan) for heat value of the loaded wastes
Savings in energy Higher capital cost

1.4.3 Autoclaving

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  Autoclaving uses wet sterilization method for decontaminating of pathogenic
microorganisms from any recyclable instruments mainly in hospitals.
 Sterilization method uses the equipment known as autoclave, where full-steam
penetrates the waste or contaminated material at temperature (minimum) of
121 °C and pressure 100 kPa or 1 bar. For complete disinfection of waste
weighing about 5–8 kg, at least 60-min of autoclaving cycle is required
 It is a low thermal treatment process where waste materials are treated with
saturated and controlled steam in a given time
 Research laboratories and hospitals generally use autoclaving because multiple
equipment are there, which need to be utilized more than once
 On-site sanitization using autoclaving can reduce waste load significantly
which is further treated in common BMW treatments and disposal facility

Pros
Suitable for solid wastes, bedding and
personal protective equipment, clinical
laboratory waste, reusable instruments,
waste sharps, and glassware
Low-heat thermal processes emancipate
significantly less air pollution than high-
heat thermal processes
No specific pollutant emissions limits for
autoclaves and other steam treatment
systems
Waste does not require further processing, it
can be disposed on a municipal landfill as it
is disinfected and not hazardous anymore
Available in various sizes from lab
autoclaves to large autoclaves used in large
waste treatment facilities
Cons
Incapable of treating volatile and semi
volatile organic compounds,
chemotherapeutic waste, mercury, other
hazardous chemical and radiological waste,
large and bulky bedding material, large
animal carcasses, sealed heat-resistant
containers
Odour can be a problem if there is no
sufficient ventilation
Poor segregation of waste may lead to the
emission of low levels of alcohols, phenols,
formaldehyde,
and other organic compounds into
environment
autoclave Treated waste retains its physical
appearance
further processing of waste is required for
final disposal

1.4.4 Microwave disinfection

 infectious solid waste is Exposed to microwave radiation
 during process, electromagnetic radiation creates a thermal effect to deactivate
the microbial colony. Microbial population destruction by the intermolecular
heating takes place at 2450-MHz frequency and a wavelength of 12.24 cm
 This method is applied on dental instruments, dentures, urinary catheters, soft
contact lenses etc.
 The technique is effective on various kinds of microorganism (such as fungi,
mycobacteria, bacteria, lipophilic or hydrophilic viruses)

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  Microwave devices under controlled process can certainly inactivate COVID-
19

Pros Cons
appropriate for solid wastes, bedding and Very limited volume reduction & no weight
personal protective equipment, reusable reduction
instruments, waste sharps, glassware, and
clinical laboratory waste
A fully closed microwave unit can be Waste requires further processing for final
installed in an open area, and used with a disposal
HEPA filter to prevent the release of
aerosols during the feeding process
The odor is reduced, except in the Treated waste from an autoclave microwave
immediate vicinity of the microwave unit unit retains its physical appearance
A large-scale, semi continuous microwave Volatile and semi volatile organic
unit is capable of treating about 250 kg/hour compounds, chemotherapeutic waste,
(3,000 tonnes per year) mercury, other hazardous chemical waste
and radiological waste can’t be treated in a
microwave
Waste does not need to be further processed, Sometimes autoclaving is required due to
it can be disposed of in a municipal landfill low spectrum of disinfection process
as it is decontaminated and is no longer
hazardous.
because of low action temperature, Less
energy required
Can be used as mobile on-site treatment
facility
Less environmental impacts due to low gas
emissions & residual waste

1.4.5 Chemical disinfection

 Treating waste for 30 min. with 2.19 mg/L residual chlorine dioxide or 0.5
mg/L residual free chlorine can prominently inactivate the SARS viruses
 Chlorine dioxide treatment provided better antimicrobial effects compared to
UV radiation and ozone disinfection
 Derivatives of chlorine-based disinfectants (such as chlorine dioxide, sodium
hypochlorite, and liquid chlorine) are widely accepted as hospital waste
disinfection practice
 Wang et al. (2020d) reported that the 6.5 mg/L residual chlorine is required for
septic tank with a 1.5-h longer contact time and faecal coliform colonies less
than 100 per litre.
 Patients infected with COVID-19 make extensive use of respirators as an
external respiratory support system. These devices should be infused for 30
minutes in 75% alcohol.

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  Clinical wastes and wastewater have to be dealt with suitable disinfectants so
that waste and wastewater ought to be free from infectious viruses before
being discharged into sewage.

Pros
Effective control of virus through the
destruction of its spores
Quick and steady operation procedure with
effective and broad disinfection spectrum
feasible during manual waste handling (i.e.
collection, storage, and
transportation)
Cons
No reduction in the waste volume
Absorption of minute particles of chemical
disinfectants into skin can
be carcinogenic
incompatibile with cellulose-based materials
and inability to penetrate targeted surfaces

1.4.6 Landfilling
 Burying aggregated waste in a close pit (2 × 3 m) with a clay or geo-synthetic
membranes on the floor
 Before disposing off COVID-19-infected healthcare waste into landfill, the
waste is treated and disinfected properly by various wet or heat methods
inclusive of autoclaving and dry heat
 treatment like irradiation methods using action of ultraviolet or microwave
radiations
 After disposing of waste in the pit the daily cover should be filled with fresh
soil or a mixture of soil and lime
 The top layer of the hole should be sealed with cement or embedded with wire
mesh
 Above the wire mesh embedded cement cover, 50 cm of soil cover should also
be given.
 The pit areas should be secluded by providing wire fencing and should be out
of animals or humans reach
 Such burials of contaminated waste may be considered during an outbreak
 When waste generated exceeds the maximum incineration capacity
 The threat of groundwater pollution is high
 a simple solution for nations without incineration or heat treatment solutions
for large quantities of hazardous waste produced

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Figure 1.2: COVID specific landfilling

Pros Cons
preferred for poor and underdeveloped Poor waste management practices like open
countries disposal of untreated infectious waste
material into water bodies, land surface, or
open pits
simplest method of waste disposal groundwater contamination

1.4.7 Ultraviolet (UV) light

 electromagnetic wavelength between 200-400 nm
 three types of UV light, i.e. UV-A (315–400 nm), UV-B (280–315 nm), and
UV-C (200– 280 nm)
 A 200–300-nm wavelength has characteristics to destruct the structure of
DNA and RNA of microorganisms (such as bacteria and viruses) which inhibit
the protein synthesis.
 253.7 nm is considered optimal for ultraviolet disinfectant.
 Corona virus was reported to be inactivated by UV radiations at 254 nm and
heat treatment of 65 °C

Pros Cons
inadequate penetration in solid and liquid cost is low as compared to chemical disinfectant
materials like chlorine

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 CHAPTER 2
INDIAN SCENERIO

2.1 Key findings: 

 Between May 1st, 2020 and May 10th, 2021, India generated 45,954 tonnes of
COVID-19-related biomedical waste, with an annual average generation of 126
tonnes per day. This was in addition to the 614 tonnes per day of biomedical waste
generated on a regular basis, indicating a 20% increase in overall biomedical waste
generation.
 The country’s treatment capacity is only 754 tonnes per day
 22 of the 35 states and union territories generated more BMW than their treatment
capacity
 The COVID-19 vaccine program in India has produced 268 million syringes and
needles and more than 18 million glass containers, all of which will be considered
COVID-19-related waste. By the end of the vaccination, India will produce more than
1.3 billion syringes and needles and more than 100 million glass containers.
 As per CPCB, In India, there are 2907 hospitals, 20,707 quarantine camps, 1539 sample
collection centres, and 264 testing laboratories are involved in generation of COVID-19 waste
 As per CPCB, approximately 587 mt of BMW was generated daily in 2018 and it is likely
that India will generate nearly 775.5 mt of medical waste per day by the year 2022
 A sudden increase in BMW production may create a critical situation for states that
have incinerators with a capacity of 70% or greater for waste treatment. As a result,
the government should use alternative treatment technologies (autoclaving,
mechanical, and chemical disinfection) to reduce waste treatment burden
 In the early months of the COVID-19 period (June–October 2020), the generation of waste
rose from 3025 mt/month in June to 5597 mt/ month in October 2020. However, there is a
decreasing trend in the next 2 months, that is, 4864 mt/month in November and 4527
mt/month in December 2020. The quantity of COVID-19 waste was extremely high in July
and August months probably due to BMW from households and quarantine centres that may
not have been segregated and general waste was mixed with BMW. This increase put pressure
on the facilitators of BMW disposal
 50% of the States/UTs have inadequate disposal facilities
 Latest statistics tells that Maharashtra, Kerala, Gujarat, Andhra Pradesh, and Delhi are the top
five BMW generator states in December 2020.

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 Table 2.1: Top & bottom Ten COVID-19 waste generator states/UTs

 CPCB had been pro-active in issuing guidelines related to COVID-19 biomedical

waste 
 CPCB and SPCB are collaborating to reduce COVID-19 waste by developing
BMWM rules and guidelines. In addition, all stakeholders, such as CBMWTFs and
urban local bodies from various States/UTs, are likely to apply BMWM rules. All
COVID-waste is classified as hazardous BMW. As a result, the CPCB proposed
management guidelines. As illustrated below

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 Figure 2.1: Guidelines & Directions by CPCB for COVID-19 BMW management
2.2. Challenges and gaps in BMW management in India
 Due to technical, practical, and financial constraints, India is struggling with poor
BMW practises; additionally, the COVID-19 pandemic has hit us hard by this sudden
increase in the volume of medical waste.

 According to a recent study, 70% of BMW produced in India is incinerated, while

30% is either illegally dumped or found as common garbage on the roads (Singh and
Saha, 2020)

 small towns and villages lack proper facilities to treat COVID-19 waste; they either
depend on neighbouring cities or use deep burial method

 As per the BMW Rules, only 40% of HCFs are authorised. Nevertheless, 27,301 HCFs
are in violation of the provisions.

 Only 12 states/UTs are in line with the regulations when CBMWTFs are upgraded to
comply with new emissions. Similarly, one of the most important reforms in BMW
rules, 2016, regarding barcode system was also not implemented well

 government strictly restricted the practice of deep burials, however, 23 States/UTs are
still using deep burial methods

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 Out of all States/UTs, 70% have not well-established systems of regular monitoring of
HCFs and CBMWTFs. New rules of CPCB (2020b), directs the district level
monitoring committee to formulate strategy to monitor these facilities

 India has only 200 CBMWTFs & 225 captive incinerators for waste treatment; these
facilities are insufficient and working at 60% limit, which is a 15% increase since
March 2020

 Only about 78 percent of India's total 200,000 tonnes of BMW was treated by
CBWTFs in 2017. The remainder were treated and disposed of in isolated treatment
facilities or by deep burial. The waste generated during pandemic is an addition to the
average BMW. This undoubtedly places a strain on India's BMWM system.

 Maharashtra is the highest COVID-19 waste generator state, but it lacks an adequate
existing treatment plant; therefore, it developed "TSDFs" (Treatment, Storage, and
Disposal Facilities) in Mumbai, Pune, and Nagpur.

 Delhi accounts for 11% of India’s daily COVID-19 BMW generation. However, at
present, Delhi has only two incinerators, and 70% of their capacity is already utilized

 Covid-related biomedical waste is produced not only in hospitals but also in homes.
Only 20% of the patients required hospitalisation. Eighty percent of Covid patients
are recovering/have recovered at home. There is no proper facility for managing
biomedical waste generated at home; it is dumped in regular municipal waste.

 Issues with Local Hospitals: local hospitals are not as updated in facilities and
infrastructure and hence, don’t have proper biomedical waste management facilities.

 Municipal Workers at Risk: large amount of covid waste being generated at

home, makes municipal workers vulnerable. Data shows that these workers too
have been impacted extensively amid the pandemic, a lot of them have died too.

 Lack of Awareness: People are aware that how to segregate the waste at source

 Issue with the Waste Management Rules: The legal provisions are only intended
to address biomedical waste in hospitals. They provide no information on how to
manage such waste at home or in any other location other than hospitals.

 Unequal Distribution of CBWTF: There are approximately 200 Common

Biomedical Waste Treatment Facilities (CBWTF) in India, but they are concentrated
in a few cities/districts such as Mumbai and Delhi. However, in some remote areas
of the country, no such treatment facility exists at all. Maharashtra has the highest of
these facilities (29), followed by Karnataka (26) and Gujarat (22). (20). Kerala,
which had the highest daily generation rate, had only one CBWTF.

 Lack of Accurate Data: During the first wave of the pandemic, the CPCB was
quick to provide clear guidelines as well as a mobile app for collecting data on

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 biomedical waste generation. However, with the occurrence of the second wave, the
impact is so severe that hospitals are no longer able to upload any data.

Figure 2.2: Mask, Hand gloves, PPE kits dumped carelessly on roadside

2.3 Measures

 Temporary transit and treatment centres must be established to provide adequate

capacity to treat the increased BMW. Infectious and contagious medical waste should
be transported directly to treatment facilities or, at the very least, transferred and
amalgamated to transit facilities.

 Make systems for tracking and collecting waste-related data. Inadequate quantitative
waste-management data continues to be a major impediment to the development and
implementation of waste disposal policies in India. Some good solutions include the
CPCB's COVID-19 Biomedical Waste Management app and the Punjab government's
efforts to track biomedical waste using barcodes.

 India should focus on establishing more CBMWTFs and should work on improving
connectivity up to the Primary Health Centres

 States/UTs that generated an average of 100 mt/month COVID-19 waste within the
preceding seven months need to be given high priority. Second, all states and
territories should have classified their districts as low, medium, or high priority based
on BMW generation status and treatment capacity.

 Sterilwave, an ultra-compact technique, can also aid in the treatment of healthcare

waste because it effectively kills the COVID-19 virus on-site, preventing community

34
 transmission during the handling of healthcare waste. This method can reduce waste
weight, and treated waste can even be managed as regular municipal waste.

 Monitoring system: Stringent record keeping of waste created, bags tagged with
barcodes and GPS and regular visit to monitor compliance at all levels

 Increase the number of the hazardous waste disposal facilities. onsite waste burial pits
and mobile incineration facilities can be economical and safe disposal options

 Resumption of previously postponed waste management services. Recycling, waste

collection and disposal, and hazardous waste incineration should be restarted
immediately to protect against further contamination and pollution caused by
mismanaged waste services.

 alternative technologies like autoclaves and burn incinerators with high temperatures,
may help to reduce the risk of exposure to infectious healthcare waste
Since governments and authorities worldwide have prioritized public health protection from
viral infection, other critical societal and environmental aspects have been largely
overlooked. The irony is that some unnoticed elements, if not properly managed, will
eventually cause a massive disruption in societal and ecological well-being. In the midst of a
global crisis and challenging circumstances, it is critical to make every effort to take proper
action for the waste management sector while maintaining the same level of public health
safety.
2.3.1 Waste Recycling
 The composition of healthcare solid waste during the COVID-19 pandemic is more or
less similar to that produced under normal conditions, with the exception of the
production of a massive amount of plastics/micro-plastics. The composition of
healthcare solid waste is crucial because it determines its ability to be recycled and
managed sustainably, which is critical during the current outbreak

 On used PPEs, techniques such as ultraviolet germicidal irradiation (UVGI), thermal

or heat treatment, and chemical disinfection are thought to be effective. Furthermore,
reusing PPEs through such disinfection techniques are energy efficient, economical,
and environmentally sound processes, as they can reduce waste volume by 93.0
percent and natural resource consumption by 28.0 percent. Instead of producing more
new PPEs, integrating reusable PPEs will be a viable option in response to pandemic-
induced PPE waste pollution and global deficiencies in the personal protective supply
chain.

 The vH2O2 and hot air disinfection process has the potential to be used for the
reprocessing of COVID-waste; however, it is preferable to overcome existing
limitations such as the reduction in oxidant concentration in the presence of specific
materials and the degree of decontamination in all layers of the trapped viruses as
soon as possible.

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  Single PPE can be used 4 times if stored in paper bags and kept out of reach of public

 Because Visors and goggles are made of hard plastic they can be prominently
disinfected by immersing in 1% sodium hypochlorite or 70% alcohol for 10 min

 N95 masks can be reused for 3 times

 To prevent pilferage, gloves and surgical masks should not be reused and should be
discarded in proper colour coded bags after mutilation.

 Latex gloves, full plastic PPE, a splash-proof apron, plastic coverall, Hazmat suites,
face shields, and nitrile gloves must be dumped into red bags for sterilisation before
recycling as plastic enveloped bricks or plastic for road construction. PPEs containing
plastic should be shredded and recycled at Material Recovery Facilities (MRFs) by
SPCB-approved plastic waste recyclers, or They can be recycled as refuse derived
fuel (RDF) for co-processing or energy recovery (through Waste to Energy Plants or
road making)

2.3.2 Possible innovative solutions

The cost of materials needs low and biodegradable nature of healthcare materials is beneficial
for environment.
The fibre from the banana tree was used to make the mask. In the Philippines, abaca (musa
textile) is used to make teabags and banknotes, and it is also used to make masks during
pandemics. It has the same durability as polyester and decomposes in two months.

Figure 2.3: Fibre of

Banana tree used to make Mask

Eco Eclectic Technologies make a “Brick 2.0” which is made by recycled PPE face masks.
This can solve the problems of waste disposal and provide a value-added product. The

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formulations of bricks are 52% of shredded PPE materials, 45% paper sludge, and 3%
binding agent. It is waterproof, is fire-resistant, and costs 2.8 INR per piece.

Figure 2.4: Brick 2.0 made up of Recycled PPE

Nano-based technologies for healthcare materials of COVID-19 for manufacturing and

treatment
Nano-based technology, also known as nanotechnology, has emerged as an appealing method
of waste management. Nano materials are materials with nano scale dimensions ranging from
1 to 100 nm in size. Nano materials can decontaminate waste in an appropriate and efficient
manner, and it is also expected that nanotechnology will aid in waste management at a low
cost. The use of a few selected nano materials has been reported to reduce energy demand to
some extent. Carbon nanotubes (CNTs), metal-based nano adsorbents, and zeolites adsorb
toxic organic compounds from wastewater, allowing them to be decontaminated. COVID-19-
generated healthcare waste includes both liquid and medical solid waste. The wastewater that
has been contaminated with SARS-CoV-2 can be disinfected using nano adsorbents.
2.3.3 Learnings from China

 In Wuhan (China), local authorities introduced “mobile incinerator” treatment

facilities to prominently treat discarded PPEs and other disposable gears.
 To counter the challenges associated with hazardous waste management, schemes
such as centralized disposal (i.e., heat treatment or incineration, cement kilns) and on-
site emergency treatment (i.e., domestic incineration, industrial furnace, mobile
incinerator) produced good outcomes
 large spaces in the premises of hospitals (usually the parking space) has been
temporarily utilized for storage, disinfectant spraying, and their seamless
transportation to the treatment facility
 innovation of mobile treatment facilities like Sterilwave SW440 microwave with a
capacity of up to 80 kg/h
 autoclave, steam, dry heat, microwave and chemical disinfection techniques were
incorporated to tackle emergency situations in relation to waste management

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  China disseminated guidelines where cement or other industrial furnaces can be
utilized to treat the COVID-19 hazardous waste. Based on such an approach, the
country increased its emergency hazardous waste disposal level by 6,067 tonnes per
day from its previous capacity of 4,903 tonnes per day.
 Developing countries such as Bangladesh and India can adopt similar techniques as an
emergency and post-pandemic treatment option for the huge quantity of hazardous
waste being generated.

2.3.4 Future prospects

Biomedical waste management is difficult in developing countries such as India, and
COVID-19 has added to the burden on biomedical waste management systems. The prudent
use of personal protective equipment (PPE) kit can help to reduce waste load. The application
of the waste to energy concept can yield beneficial results in the direction of energy
generation from waste, such as gasification. The use of biodegradable materials in the
manufacture of PPE kits is a sustainable waste management option. On-site waste treatment
facilities can easily reduce the risk of contamination, aiding in the creation of a clean
environment. More research and development is required so that innovative solutions to
future challenges can be easily implemented.

Forthcoming Works
The works in the next semester would mainly focus on experimentation part, such as
performing pyrolysis technique on different COVID related waste, and denoting the
proportions giving the most effective outcome. In addition, I will also do hands on with other
treatment methods, like microwave, incineration, autoclave and UV, and try to come up with
some new & unprecedented results.
Discovering more new treatment options and their applicability in developing nations like
India. I would also like to conduct more research on recyclability of healthcare waste.

38
39
References
 Coronavirus disease 2019 (COVID-19) induced waste scenario: A short
overview; Md. Sazzadul Haque, Shariar Uddin

 Current perspectives of biomedical waste management in context of COVID-

19”; Malini R. Capoor and Annapurna Parida

 Disinfection technology and strategies for COVID-19 hospital and bio-medical

waste management; Sadia Ilyas, Rajiv Ranjan Srivastava, and Hyunjung Kim

 Challenges, opportunities, and innovations for effective solid waste management

during and post COVID-19 pandemic; Hari Bhakta Sharmaa, Kumar Raja
Vanapallib, VR Shankar Cheelaa

 Waste Management during the COVID-19 Pandemic From Response to

Recovery; United Nations Environment Programme

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 COVID-19 pandemic and healthcare solid waste management strategy – A mini-
review; Atanu Kumar Das, Md. Nazrul Islam, Md. Morsaline Billah, and Asim Sarke

 The Big Picture: Biomedical Waste Management during Covid Pandemic;

Drishtiias
 Biomedical Waste and COVID-19 in India and the World: Are We Ready?;
Agrawal Anoli 1, Dodamani Arun S 2, Vishwakarma Prashanth 3, Agrawal Aniket S

 A Waste-Ful Enterprise: COVID-19 And India's Waste Management Story;

Tanvi Banerjee

 Managing Covid-19 Biomedical Waste in India; CSE webinar on “Managing

COVID-19 biomedical waste in India
 Updates on biomedical waste management during COVID-19: The Indian
scenario; C.S.Shastrya ShivakumarHiremath

 COVID-19 and waste management in Indian scenario: challenges and possible

solutions; Richa Kothari, Tanu Allen, Sohini Singh, and Vineet Veer Tyagi
 Assessment of bio-medical waste before and during the emergency of novel
Coronavirus disease pandemic in India: A gap analysis; Rahul Rajak , Ravi Kumar
Mahto, Jitender Prasad and Aparajita Chattopadhyay

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