Managing Bio-Medical Waste During a Global Pandemic
April 9, 2020

Infectious materials are becoming a significant concern for hospitals as the COVID-19 pandemic continues to infect our world. Hospitals are bracing for a surge in patients, and health care workers are already going through medical supplies quicker than ever seen before.

Disposable personal protective equipment, such as masks, are all ending up in piles of medical waste that has to be disposed of safely. In China, where this crisis began, officials not only had to build new hospitals to deal with the sick, they had to construct new medical waste plants to deal with infectious waste.

Hospitals across the globe are seeing medical waste being generated at six times the standard rate, with an output of more than 200 metric tons of waste a day.

Global Pandemic is Changing How Bio-Medical Waste is Generated

COVID-19 has created a change across the globe in the amount and the type of bio-medical waste being generated. From the amount of personal protective equipment to items such as food until the pandemic was not considered medical waste.

The world has undergone a complete change, and it is difficult to forecast the volumes of bio-medical waste that is yet to be generated, but it has to be addressed as to how it will be disposed of properly.

CDC Recommendations for Managing Bio-Medical Waste Generated During Crisis

The CDC has stated medical waste generated during this global pandemic can be treated as regular medical waste. Treating the medical waste generated in hospitals from patients with the virus will vary by location. Regulations set forth by environmental departments, state health agencies, along with OSHA (Occupational Safety and Health Administration) and the DOT (Department of Transportation) are in place for the treatment of medical and hazardous waste.

Regulations already require that contaminated trash from medical facilities do not pose a threat to the public before they end up in a landfill. These wastes are typically sterilized with steam, chemically disinfected, or burned.

What is more of a worry is the waste generated outside hospitals and medical centers. COVID-19 isn’t just in our hospitals; it has spread beyond as people who have minor symptoms are staying at home to recover. There are also those that do not realize they are asymptomatic and are throwing trash that could potentially be contaminated.

People are generating and throwing trash that could be contaminated, which is a concern for sanitation workers. COVID-19 has the ability to persist for up to a day on cardboard and even longer on plastic and metal. These factors make it even more critical for waste handlers to wear protective equipment.

Anyone handling health care waste must be wearing the appropriate gear, including long-sleeved gowns, masks, goggles, boots, face shields, and thick gloves. The World Health Organization has not reported any evidence of unprotected human contact with health care waste resulted in the transmission of the virus, but as the pandemic grows, so will the waste.

Handling of Bio-Medical Waste During the Global Pandemic

With the COVID-19 outbreak, a significant increase in regulated medical waste is being generated. These wastes include material contaminated with the virus, such as gowns, gloves, and gauze, needles, pathological wastes, and sharps. These types of medical waste are federally regulated for safe handling, including transportation. They are all required to be treated before disposed of.

The CDC states the risks of catching COVID-19 are higher when you are in close contact with someone who has the virus. It is thought to be spread mainly through respiratory droplets when an infected person sneezes or coughs. It can also be possible to catch it from touching a surface that an infected COVID-19 person has contaminated and then touching your eyes, mouth, or nose. OSHA states they believe without human-to-human transmission, most workers in America are not at significant risk, except for those working with wastewater or solid waste management.

The CDC states the waste generated while caring for patients with COVID-19 should be handled like any other hazardous waste material. Coronaviruses are just as susceptible to disinfection as other viruses. The agency is stating they do not feel hazardous waste disposal services need any additional disinfection when dealing with the waste generated from COVID-19.

The CDC is recommending COVID-19 medical waste be managed as a Category B waste. The waste should first be treated under other disposal methods for handling infectious medical waste materials and then follow the Category B disposal process.

Some of the hazardous waste disposals services are requesting COVID-19 waste materials be handled by healthcare facilities as:

  • Waste that is being transported to waste facilities for treatment is to be packaged. It should not be expected of a disposal service to package these materials. 
  • All bags containing waste materials should be hand-tied by twisting and gathering the neck of the bags and then applying a hand knot to ensure the bag is closed tightly.
  • The closed bags should be placed into a secondary container, such as a reusable tub or box, and not be visible once the container is closed.
  • If the containers are not adequately secured, or the containers are damaged, the disposal service has the right to deny a pickup or return them to the facility where they originated. 

These recommendations or rules will differ between the different hazardous waste disposal services. Check with your local facility to learn what their specific guidelines include.

Hospitals and other healthcare facilities dealing with waste materials from COVID-19 treatments should ensure their waste management service is following proper disposal procedures. It should be determined that the disposal service has contingency plans and ample capacity to deal with the increased volume of infectious materials this crisis is going to generate.

China is the first country to experience this outbreak, and they have been dealing with treating this virus longer than others. They are seeing an overwhelming generation of bio-medical waste being generated and warn the United States that we should be having healthcare facilities working with waste management providers as a preventive measure as our amounts increase.

Guidance for Waste and Recycling Industry During this Global Pandemic

There have been no specific warnings issued by governing agencies of the waste management industry. Guidance has been offered that all hazardous waste facility workers continue to take the proper steps to protect themselves and to stay alert for any updated or changing conditions.

These are some of the frequently asked and answered questions presented to the National Waste and Recycling Association that may help you in managing bio-medical waste during this pandemic:

Q: What precautions should be taken by waste management workers to protect themselves?

A: Continue to follow general precautionary measures and also avoid touching your mouth, nose, or eyes unless your hands have been washed with soap and water for at least twenty seconds. You should also use an alcohol-based sanitizer, which contains at least sixty percent alcohol if you do not have access to soap and water.

Q: Should waste from a household where a patient with COVID-19 lives be managed differently?

A: The CDC is stating household wastes can be managed as they also have been for the flu. There are no special precautions in place for COVID-19.

Q: Should waste from a retail or commercial business where a patient with COVID-19 visited be handled differently?

A:  Commercial and retail businesses’ waste can be handled as they usually were unless your local health department advises differently.

Q: How should RMW (regulated medical waste) from a facility treating COVID-19 patients be managed?

A: The CDC has determined bio-medical waste generated from COVID-19 treatments is classified as a Category B waste. As per the regulations established by the DOT and CDC, these wastes can be discarded as regulated medical waste. Employers and workers should be managing contaminated COVID-19 materials as they would any other regulated medical waste.

Q: Can sharps, single-use, and reusable containers from COVID-19 be placed in red bags?

A:  It is recommended that only single-use containers be used for COVID-19. The protocol for single-use sharps containers follows standard protocols for overpacking, closing, and shipping for disposal and treatment.

Q: How should general waste from COVID-19 patients be handled, such as used tissues?

A: Unless a PPE or general waste from a patient is grossly contaminated, it can be disposed of with regular trash, unless your local health department has advised differently.

Q: Does the waste generated from COVID-19 patients need to separate from other infectious wastes?

A: It is not required, but recommended that waste from COVID-19 patients be labeled or identified to protect the workers in the event a bag or container is opened. Your hazardous waste disposal service may adopt special provisions or specific conditions for your facility to safely handle these wastes to protect their employees during this crisis. It would be to your advantage to stay in touch with your hazardous waste disposal service to keep updated on the handling of these bio-medical wastes.

Managing Bio-Medical Waste During COVID-19 Pandemic

Different safety precautions are needed depending on the job you have. This breakdown is for the various positions related to managing waste disposal:

  • Management should be ensuring CDC guidelines are being followed, and all proper safety precautions are in place. You should be conducting meetings in smaller sizes with no more than ten employees gathering at one time in the same place. You can change the start and stop times by staggering them at different times, so there is not a large group leaving or coming at the same time. You should also be staggering breaks and ensure employees are maintaining safe distances from one another. Another measure is to increase the frequency of cleaning efforts and make sure sanitation products are well stocked. 
  • Technicians should be sanitizing vehicles before servicing them. The commonly touched parts of the vehicle, such as the steering wheel and door handle, automated joystick, and other commonly used surfaces should only be touched if you are wearing gloves. The gloves should be disposed of after service, and you should be washing hands for at least twenty seconds several times throughout your shift. 
  • Scale house or dispatch operators should make sure they are disinfecting and cleaning their hands hourly. When relaying information, you should use the radio-based communications system and avoid sharing phones, pencils, or pens. If you handle keys, clipboards, phones, or other items that may have been touched by others, make sure you sanitize your hands. 
  • Post-collection operators, sorters, helpers, and drivers should be sanitizing your hands at the beginning of your shift as well as at the end of each shift. Sanitize any commonly used surfaces, such as steering wheels, joysticks, or door handles. Avoid human contact during your breaks, departures, arrivals, or on your route. If you fuel your vehicle, make sure you sanitize the handle before using it and make sure you wear the proper PPE. 

As the coronavirus pandemic continues to rip across our world, we all have to remember to take the necessary safety precautions. These precautions are not only going to save your life; they are going to help stop this virus and save our world.

 

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