The pandemic will change much of the world even if we exclude the heavy blow it inflicted on the economy. It is time for a new approach to various segments of life. The coronavirus and future crises warrant much more careful handling of medical and infectious waste. The latest information shows Serbia and other countries in the region have a long way ahead in improving the system for the people’s safety as well as environmental protection.
Soon after the outbreak, the world saw how the beaches in Hong Kong were covered in used face masks and gloves. After that, the same kind of waste came to our streets and the natural landscape, while households got little or no guidance on what to do with the protective gear. What are the regulations and how dangerous is it? Does the coronavirus change the way medical and, particularly, infectious waste is managed?
Professionals from different sectors have expressed commitment to responsible and secure management of the material and the need to upgrade it in the current emergency and beyond the challenge that COVID-19 posed.
The infectious disease only changed the protection of the staff and it must be at the highest level, “as if it were a smallpox epidemic,” according to Goran Belojević. The Head of the Department of Hygiene and Medical Ecology at the University of Belgrade’s Faculty of Medicine told Balkan Green Energy News that protective masks, gloves and handkerchiefs are hazardous, “doctrinally infectious waste.” He recommended that it be treated with diluted sodium hypochlorite in spray or cooked for ten minutes.
University professor of medicine Goran Belojević explains the staff that is in contact with medical waste must now be protected just like a smallpox epidemic was at hand
Asked about the risk for the people collecting secondary raw materials from municipal waste and at landfills, the professor categorically said that the practice as well as trading “must end completely during the pandemic.”
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Program Coordinator of A11 Initiative for Economic and Social Rights Danilo Ćurčić argues the state hasn’t changed its stance and that there is still no progress with regard to valuing and legalizing the work of the collectors of secondary raw materials.
Most reside in temporary settlements, where there is often no fresh water, crucial for hygiene and to prevent the disease from spreading, he noted and said the responsible institutions should urgently provide it. Movement is limited just like for all citizens and reports from the ground reveal there is less material in waste than before the start of the crisis, Ćurčić pointed out.
Criterium for infectious waste must be expanded
The amount of medical waste has tripled since the COVID-19 pandemic erupted, claims Bojan Sudarev, who manages the Serbian subsidiary of Remondis Medison from Germany. The company is the only one in the private sector in the Balkan country to burn medical waste, while 90% is incinerated within some of the healthcare facilities.
Sudarev told us that, for protection from the coronavirus, the category must, for instance, include plastic cutlery and bedsheets from special hospitals. The collected clinical waste is transported with specially equipped vehicles and then it is sterilized and crushed, after which it is no longer hazardous. It is also burned, as recycling is not allowed.
Remondis suffered a drop in demand for its services in Serbia, Sudarev said and pointed out that the company now collects and disposes of more waste than usual in its other markets. He highlighted the obligation of all institutions, firms and organizations to deliver their single use protective equipment for treatment before it can be landfilled.
The authorities must raise awareness on the containment of the disease, primarily in the advisory capacity, in Sudarev’s words.
Separate stream for disposal of masks, gloves
“Local authorities must set up collection spots for used masks and gloves so that authorized operators could successfully evacuate the potentially hazardous waste. The sterilization devices installed at larger medical facilities and the existing capacities are sufficient for their needs,” he said and asserted that bringing hazardous waste from other units “drastically increases the risk for employees and patients.”
It is much safer to hand over such material to authorized operators, Sudarev argued. He stressed it is necessary to register all producers of waste so that they would be obligated to dispose of it properly, and called upon the responsible authorities to exert influence on small dispensaries.
Caution within self-government, households
The Municipality of Gornji Milanovac in the country’s west put bins for gloves, masks and handkerchiefs in 30 locations so that citizens can safely leave them there and protect municipal waste collectors to a great extent. People in nearby Čačak who are isolated get special bags for the said items.
Belgrade’s public waste management enterprise Gradska čistoća picks up medical waste only after it is sterilized with steam in an autoclave. The material is processed further at the Vinča landfill and disposed of in special cartridges. The International Solid Waste Association (ISWA) has published recommendations, against the backdrop of the coronavirus outbreak, on how to isolate and landfill medical and infectious waste.
The waste disposal company in Serbia’s capital city and Institute of Public Health of Serbia Dr Milan Jovanović Batut both appealed to households to spray used items like masks, gloves and napkins with a disinfectant and put them in plastic bags and tie those up before throwing them away.
Prominent infectologist Goran Stevanović advised people to turn gloves inside out and leave the mask in them.
In the wake of the coronavirus outbreak, ISWA published recommendations on how to isolate and landfill medical and infectious waste
The special COVID-19 hospitals have received single use bed sheets. The full gowns, face shields and other gear is packed and taken away after use.
PWW, which collects, transports, sorts and disposes of municipal waste in six cities and municipalities in Serbia, asked citizens to leave trash bins open for now so that they wouldn’t touch the lid. The company revealed the waste in landfills is covered more often than earlier.
Infrastructure investment together with private sector
In the meantime, the Chamber of Industry and Commerce of Serbia or PKS initiated a dialogue between all stakeholders on environmental protection during and after the pandemic. Siniša Mitrović, Director of PKS’s Center for Circular Economy, told Balkan Green Energy News that small and medium enterprises and private capital overall must be allowed to participate in investing in the hazardous waste management infrastructure. It is a national security issue and the current crisis is about healthcare and climate and the economy, he stated.
The European Union is preparing a protocol for waste from households with people in precautionary isolation or with indications they have been infected.
How medical, infectious waste are handled in region
Vesna Miranović from Montenegro’s contagious diseases coordination body said, as reported by the Center for Investigative Journalism Montenegro (CIN-CG), that there is increased caution in the collection of medical and infectious waste from medical units caring for those infected with the coronavirus, even though the protocol hasn’t changed. She added even the bags containing the waste are disinfected.
Komunalna djelatnost, the utility handling waste in Ulcinj, secured single use masks and gloves for its workers. They disinfect both the area around the dumpsters and their trucks.
Rade Đikanović from Ekomedika in Podgorica said the material must be packed and marked in line with the regulations. The representative of the firm handling hazardous medical waste asserted the package containing the waste is disinfected before it is picked, and after it, the container.
Constant disinfection is recommended for all potentially contaminated surfaces, Đikanović said and underscored the costs have risen due to increased activity and protective measures. “Local authorities, acting via their utility services and capacities, issued instructions and secured the timely collection of protective gear on different levels, both from individuals and collectives. As for the correct way to put on and take of gloves and masks, all should follow the recommendations by the Institute for Public Health and the World Health Organization,” he stated.
In Bosnia and Herzegovina, Medic-OTP plans to build an incineration facility for hazardous waste in Karakaj near Zvornik in the country’s east. Hazardous medical waste is landfilled locally and it has also been transported to Vienna to be burned.
Aida Commerce from Sarajevo said, as carried by CIN-CG, that the amount of waste from primary healthcare has grown. At the same time, the volumes coming from small dispensaries like dentists and cosmetic surgery is decreasing, the firm said and added the sector is working with “weaker capacity utilization or not at all.”
China’s leap during crisis
China’s Hubei province, in which the coronavirus started its expansion to reach the most remote corners of the Earth, managed in just these few months to establish a system for medical and infectious waste to be treated in 24 hours. The capacity grew to 667.4 tons per day from 180 tons. Wuhan, its capital city and the epidemic’s first epicenter, lifted its maximum volume to 265.6 tons from just 50 tons a day.
The Hubei province in China managed in a few months of the fierce battle with the novel coronavirus to almost quadruple the capacity to 667.4 tons per day and the treatment of medical and infectious waste is completed within a day
Gient has built an emergency medical waste treatment plant with the capacity of 30 tons per day in just 15 days.