Biomedical hazard: Untended challenge of pandemic- COVID-19

The virus SARS-CoV-2, responsible for COVID-19, with a spread across the world, since it was first reported in China late last year has surpassed 3.2 million cases and 1,28,000 deaths globally.

With India exiting in the third phase of nationwide lockdown that is planned to stretch till May 17, 2020 is going to be a challenging road ahead adding on to the cases surging each day with more than 35000 total cases and a death toll crossing the mark of 1147 at present with states like Maharashtra, Gujrat, and Delhi as the worst affected with the virus.

This pandemic of COVID-19 has demonstrated the need for a robust healthcare infrastructure focussing on public health in India, as well as the importance of our frontline warriors such as doctors, nurses, waste handlers and sanitation workers among others.

The worry over handling the garbage menace has also mounted and should be an area of concern as this waste is a high potential source of infection for the people around. Waste handlers, sanitation workers, rag pickers and even the general public are at risk from handling such unmarked biohazardous waste being produced where COVID-19 patients are quarantined as well as during the screening processes in the community where the presence of asymptomatic carriers as well as infective persons is not known. No mechanism and awareness for collection and disposal of masks and medical waste generated by people under home-quarantine across the country is a matter of concern too.

A major flout in following the guidelines arise during the screening processes being conducted in the communities and hot spots in India which needs a special focus and vigilance. With the most recent example of Nizamuddin Markaz incident in Delhi where out of nearly 2300 people, more than 700 were positive for covid-19, due to which the country witnessed a major setback in the fight against the deadly corona virus pandemic.

A heap of medical waste consisting of discarded face masks, gloves, gowns, goggles and caps were found in the dump lying near the screening area with no proper disposal in yellow bags as mentioned in the guidelines.

This surely lead to a potential hazard to the uninfected people, health workers, screening teams and waste handlers where no proper wearing and removing i.e. doffing and donning procedure for PPEs was followed due to unavailability of space and resources and lack of awareness which posed a health hazard and looking into the situation where many of the health team personal were without the complete Personal Protective Equipments (PPEs) for an infection with such high transmission rates.

Adherence to the basic rules of biomedical waste segregation and management is still low in India. Discarded masks, gloves and Personal Protective Equipments (PPE) could be potential sources for the spread of this highly contagious virus. It is very critical to manage this waste as this could infect rag pickers, children or the poor living on the streets as well as the people living around and being exposed to such infections.

Households and communities avoid following rules of proper waste management by not marking the waste produced at home as well as during quarantine period before handing it over to the waste handlers making them more prone to health hazards with a number of used masks being discarded each day in domestic or household waste. Reasons for such incidents could be the limited awareness about the need for separate disposal of biomedical waste generated by households and absence of proper disposal mechanisms for the households despite a set of guidelines released by the Central Pollution Control Board (CPCB).

Recommendations:

• For community screening and quarantine camps and home care of the suspected cases, collection of biomedical waste in yellow bags should be done with a strict check on its handling and disposal on site of generation before being handed over to the authorised waste handlers and collectors.
• Waste handlers and sanitation workers should be provided with protective gear such as masks and gloves.
• Responsible behaviour and awareness should be instilled in the community in such times of a highly contagious pandemic.
• Use of reusable cloth masks that can be washed and used again and should be disposed off responsibly in a separate marked bag when required.

Fight against Corona virus should be a collective responsibility of each one in the community.

Stay aware, stay safe and act responsibly.

The writer of this article is a Resident Doctor at Lady Hardinge Medical College, Delhi and National Co-ordinater Vichar Vibhag, AICC & incharge Delhi-NCR