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Management of Biomedical Waste during COVID-19: Challenges and Solutions

Vaccination in India is the largest vaccination drive, but for now, we are able to administer the vaccine to just over five percent of its population, which used almost 268 million syringes and needles and almost 18 million glass vials up to month of June 2021, which may lead pollution due to Biomedical waste to a greater extent and also in June, the Central Government told the Supreme Court by the way of affidavit that 1.35 billion doses will be available between August and December, so by this, we can estimates the pollution due to Biomedical waste due to vaccination only. Along this surgical masks, face shields, gloves, shoe covers, personal protective equipment, started being disposed as a part of household waste, discharged by the roadside, behind hospitals, on beaches, parking facilities, landfills, and sometimes burning along with the pyres.

While dealing with the COVID-19, Biomedical waste may lead to various diseases and may develop harmful pathogens, viruses, and bacteria that can be hazardous to human health. Regards to this alarming situation, the Central Pollution Control Board categorized it as hazardous. The Biomedical Waste Management Rules 2016 were expanded to encompass waste discharge from vaccination camps, blood donation camps, and surgical camps.

Biomedical waste is not only generated during the treatment but generated during the attempt to prevent it. Vaccination administration of COVID-19 on January 2021 and as of June 2021 is 289 million doses and also expected to increase in future which may also increase the discharge of all these biomedical wastes.

Constitutional Provisions
Article 21 defines "right to life" as "a life of dignity to live as entrenched in the Constitution, in a proper environment free of diseases and infection. Article 21 of the Indian Constitution has been interpreted to cover health, sanitation, and the environment, as it adversely affects the life of the citizens and it amounts to slow poisoning and reducing the life of the citizens because of the hazards created if not checked and should be bind by statutory provision.

Some of the well-known cases on the environment under Article 21:
In M.C. Mehta v. Union of India[1] (1988), the Supreme Court ordered the closure of tanneries that were damaging the water supply, as well as various rules and directions for the conservation of the Taj Mahal, an ancient monument, from environmental degradation.

In Vellore Citizens Welfare Forum v. Union of India[2], the Court took cognizance of the environmental problem being caused by tanneries that were polluting the water resources, rivers, canals, underground water, and agricultural land. The Court issued directions to deal with the problem.

In Murli S. Deora v. Union of India[3], Persons who do not smoke cannot be forced to or subjected to passive smoking as a result of a smoker's actions. Because a non-smoker may become a victim of someone smoking in a public place, a non-right smoker's to life under Article 21 of the Indian Constitution is impacted.

Role of Central Pollution Control Board
On March 2020, CPCB releases its guidelines on COVID-19 biomedical waste handling and after performing three reviews respectively on dates 25 March, 18 April, and 6 June, in the final review, it addressed the issue of segregation of general and biomedical waste in quarantined households. Data collected by the CPCB shown on the Biomedical Waste Management App, stated that the country has generated 45,954 tonnes of COVID-19 waste in the past year till May 10, 2021.

Our country is also well equipped to handle the additional load which is increasing day by day, in a report submitted to the National Green Tribunal on January 2021, stated that the country has 198 common biomedical waste treatment and disposal facilities and capacitive facilities in hospitals having the capacity to treat 754 tonnes of biomedical waste a day. But in May 2021, the CPCB reported the maximum biomedical waste generation, which reached 800 tonnes a day which is above the National Treatment Capacity and any further increase leads to the uncontrolled discharge of biomedical wastes. The biomedical waste generation is par above the processing capacity of the country which is below its actual generation of COVID-19 waste.

Our country has too much to handle with the risk of the third wave also and also in may there is maximum number of covid cases, and these are just the iceberg's tip which shows states the indication that the 45,954 tonnes of COVID-19 waste collected by CPCB is a gross underestimation of the actual volume of waste generated so far.

Challenge of Missing Waste
The major challenge is the monitoring the flow of biomedical waste, which comes through innumerable sources that vary from the household to quarantine camps. On this behalf, on 30th July 2020, the Supreme Court on basis of a report submitted by the Environmental Pollution (Prevention and Control ) Authority, made an order for mandatory reporting through Biomedical Waste Management App but also even after that there are very few application so far and even fewer are reporting on regular basis.

According to the findings, there are large-scale healthcare facilities that must update their COVID-19 waste data on the BMW app on a daily basis, as well as COVID-19 families whose information is not updated on the app by the municipal corporation or village panchayat.

Central Pollution Control Board on January 2021 report of National Green tribunal, that 184 of the 198 biomedical waste treatment were repoting waste handling on the BMW app, this number reduced significantly to 168 in May this year. On November 2020 there are 100000 generators, from which most of them shared information on the BMW app. In all other months, the number is between 5000 to 8000, the gap becomes too huge to be an expected variation, that in May 2021, and only 5084 generators had published their data on the BMW app at the time when our country accounted for over half of the world's new cases on its own.

A way too ahead
Usually, healthcare facilities follow a color-coded system for waste disposal and hand it over to treatment facilities within 48 hours as according to the Biomedical Waste Management Rules, 2016. At treatment facilities, a considerable part of waste that comes in red and blue bags or in white containers is channelized for recycling.

Poor segregation is also creating an alarming situation as a high quantity of plastic waste is incinerated, which results in scaling of the inner lining wall of an incinerator, which decreases the efficiency. The burning of plastic waste results in the release of noxious gases like dioxins and furans, but we cannot monitor the pollution though this way. As a result, the EPCA wrote to the Supreme Court on July 2, 2020, stating that online continuous emission monitoring system has been established in most biomedical waste treatment facilities, but this is not working satisfactorily.

Disposal Challenge
The use of auto disabled syringes ensures safety as it restricts the use of syringes twice but also generates massive quantities of biomedical waste which the country has to deal with in the coming months. By the end of the vaccination drive, the country would have generated more than 1.3 billion used syringe, needles and more than 100 million discarded glass vials, that would require careful disposal according to the Vaccine operational guidelines released on December 28, 2020.

No space to be left untouched in the safe handling and disposal of the COVID-19 waste to ensure that it does not snowball into the next crisis.

Solutions
  1. Spreading awareness among citizens and enforce segregation at source for proper disposal.
  2. Ensure all waste generators and processors are registered for COVID-19 , as only a few of them are registered on Biomedical Waste Management App.
  3. Limit the use of PPE kits and other single-use paraphernalia only to frontline workers, which is to be used by many individuals. Encourage the general people to wear reusable/cloth masks.
  4. Use washable utensils in quarantine camps/ homes to minimize waste.
  5. Plug the gaps in the guidelines by regularly updating them on the BWM app.
  6. The Central Pollution Control Board (CPCB) should provide data that is segregated according to generation sources, waste types, and treatment facilities as we saw above with the help of data analysis.
  7. CPCB should also reflect on the rural scenario in terms of quantum of generation and the general practices followed to dispose of the COVID-19 biomedical waste, which should be disposed off by municipal corporations or village panchayat.
  8. Ensure that vaccination camps outside hospitals segregate the waste properly and orderly.
  9. As per Bio-Medical Waste Management Rules, 2016 bar-code the bags used for collecting biomedical waste for tracking the source of the waste once it reaches the treatment facility is to be used by all states. Kerala is one of the few states that has been bar-coding its waste bags and this has been a major part of its responsibility towards the pandemic and helps in the segregation of biomedical waste at new limits.
  10. Spreading awareness from the root level will help in dealing with the current problem.

Conclusion
Article 21 of the Indian Constitution grants the right to live in a clean and safe environment. To defend this right, not only the government, but also the people themselves should manage biological waste efficiently and effectively. The Biomedical Waste Management Rules, 2016 are improved in terms of the facilities like segregation, collection, transportation, and disposal methods to mitigate environmental pollution and safeguard human health and by which CPCA functions accordingly.

These rules put a checklist to achieve the goal of biomedical waste management for the operator occupier, the regulatory authority, and other authorities like a municipal corporation, etc. The segregation of trash and the notion of the 3 Rs, which it is built on, namely reduce, recycle, and reuse, are the cornerstones of these guidelines.

Eco-friendly systems and the development of newer advanced technologies for disposal of biomedical wastes should be encouraged rather than using the methods which harm the environment in one or another way. Everyone should be a part of the biomedical waste management process and make a commitment to a cleaner, greener environment.
Reduce, Recycle, Reuse, and Repeat.

End-Notes:
  1. AIR 1988 SC 1037 : (1987) 4 SCC 463
  2. AIR 1996 SC 2721 : (1996) 5 SCC 647
  3. AIR 2002 SC 40 : (2001) 8 SCC 765

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