How to defuse a ticking time bomb? Sanitation in the time of COVID-19

By Shivanshu Chauhan & Antara Ray

When the COVID-19 pandemic struck, the Central Pollution Control Board (CPCB) released guidelines to ensure safe handling and disposal of waste generated during the testing, treatment and quarantine of COVID-19 patients and suspected cases. This was in addition to the already existing Biomedical Waste Management Rules, 2016. The guidelines direct medical establishments, isolation wards, quarantine centres, sample collection centres, laboratories, urban local bodies, and operators of common biomedical waste treatment facilities to follow stringent handling practices for COVID-related waste.

Similar steps were recommended during previous outbreaks like swine flu in 2014 and Nipah in 2018. These guidelines underpin the necessity of reinforcing strict measures in order to prevent any secondary transmission through infectious waste streams.

Some states have taken early note of these guidelines and instructed city authorities to regulate COVID-19 waste collection and safe disposal through existing biomedical waste management operators. However, in many cases, the lockdown has resulted in communication challenges at times between government departments and covered organisations, with sometimes important communication being delayed. It would also be useful for urban local bodies to have a detailed guidance framework and action plan following the CPCB guidelines and initiate regular monitoring.

To avoid further contamination, the guidelines should have a detailed action plan at these two levels -(a) small and neighborhood-level non-government clinical establishments that infected and non-identified people might have visited for routine checkups/pathological tests; and (b) household waste from untested, untraceable contacts or asymptomatic population from hotspot areas who would continue to generate infectious waste which would flow into and contaminate municipal waste streams.

The CPCB had always been a strong proponent of maximum segregation at source, and of at least a three-bin system at the household level to segregate wet, dry, and hazardous and infectious domestic waste. Following the push from the Swachh Bharat Mission and the National Green Tribunal, most cities had started mandating source segregation into wet and dry waste using green and blue bins. Until this point though, segregation of infectious and hazardous domestic waste was not extensively discussed. The COVID-19 crisis, however, has forced us to re-evaluate priorities, and the yellow bin is increasingly emerging as an important part of decentralised waste management to eliminate the risk of unintentional contamination of the entire municipal waste value chain.

The lockdown understandably has temporarily slowed down the existing mechanisms of awareness, communication and segregation drives in many places, which further increases the need to innovate and create newer platforms to drive change programmes. This pandemic is perhaps a reminder about the need to make waste segregation a practice and bring about a change in behavior. Not only would they be willing to segregate for their own safety, but this move would also boost their confidence in the administration for taking adequate action to safeguard them against disease transmission. While the CPCB also lays down safety measures for sanitation workers, its implementation and social safeguards need to be strengthened on ground. Sanitation workers are the second most important human shield to coronavirus, after health workers.

Segregation of potentially infectious waste from mainstream waste would make treatment of all fractions of waste safer. However, COVID-19 could leave us with high volumes of infectious waste at the domestic level. Reports suggest that due to COVID-19, biomedical waste from hospitals in Wuhan rose exponentially by six times (from 40 tonnes to 240 tonnes per day). So the bigger question to ask is: Are we equipped to deal with such huge quantities of biomedical waste? Considering the lack of segregation and potentially large volumes of mixed infectious waste that will need safe disposal quickly, we need to understand how well we are prepared and how quickly we can act so that a larger contamination on this account is averted. A quick readiness assessment of infrastructure assets is vital for an integrated response. Stronger enforcement of the Biomedical Waste Management Rules and strict monitoring of compliance with the waste-handling protocol across the waste chain are imperative. Additionally, we can look at possible solutions like decentralising incineration, mobile solutions or other thermal technologies for biomedical waste treatment; fast-tracking adoption of superior technologies; ramping up of existing facilities to accept additional waste; setting up of new facilities through emergency procurement processes and making them operational soon; and expeditious sanitisation of the entire waste chain.

In the battle against COVID-19, time may not be on anyone's side. It is the agility shown in adapting to challenges and taking quick decisions that will determine success in tackling the pandemic and avoid a larger health crisis.

(The co-authors are Shivanshu Chauhan - Partner, Urban Infrastructure, PwC India and Antara Ray, Associate Director, PwC India)

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