India stares at biomedical waste crisis
Mahadev is squatting at a corner of the mountain of waste in north Delhi’s Bhalswa landfill, hunting for plastic in any form. The work of the 45-year-old, who uses only one name, is crucial: the more plastic is recycled, the better it is for the planet as plastic takes anywhere between two decades and five centuries to decompose, choking rivers, and releasing harmful chemicals and heavy metals into water and soil.
Mahadev’s work has increased in the past three months and also become more dangerous. He now skims through dozens of discarded masks and plastic gloves with his bare hands to find recyclable plastic ware.
The personal protective equipment, the mask, the gloves, the face shield, the shoe cover, and the sanitiser bottle have two things in common: they protect people – and prevent them from transmitting – from the Sars-CoV-2 virus; and they are also made up (mostly) of plastic. In the past three months, a lot of them have ended up in already overflowing landfills, posing a health risk to waste pickers, sanitation workers and garbage collectors tasked with handling them.
The coronavirus pandemic has created a new waste crisis.
Yet, the only protective gear Mahadev wears is a tattered mask, handed to him a few weeks ago by a group of social workers.
“Since April, there is a mound of discarded masks and gloves dumped here. We know it is a risk and we try to take all the necessary precautions, because our safety is only our responsibility. We do not come in any government’s priority list so we have to make do with whatever we have,” says Mahadev, who has been a waste picker for 30 years.
While there are no figures available for the amount of plastic that has ended up in landfills during the pandemic, since there is no separate collection of potentially hazardous domestic waste from non-Covid designated houses and institutions (which is what ends up in landfills), local administration officials in both cities admit that there has been an increase in the amount of garbage generated, and that gloves, masks, and personal protection equipment account for at least some bit of the increase. And this is the waste that is collected along with other routine waste -- not biomedical waste from hospitals and other facilities that is collected and treated differently.
In Delhi, over 40 sanitation workers have tested positive for the virus, and 15 have lost their lives. In Mumbai, 10 workers and two security guards at the city’s two landfills, in Deonar and Kanjurmarg, have been infected with Covid-19, and recovered. These are just figures from two of the most affected cities in the country today.
India is on the brink of a Covid-induced waste crisis, and the authorities are aware of it.
Rules of engagement
On April 18, the Central Pollution Control Board (CPCB), the country’s apex body on the regulation of waste disposal, released a set of guidelines on what to do with Covid-related waste generated by designated sites such as hospitals, laboratories, quarantine centres, containment zones and isolation facilities.
Accordingly, used masks, tissues, head covers, shoe covers, disposable linen gowns, non-plastic and semi plastic coveralls were to be disposed of in a yellow bag meant for incineration at a common biomedical waste treatment facility (CBWTF). So were leftover food, disposable plates, glasses, used masks, tissues and toiletries of Covid-19 patients.
It was also stipulated that those in home isolation, in containment zones, should deposit biomedical waste generated from suspected or recovered Covid-19 patients in yellow bags to authorised waste collectors, engaged by urban local bodies, or at designated centres or hand over these bags to CBWTF operators.
“We share the list of everyone in home isolation in the district with the waste collectors. Plus, there are stickers outside the houses, so they know. The garbage from these houses is collected last and taken in a separate vehicle for proper disposal as biomedical waste,” said a senior district official from Delhi, who asked not to be named.
This waste is either taken to a CBWTF or a waste-to-energy plant, where it is then either incinerated, autoclaved (sterilised for shredding and recyling) or burnt to produce energy.
However, Swati Singh Sambyal, an independent waste management expert, pointed out that this elaborate exercise gets compromised due to a small but critical issue -- lack of segregation. Municipalities pick up biomedical waste from Covid houses, but it often has other household waste mixed in it. Not only does this put the waste collector at risk, it decreases the efficiency of the incinerators at waste treatment plants as it results in greater emissions and unburnt ash. These facilities, she added, are for anatomical waste, cotton swabs and other items that cannot be autoclaved.
“Once the yellow bag reaches the plant, it cannot be opened because it can contaminate, so segregation at the household level is key,” Sambyal said.
Residents say that they are not even aware of the need for segregation inside their homes. “It is scary to touch medical waste that is being used regularly for fear that I may contract the disease as well. So we try to put everything in one bag and give it to BMC because they know how best to separate it,” said a 44-year-old woman from Jijamata Nagar, a containment zone in Mumbai’s Worli, whose husband tested positive for Covid-19.
“Residents are still not on board about segregating their waste in the basic two categories -- dry and wet -- so the differentiation of a third category becomes difficult. But under the present circumstances, we will require a tailor-made document, taking from the 2016 waste management rules, to address the piles of hazardous waste that is ending up in landfills and dhalaos,” a senior official from the South Delhi Municipal Corporation said on condition of anonymity.
But that’s just one part of the problem.
The other part is that while the guidelines have accounted for a new kind of waste – after all, PPE are being used everywhere, from hotels to hospitals, railway stations to airports, crematoriums to burial grounds – the disposal mechanisms available in the cities simply aren’t equipped to deal with the volume.
Treatment facility crunch
The country has 200 biomedical waste treatment facilities; of these two are in Delhi and one is in Mumbai. And, according to CPCB data, these facilities are already running at 60% capacity – that’s a 15% jump since March.
The national average is low, because many cases have not surged in many cities, the way they have in Delhi and Mumbai. In these two cities, the CBWTFs are running at 70-75% and 70% capacities, according to CPCB and the Maharashtra Pollution Control Board respectively.
Before the Covid-19 outbreak, a government or a private hospital would typically produce 500 grams of biomedical waste (like syringes, urine bags, gauze etc) per bed, daily. Now, that number has gone up to between 2.5kg to 4kg per bed, daily, according to SMS Water Grace BMW Private Limited, one of the two CBWTFs in Delhi, which collects waste from labs, quarantine centres, and hospitals, including one of the city’s Covid-19 government facilities, the Lok Nayak Jai Prakash Narayan Hospital. A large Covid-19 facility can anywhere between 1800 to 2200 kg of biomedical waste per day.
Now multiply this with the number of Covid-19 hospitals in the country: 2,900. Add to it the biomedical waste generated from 20,700 quarantine centres, 1,540 sample collection centres and 260 laboratories dealing with the Covid-19 pandemic, and the biomedical waste collected by municipalities (Delhi alone has 12,000 home isolation facilities) and one gets a sense of the sheer volume of the problem.Delhi generates 27 tonnes of non-Covid biomedical waste and up to 11 tonnes of Covid-19 related waste every day, according to the CPCB; Mumbai has been generating 9 tonnes of Covid-19 waste and 6 tonnes of non-Covid biomedical waste every day, BMC estimates.
Much of this is plastic -- N-95 masks are made up of polyisoprene (natural rubber) and polypropylene (thermoplastic); face shields are all plastic.
As it turns out, CPCB guidelines also include red bag waste for contaminated plastic such as goggles, splash proof aprons, plastic coverall, hazmat suits, and nitrile gloves , which are meant to be sterilised, shredded and sent for recycling.
Yet, Delhi, in particular, is at a critical stage — the Capital’s total incineration capacity is 37 tonnes per day and it is already utilising approximately 70% to 75% of that.
“The amount of waste generated from the hospital has certainly gone up with so many disposable items now,” said Dr DK Sharma, medical superintendent of All India Institute of Medical Sciences, New Delhi.
Biotic Waste Management, the second CBWTF in Delhi collects 7,212 kg of Covid-19 related waste every day from various facilities, besides 10,666.8 kg of general biomedical waste.
“We are staring at a big crisis in the coming days if waste is not segregated properly and the load on incineration is not reduced,” said Vikas Gehlot, spokesperson for Biotic.
Part of the problem, Gehlot said, is that a lot of organic biomedical waste is making its way to incinerators due to the CPCB guidelines, when it should ideally be going to the waste-to-energy plant in Okhla.
“The biomedical waste plants are established based on projections of how much the biomedical waste generation will increase in the next say, 10 years. We didn’t foresee something like Covid-19 coming. It’s a once-in-a-hundred-years crisis,” Gehlot said.
The government in Delhi is aware of this problem, but increasing the number of such treatment facilities doesn’t seem to be a viable solution, a senior official told HT.
“The capacity of incinerators is a problem, especially when the projection says that we will see a spike in the first week of July and the active cases could go up to as many as 50,000 cases. But that said, it still doesn’t make sense to invest in these machines because we do not know if this infection is episodic or will it be recurring. What do you do with these machines once cases start decreasing?” a senior official from the Delhi health department said, on condition of anonymity.
If, and it’s very likely to be so, Covid-19 cases rise further in the coming months – and testing capacities continue to get ramped up – some cities, including Delhi might have to send its Covid-19 waste to neighbouring states for disposal, CPCB scientists warned.