One false move can foil grand plan or preparation, especially in the battle against a deadly virus. Since the onset of the COVID-19 pandemic, governments and healthcare organisations have directed their attention towards educating citizens on the proper use of personal protective equipment and apparel in order to check the contagion.
What seems to have eluded the powers that be is the urgent need for the safe disposal of biomedical waste. Biomedical waste is a threat to global public environmental health, especially in lower-middle-income countries. The definition of biomedical or clinical waste is fairly broad: all waste materials generated at health care facilities, medical research facilities, laboratories can be considered as medical waste.
However, it is important to note that even households produce their clinical waste, as does any organization that deals with needles and/or syringes. Regardless of how you describe medical waste, one thing is certain: its disposal and management isn’t something to be taken lightly. Worldwide, it is estimated that at least 5·2 million people, including 4 million children, die each year because of diseases related to un-managed medical waste. Considering the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) globally, excessive biomedical waste has become a new major threat to public health and the environment.
Improper handling of hospital waste might aggravate the spread of SARS-CoV-2 to medical staff and people who handle the waste. Medical experts have described the management of medical waste in the country as ‘distorted and ineffective.’ They warn that lack of a safe and effective system to properly dispose of hazardous materials may increase the spread of COVID-19, hepatitis and other infectious diseases. According to them, health care waste contains microorganisms that can infect hospital patients, health care workers and the general public and should be given top priority. The World Health Organisation noted that every year, an estimated 16 million injections are administered worldwide, but not all of the needles and syringes are properly disposed of afterwards.
It also estimated that in the year 2000, injections with contaminated syringes caused 21 million hepatitis B virus (HBV) infections, two million hepatitis C virus infections and 260,000 HIV infections worldwide, noting that many of the infections would have been prevented if the syringes had been disposed of safely. Before now, experts have expressed concerns about the dangers posed by improper management of medical wastes. However, since the outbreak of COVID-19, fears have heightened about the danger posed by poor disposal of Protective Personal Equipment used by health care workers. Health bodies have advised that medical waste such as used PPE should be labelled as infectious or offensive and professionally disposed of and incinerated to prevent transmission of COVID-19 to the wider population.
A major step in preserving public health and ensuring environmental sanitation in Nigeria during this COVID-19 pandemic is for waste management services to be declared as part of essential services by the three tiers of government. Additionally, emergency guidelines for waste management must be put in place during this period. The responsibility for this lies essentially with the state government but all hands should be on deck during these times. As is the case for all waste, the best practices for managing it starts at the point of generation, when waste is produced. In order to collect waste, one must first be familiar with what to collect exactly, since there each category of medical waste needs to be separated from the other types.
In practice, this means using the right containers. These are usually colour-coded to help biomedical waste segregation. Red containers: sharps waste collection (e.g. needles, blades, razors). Red containers with a biohazard symbol: infectious waste collection (e.g. blood, contaminated equipment, IV tubing). Yellow containers: trace chemotherapy waste collection (e.g. empty vials, gloves, gowns). Black containers: hazardous waste collection (e.g. hazardous meds, P-listed drugs, bulk chemo) Blue containers: pharmaceutical waste collection (e.g. pills, injectables, antibiotics). Yellow, shielded containers with a radioactive symbol: radioactive waste collection (e.g. lab research liquids, anything contaminated by radiotherapy). Generally, to make sure contaminated trash from health care facilities doesn’t pose any harm to the public before going to a landfill, it’s typically burned, sterilized with steam, or chemically disinfected. There’s more to worry about than waste from medical centres.
Like in the case of COVID-19, the disease is spread out beyond hospitals. Some people who have minor symptoms are recovering at home. Others who are asymptomatic might not know that the trash they’re throwing out could be contaminated. That means people may be generating plenty of virus-laden trash. That’s worrying for sanitation workers, as the virus can persist for up to a day on cardboard and for longer on metal and plastic. People handling health care waste, in particular, should wear appropriate gear, including boots, aprons, longsleeved gowns, thick gloves, masks, and goggles or face shields. Existing infrastructural inadequacies in medical waste management must be tackled on a war-footing.
To this end, the government should consider modernizing approaches. Engaging citizens and monitoring waste management through mobile apps could be one option. The international community has already foreseen a surge in environmental pollution owing to biomedical waste. Nigeria must begin to take steps at once