Planning for disposal of COVID-19 pandemic wastes in developing countries: a review of current challenges

Risk Management for Whole-Process Safe Disposal of Medical Waste: Progress and Challenges

Over the past decade, the global outbreaks of SARS, influenza A (H1N1), COVID-19, and other major infectious diseases have exposed the insufficient capacity for emergency disposal of medical waste in numerous countries and regions. Particularly during epidemics of major infectious diseases, medical waste exhibits new characteristics such as accelerated growth rate, heightened risk level, and more stringent disposal requirements. Consequently, there is an urgent need for advanced theoretical approaches that can perceive, predict, evaluate, and control risks associated with safe disposal throughout the entire process in a timely, accurate, efficient, and comprehensive manner. This article provides a systematic review of relevant research on collection, storage, transportation, and disposal of medical waste throughout its entirety to illustrate the current state of safe disposal practices. Building upon this foundation and leveraging emerging information technologies like Internet of Things (IoT), cloud computing, big data analytics, and artificial intelligence (AI), we deeply contemplate future research directions with an aim to minimize risks across all stages of medical waste disposal while offering valuable references and decision support to further advance safe disposal practices.

Research on the impact mechanism of changes in the production of medical solid waste in China before and after COVID-19

The changes of medical solid waste (MSW) output in recent years have had a significant impact on the spread of the virus. There is a high-risk transmission of MSW in various stages such as storage, transportation, and treatment during the COVID-19. To cope with the risks brought by the epidemic, normalized prevention consumes a large amount of protective clothing, medical masks, goggles, packaging bags, and other related medical supplies. There is a significant uncertainty in the amount of MSW output that poses a risk of COVID-19 infection in the event of an emergency, which increases the difficulty of collecting and handling epidemic prevention MSW. The analysis of MSW data from 2000 to 2022 found a stable growth trend before 2019. However, the MSW data was a sudden increase trend from 2020 to 2022, and the COVID-19 in China was characterized by an initial stage, an outbreak stage, and a stable growth stage. The range of MSW output during the epidemic was (1.19-1.75) × 106 t a-1. The amount of MSW was approximately 1.19 × 106 t a-1 during the normalized epidemic period, and its treatment cost was as high as 3.57 × 109 yuan (RMB)·a-1. The distribution of MSW output was uneven due to factors such as climate conditions, population data, and local economy. This study has important reference value for epidemic medical material reserves and MSW treatment.

Orphans in Syria and Iraq Juggling Balls: Wars, COVID-19, and the NGO's financial crisis

The COVID-19 pandemic's impact varies between and within nations, causing new forms of inequality. Refugee and orphan children in conflicted areas are more likely to suffer due to poverty, vulnerability, and limited access to essential services including reduction in donor funding. This qualitative study is the first to assess the effects of the COVID-19 pandemic and the financial crisis on Iraqi and Syrian orphaned children and their mothers. The Modified Grounded Theory was used for the preliminary analysis to expand the range of themes. This study has identified five major themes: financial crisis, low educational attainment, child labour, mental health issues, violence, and social problems. The impact of COVID-19 children and adolescents' mental health is of great concern. These multiple crises may significantly impact orphan children and adolescents' cognitive, mental health, and physical development. It is critical to address mental health issues during the current crisis and to plan for possible future pandemics and their intersecting outcomes. A Holistic approach requires providers to be aware of their clients' intersecting circumstances and needs using a range of lenses, including the person in the environment, family dynamics, culture, politics, and structural challenges. Offering food, medical supplies, and housing are considered basic needs.

A hybrid machine learning-mathematical programming optimization approach for municipal solid waste management during the pandemic

This paper provides a mathematical optimization strategy for optimal municipal solid waste management in the context of the COVID-19 epidemic. This strategy integrates two approaches: optimization and machine learning models. First, the optimization model determines the optimal supply chain for the municipal waste management system. Then, machine learning prediction models estimate the required parameters over time, which helps generate future projections for the proposed strategy. The optimization model was coded in the General Algebraic Modeling System, while the prediction model was coded in the Python programming environment. A case study of New York City was addressed to evaluate the proposed strategy, which includes extensive socioeconomic data sets to train the machine learning model. We found the predicted waste collection over time based on the socioeconomic data. The results show trade-offs between the economic (profit) and environmental (waste sent to landfill) objectives for future scenarios, which can be helpful for possible pandemic scenarios in the following years.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10668-023-03354-2.

Capacity assessment to secure COVID-19 waste treatment in Vietnam

The accelerated generation of COVID-19 waste under the Delta-fuelled outbreak placed a sudden burden on waste disposal in Vietnam. To secure the treatment of COVID-19 waste amid the pandemic uncertainty, treatment capacity was assessed by determining treatment occupancy rate-the ratio of estimated demand to calculated capacity-both nationally and in Ho Chi Minh City. At the general occupancy rate for COVID-19 waste treatment of 7.4%, the country was capable of handling COVID-19 waste, with a capacity to treat 62 191 t month^-1. However, Ho Chi Minh City became overwhelmed, indicated by a treatment occupancy rate of up to 780% during the Delta outbreak, as the unanticipated growth of demand for COVID-19 waste treatment caused waste to back up. The assessment results, in addition to current legislation, support collaboration in waste treatment as a solution to using existing resources to address the acute shortage of treatment capacity, so as to secure COVID-19 waste treatment. The findings could be used by other developing countries to tackle the waste problem in the pandemic era.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10163-022-01529-z.

Environmental challenges of COVID-19 pandemic: resilience and sustainability - A review

The emergence of novel respiratory disease (COVID-19) caused by SARS-CoV-2 has become a public health emergency worldwide and perturbed the global economy and ecosystem services. Many studies have reported the presence of SARS-CoV-2 in different environmental compartments, its transmission via environmental routes, and potential environmental challenges posed by the COVID-19 pandemic. None of these studies have comprehensively reviewed the bidirectional relationship between the COVID-19 pandemic and the environment. For the first time, we explored the relationship between the environment and the SARS-CoV-2 virus/COVID-19 and how they affect each other. Supporting evidence presented here clearly demonstrates the presence of SARS-CoV-2 in soil and water, denoting the role of the environment in the COVID-19 transmission process. However, most studies fail to determine if the viral genomes they have discovered are infectious, which could be affected by the environmental factors in which they are found.The potential environmental impact of the pandemic, including water pollution, chemical contamination, increased generation of non-biodegradable waste, and single-use plastics have received the most attention. For the most part, efficient measures have been used to address the current environmental challenges from COVID-19, including using environmentally friendly disinfection technologies and employing measures to reduce the production of plastic wastes, such as the reuse and recycling of plastics. Developing sustainable solutions to counter the environmental challenges posed by the COVID-19 pandemic should be included in national preparedness strategies. In conclusion, combating the pandemic and accomplishing public health goals should be balanced with environmentally sustainable measures, as the two are closely intertwined.

Analysis of COVID-19 waste management in Vietnam and recommendations to adapt to the 'new normal' period

Amid the 4th wave of COVID-19, Vietnam reopened its economy, which placed extra burdens on the COVID-19 waste management system. This study analyzed existing issues and recommended adaptations to secure appropriate management of COVID-19 waste under the 'new normal' pandemic period. Results showed changes in COVID-19 waste characteristics (e.g., rapid rise in waste generation, lower percentage of plastic) and multiple other issues (e.g., presence of COVID-19 waste in municipal waste, lack of temporary storage sites and local treatment capacity), along with greater waste-handling responsibilities placed on authorities and higher infection risks. To adapt to the 'new normal', introduction of separate handling routes and collaboration in waste treatment were recommended. Employing the network of pharmacies used for vaccination would require COVID-19 waste collection from scattered, small-scale sources as part of the waste management solution. Also, following the 4R initiatives (reduce, reuse, recycle, recovery) could help ease the burden on the country's waste system and provide additional opportunities to move towards a circular economy in the post-acute COVID-19 era. The findings should contribute to a safer co-existence with the virus through appropriate waste management in Vietnam and could be used to tackle waste problems in other developing countries.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10163-022-01563-x.

Waste management, COVID-19 and occupational safety and health: Challenges, insights and evidence

Different fields of knowledge have faced challenges due to the COVID-19 pandemic. Essential public services serving the population's needs were maintained. Previous studies have addressed the possibility of health hazards from handling solid waste (SW) among trash collection service workers, without introducing any data proving or dismissing those risks. Occupational health is stated in at least 2 of the 17 Sustainable Development Goals. Pearson Coefficient (r) was employed to analyze the correlation between the number of cases of COVID-19 in SW collection workers in the city of São Paulo, considering the district city halls where the COVID-19 patients live and the SW collection workers' route, from March 2020 to March 2021. Employees who collected wastes with COVID-19: 2% collected healthcare SD, 4% worked at the waste transshipment stations, 10% household variable route collection, and 83% in defined routes collecting household wastes. Positive and moderate correlation was confirmed (r = 0.59) between the total number of COVID-19 cases and the trash collection routes, and the number of contaminated COVID-19 workers from their trash collection routes. Considering concessionary companies separately, the correlation found in the Southeastern grouping is 0.77 (positive and high correlation), and the correlation found in the Northwestern grouping is 0.18 (positive but insignificant correlation). The Northwestern grouping's concessionary had implemented more effective occupational health and safety management policies and disclosed them among their stakeholders. Results suggest concern related to occupational health and safety for SW collection workers and substantiating the vulnerability of this essential activity during the pandemic.

Comparison of microwave and autoclave treatment for biomedical waste disinfection

As the world is facing a Covid-19 pandemic, this virus teaches a lesson about the importance of on-site disinfection. On-site disinfection/sterilization with real-time monitoring of biomedical waste generated from the medical facilities is mandatory to prevent hospital-acquired infection (HAI). In this study, the life cycle assessment of two technologies, i.e., microwave (radiation-based) and autoclave (steam-based) were performed to summarize the inside-out evaluation of both technologies in terms of efficiency, efficacy, and cost-effectiveness. The results of disinfection efficacy indicated a log 10 reduction (almost 100%) in the vegetative load of microorganisms compared to the control, showing a similar level of disinfection efficacy of both strategies. Additionally, both technologies were compared on several parameters, and it was discovered that the autoclave uses more time and resources than the microwave. The total cost of an autoclave to the government is approximately double that of a microwave, while the operational cost of an autoclave is more than double that of a microwave. The findings from this study indicate that MACS may be used as a dry technique of biomedical disinfection, and its portability, tunability, and compactness make it a suitable alternative for biomedical disinfection and sterilization.

Graphical abstract

A review on emergency disposal and management of medical waste during the COVID-19 pandemic in China

The surge of medical waste (MW) generated during the COVID-19 pandemic has exceeded the disposal capacity of existing facilities. The timely, safe, and efficient emergency disposal of MW is critical to prevent the epidemic spread. Therefore, this review presents the current status of MW generation and disposal in China and analyzes the characteristics and applicability of emergency disposal technologies. The results show that movable disposal facilities can dispose of infectious MW on site, even though most of their disposal capacity is at a low level (<5 t/day). Co-disposal facilities need to be reformed completely for emergency MW disposal, in which separate feeding systems should be taken seriously. Specifically, municipal solid waste (MSW) incineration facilities have great potential to improve emergency MW disposal capacities. For hazardous waste incineration facilities, compatibility of the wastes must be matched to the composition and calorific value of the waste. As for cement kiln, MW can only be used as an alternative fuel instead of a raw material for cement. Based on the environmental risk and technical adaptability, the six emergency MW disposal technologies are recommended to be prioritized as follows: movable microwave sterilization, movable steam sterilization, movable incineration, co-incineration with hazardous waste, co-incineration with MSW and co-disposal in cement kilns. Infectious MW, especially COVID-19 MW, should be prioritized for disposal by centralized and movable disposal facilities, while non-infectious MW can be disposed of using co-disposal facilities. All stakeholders should strengthen the delicacy management of the end-of-life stage of MW, including collection, classification, packaging identification, transportation, and disposal. Currently, it is necessary for centralized disposal enterprises to follow the emergency disposal operation flowchart. From a long-term strategic perspective, making full use of regional movable and co-disposal facilities in the megacities can effectively enhance the emergency MW disposal capacity.

Review of hospital plastic waste management strategies for Pakistan

Healthcare waste management is considered one of the biggest challenges that the world is going to face in the future. This threat is becoming reality owing to the worldwide sharp rise in healthcare waste generation particularly during the current COVID-19 pandemic. Like many other environmental crises, hospital plastic waste management is an area that got very little attention despite being highlighted in the literature, local media, as well as in international electronic and print media. This mini-review was conducted to assess the overall prevailing situation regarding hospital plastic waste management in Pakistan. Several illegal and unethical activities have been observed regarding hospital plastic waste management in Pakistan which includes unhygienic recycling, repacking of used hospital plastic items, open dumping on land, and disposal of hospital plastic waste in the ocean. To improve these conditions, suggestions have been made regarding the better management of hospital plastic waste.

Medical Waste Treatment Technologies for Energy, Fuels, and Materials Production: A Review

The importance of medical waste management has grown during the COVID-19 pandemic because of the increase in medical waste quantity and the significant dangers of these highly infected wastes for human health and the environment. This innovative review focuses on the possibility of materials, gas/liquid/solid fuels, thermal energy, and electric power production from medical waste fractions. Appropriate and promising treatment/disposal technologies, such as (i) acid hydrolysis, (ii) acid/enzymatic hydrolysis, (iii) anaerobic digestion, (vi) autoclaving, (v) enzymatic oxidation, (vi) hydrothermal carbonization/treatment, (vii) incineration/steam heat recovery system, (viii) pyrolysis/Rankine cycle, (ix) rotary kiln treatment, (x) microwave/steam sterilization, (xi) plasma gasification/melting, (xii) sulfonation, (xiii) batch reactor thermal cracking, and (xiv) torrefaction, were investigated. The medical waste generation data were collected according to numerous researchers from various countries, and divided into gross medical waste and hazardous medical waste. Moreover, the medical wastes were separated into categories and types according to the international literature and the medical waste fractions’ percentages were estimated. The capability of the examined medical waste treatment technologies to produce energy, fuels, and materials, and eliminate the medical waste management problem, was very promising with regard to the near future.