How to deal with discarded face masks, protective suits, syringes and needles for injecting medicine is another headache for Chinese authorities already caught between containing the viral disease and limiting the economic damage caused by it. While the government suggests everyone wear a mask in public places to contain the spread of the virus, their use has added to the piles of medical waste to be disposed of, and this situation has the potential to become an ecological disaster.
The outbreak saw Wuhan’s medical waste volume increase five-fold, from 40 metric tons per day to 240 metric tons per day, said Zhao Qunying, head of the emergency office of the Ministry of Ecology and Environment, at a recent press conference. But there was only one company capable of shipping and processing medical waste, Wuhan Hanshi Environmental Engineering Co., with a daily processing capacity of around 49 tons in 2018.
On January 28, the Ministry of Ecology and Environment published a guideline that lays out such emergency measures as building centralized disposal plants, deploying mobile station for medical waste incineration, and on-site incineration equipment for temporary hospitals, to close the gap in the processing capacity.
Medical waste produced in Wuhan was also allowed to be shipped to nearby cities for treatment, said Leng. From early February, trucks carrying medical waste from Wuhan were sent to incineration plants in Xianyang. They were driven by volunteers, because of the shortage of staff as the city was under lockdown.
The risk of cross-infection made the medical waste management business a highly-dangerous job. “Though many of our workers dealt with medical waste during SARS, they still expressed their worries due to the highly contagious nature of COVID-19,” said Leng.
All workers at the incineration plants lived in hotel rooms paid by the company, for fear of spreading the virus to family members. They worked on three shifts to make sure that the incineration plants operated non-stop. “The heat at the incineration plants would kill all viruses, and the gas released would be processed to make sure that no toxic substance is released into the air,” he added.
Help from medical waste companies across the country has also been enlisted. According to media reports, at least six medical waste management companies have come to the rescue of Wuhan, offering mobile waste treatment stations and converting industrial waste disposal plants to treat medical waste.
But the shipping of medical waste still incurs high risk, said Chen Qingping, founder of Xinhuochuan Environment Technology Company based in neighboring Hunan Province. His company sent 15 on-site medical waste disposal units to aid hospitals in Wuhan and is in charge of processing medical waste at Leishenshan Hospital, the newly-built hospital to address bed shortage.
The capacity of on-site medical waste disposal equipment is still limited. Chen’s company is now able to process up to 6 metric tons of medical waste at Leishenshan Hospital. But whether or not the on-site medical treatment equipment can be environmentally-friendly is another question, since most of the units were installed in a short time, it is unclear if they can meet emission standards, Leng cautioned.
Incineration still remains the method of choice for dealing with infectious waste, said Eric Liu, a toxics campaigner at Greenpeace East Asia. Incineration can kill viruses most effectively. On top of that, it can reduce the quantity of medical waste, unlike steam microwaving or steam autoclaving, two alternative ways of dealing with medical waste.
Environment and health authorities say masks and other protective gear, especially items used by medical personnel and people infected with the coronavirus, should be treated as clinical waste, and sterilised before being incinerated at high temperatures at dedicated facilities. Most of the medical waste facilities – built in the wake of the Sars outbreak 17 years ago – are near the end of their operating lifespan, the Ministry of Ecology and Environment said last year. That partly explained why authorities in Wuhan – a city of 11 million people that is home to 75 per cent of those killed by the virus – appeared to have been overwhelmed by the volume of medical waste produced over the past few months, experts said.
Eric Liu, a toxic waste specialist at Greenpeace’s Beijing office, said China had a huge shortage of waste disposal facilities, specifically those capable of handling clinical waste. “The waste treatment capacity in China, especially in terms of medical and hazardous waste, is barely enough to cope with everyday needs, let alone the country’s biggest public health crisis in decades,” he said.
Du Huanzheng, director of the Recycling Economy Institute at Tongji University in Shanghai, also expressed concerns over the widening supply-demand gap in medical waste treatment, but said a large number of new facilities were being built or planned. “The disposal of medical waste is a major part of the battle against the outbreak, which is a wake-up call for the government to speed up the construction of new facilities and research into waste treatment technologies,” he said.
The coronavirus outbreak could be the catalyst for expanding the medical waste sector and lead to the building of more incineration facilities, the experts said.
Liu said that while environmental concerns may need to take a back seat as the country battled the coronavirus epidemic, that should not be used as an excuse to neglect the ecological impact of an incinerator building boom.
“Although incineration is widely used around the world, it remains a fairly controversial technical solution and can hardly be described as environmentally friendly, which is why the US and other developed countries in Europe have moved away from the technology,” he said.
At a recent press conference, Zhao Qunying, head of the Ministry of Ecology and Environment’s emergency office, assured that there was no toxic air and water released from processing medical waste in Wuhan.
The coronavirus outbreak reveals the lack of preparation in the medical waste treatment system, said Leng. Many central disposal facilities are in need of reform and upgrade, he added, and they should have excess capacity to deal with emergency situations.
“If we want to make sure that rural areas are covered by the waste management system, we cannot simply rely on corporations because the cost is too high,” Leng said. “This is why medical waste management should be incorporated into the national infrastructure development.”