Garbage con­t­a­m­i­nat­ed with bod­i­ly flu­ids or oth­er infec­tious mate­ri­als is becom­ing a big­ger con­cern for hos­pi­tals as they brace for a surge in patients sick with COVID-19 in the US. Patients and health care work­ers are quick­ly going through med­ical sup­plies and dis­pos­able per­son­al pro­tec­tive equip­ment, like masks. Even­tu­al­ly all that used gear piles up as med­ical waste that needs to be safe­ly dis­card­ed.

In Wuhan, where the nov­el coro­n­avirus first emerged, offi­cials didn’t just need to build new hos­pi­tals for the influx of patients; they had to con­struct a new med­ical waste plant and deploy 46 mobile waste treat­ment facil­i­ties too. Hos­pi­tals there gen­er­at­ed six times as much med­ical waste at the peak of the out­break as they did before the cri­sis began. The dai­ly out­put of med­ical waste reached 240 met­ric tons, about the weight of an adult blue whale.

Hos­pi­tals gen­er­at­ed 6 times as much med­ical waste

There’s already been an uptick of garbage from per­son­al pro­tec­tive equip­ment in the US, accord­ing to med­ical waste com­pa­ny Ster­i­cy­cle, which han­dled 1.8 bil­lion pounds of med­ical waste glob­al­ly in 2018. And some things that aren’t usu­al­ly con­sid­ered med­ical waste, like food, now need to be han­dled more care­ful­ly after com­ing in con­tact with a COVID-19 patient. Ster­i­cy­cle didn’t pro­vide num­bers for how much of an increase it’s see­ing so far, adding that it believes it has the capac­i­ty to han­dle the swell and may add shifts to the company’s 50 treat­ment cen­ters in the US if nec­es­sary. Addi­tion­al­ly, the drop in elec­tive surg­eries might off­set some of the rise in waste we’re see­ing from the pan­dem­ic, a spokesper­son for Ster­i­cy­cle tells The Verge.

“It’s a rapid­ly chang­ing envi­ron­ment right now and fore­cast­ing vol­umes is chal­leng­ing,” Ster­i­cy­cle Vice Pres­i­dent of Cor­po­rate Com­mu­ni­ca­tions Jen­nifer Koenig wrote in an email to The Verge. “We are close­ly mon­i­tor­ing the sit­u­a­tion with all rel­e­vant agen­cies to deter­mine next steps.”

“It’s a rapid­ly chang­ing envi­ron­ment”

The CDC says that med­ical waste from COVID-19 can be treat­ed the same way as reg­u­lar med­ical waste. Reg­u­la­tions on how to treat that waste vary by loca­tion and can be gov­erned by state health and envi­ron­men­tal depart­ments, as well as by the Occu­pa­tion­al Safe­ty and Health Admin­is­tra­tion and the Depart­ment of Trans­porta­tion. 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 cen­ters. 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, accord­ing to one study of the virus in lab con­di­tions.

But if garbage is prop­er­ly bagged instead of kept loose and work­ers are wear­ing per­son­al pro­tec­tive equip­ment, espe­cial­ly gloves, then there shouldn’t be a risk of catch­ing the virus, David Bider­man, CEO of the Sol­id Waste Asso­ci­a­tion of North Amer­i­ca, tells The Verge. Prac­tic­ing social dis­tanc­ing while on the job, includ­ing main­tain­ing appro­pri­ate dis­tances from peo­ple, may also help reduce san­i­ta­tion work­ers’ risks, says Elise Paef­f­gen, a part­ner with the firm Alston & Bird who works on med­ical waste issues.

Peo­ple han­dling health care waste should wear appro­pri­ate gear

Peo­ple han­dling health care waste in par­tic­u­lar should wear appro­pri­ate gear, includ­ing boots, aprons, long-sleeved gowns, thick gloves, masks, and gog­gles or face shields, accord­ing to rec­om­men­da­tions from the World Health Orga­ni­za­tion. Luck­i­ly, pro­tec­tive efforts so far seem to have paid off. “There is no evi­dence that direct, unpro­tect­ed human con­tact dur­ing the han­dling of health care waste has result­ed in the trans­mis­sion of the COVID-19 virus,” accord­ing to a March 19th tech­ni­cal brief from the WHO. As the pan­dem­ic grows, so will the waste, and keep­ing that garbage safe and con­tained will con­tin­ue to be a chal­lenge for com­mu­ni­ties until the cri­sis is over.

A staff mem­ber col­lects and trans­fers med­ical waste at the Henan Provin­cial People’s Hos­pi­tal in Zhengzhou, cen­tral China’s Henan Province, March 3, 2020.  Xinhua/Hao Yuan via Get­ty Images

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