Covid-19 Update: Revised Guidelines For Handling of Waste Generated During Treatment Of Covid-19 Patients

The Central Pollution Control Board (“CPCB”) on 19^th March 2020 issued guidelines for handling, treatment and disposal of Covid-19 waste at Healthcare Facilities, Quarantine Camps/ Quarantine-homes/ Home-care, Sample Collection Centers, Laboratories, State Pollution Control Boards (“SPCBs”)/ Pollution Control Committees (“PCCs”), Urban Local Bodies (“ULBs”) and Common Biomedical Waste Treatment Facilities (“CBWTF”) which includes setting up of quarantine centers and camps, isolation wards, sample collection centers and laboratories in order to deal with Covid-19 pandemic (“Guidelines”). These guidelines are required to be followed by all the stakeholders including isolation wards, quarantine centers, etc. in addition to existing practices under Bio-Medical Waste Management Rules 2016 (“BMWM Rules”).  

The said Guidelines were further suppressed by the guidelines issued on 22^nd March 2020 and 18^th April 2020. The latest revised guidelines were issued by CPCB on 10^th June 2020 (“Revised Guidelines”) mainly for the purpose of incorporating guidance on segregation of general solid waste and biomedical waste and to address safety of waste handlers/ sanitation workers associated with healthcare facilities, local bodies and CBWTFs in handling of biomedical waste and solid waste generated from Quarantine centers/ home-care/ healthcare facilities treating Covid-19 patients. The key additions imposed by the Revised Guidelines for handling, treatment and disposal of Covid-19 waste are detailed hereinbelow:

Covid-19 Isolation wards

• General solid waste like wrappers of medicine/ syringes, etc. carton boxes of medicines and any other items which are not contaminated by the patients, body fluids should be collected separately as per Solid Waste Management Rules 2016 (“SWM Rules”). In order to minimize waste generation, as far as possible, non-disposable items must be used, which are to be handled with appropriate precautions and cleaned and disinfected as per the hospital guidelines. The wet and dry solid waste bags should be securely tied and handed over to authorized waste collector of ULB’s on a daily basis.
• Items like used masks, used tissues, etc. used by Covid-19 patients shall become biomedical waste and shall be segregated in a “yellow bag”. Used gloves and plastic bottle from patients shall be disposed-off in a “red bag”. Training should be provided to waste handlers about infection prevention measures such as social distancing, use of appropriate PPE, etc.

Responsibilities of persons operating Quarantine Camps/Homes or Home-Care

• Agency responsible for operation of Quarantine Centre/ Camp shall designate a nodal person who will be responsible for waste management and for maintenance of its record.
• Designated nodal person of the Quarantine Centre/ Camp shall register the Centre/ Camp on CPCB’s biomedical waste Tracking App “COVID19BWM” and update the details of waste generated on daily basis.

Additional duties issued to CBWTF

• CBWTF operator shall register on ‘COVID19BWM’ Tracking App developed by CPCB and also ensure registration of waste handler (with vehicle) for entering the data of Covid-19 biomedical waste received and disposed.
• Provide training to waste handlers on infection prevention measures, hand hygiene, respiratory etiquettes, social distancing, use of PPE, etc. via videos and demonstrations translated in local language. Sanitation workers more than 50 years of age should be posted for management of non-Covid waste.

Additional duties issued for SPCBs/ PCCs

• In case of generation of large volume of yellow colour coded (incinerable) Covid-19 waste beyond the capacity of existing CBWTFs and the captive BMW incinerators, SPCBs/ PCCs shall permit HW incinerators at existing TSDFs or captive industrial incinerators, if any, existing in the State/ UT.
• During the subsistence of the Covid-19 pandemic, SPCBs/PCCs may direct the ULBs to collect dry general solid waste in bags from quarantine centers/ quarantine homes/ homecare units, and sprayed with disinfectant solution, for disposal in waste to energy plants/ industrial incinerators/ landfills, as per existing practice or availability in the State.
• Every SPCB/ PCC shall use ‘COVID19BWM’ web-portal developed by CPCB to track and verify Covid-19 biomedical waste and to submit daily data to CPCB through said portal.

Additional duties issued to ULBs

• ULBs shall ensure that general solid waste and biomedical waste generated from quarantine camps/ quarantine homes/ homecare RE not mixed. The biomedical waste and general solid waste should always be collected separately.
• As a matter of caution, the bags containing general waste may be sprayed with disinfectant solution (1% sodium hypochlorite solution) prior to disposal.
• Create awareness among citizens regarding segregation of municipal solid waste and biomedical waste (as part of domestic hazardous waste) generated from homes/ Quarantine homes, etc.
• Waste handlers must be given basic/ elementary training by ULBs/ SPCBs/ PCCs with help from NGOs on solid waste management, social distancing, etc.
• ULBs shall collect segregated general solid waste from Quarantine centers, home-care and hospitals in bags (without opening them to ensure waste collector’s safety and to avoid pilferage). General solid waste may be disposed as per SWM Rules 2016, which may include disposal in landfills, waste to energy plants, depending on available infrastructure. Access to landfills sites should be strictly restricted.
• In case ULBs are unable to manage solid waste with their existing staff, professional solid waste management agencies may be engaged/ authorized during Covid-19 situation for timely collection of solid waste and biomedical wastes separately from Quarantine centers, home-cares, etc.

In Sum

It can be inferred that CPCB has issued these Revised Guidelines primarily to address the issue of waste segregation and to ensure safety of healthcare and sanitation workers. The Revised Guidelines also act as a handbook to aid hospitals and healthcare facilities to deal with the ongoing Covid-19 pandemic situation.

Key takeaways for service providers: People who are undergoing training pursuant to the Revised Guidelines or people who are undertaking service contracts for handling, treating or disposing of waste shall set out their obligations very clearly in their contracts. The service providers should identify and account for potential costs in their contracts that may arise in accordance with these Revised Guidelines. They should also build-in escalations in their existing SOWs in the event that such SOWs are automatically renerwed – to ensure some upside for costs of provision of services.

Key takeaways for healthcare service providers: Healthcare service providers should ensure that they abide by these Revised Guidelines as well as any guidelines that may come into effect in future, along with compliance of applicable laws prevalent at that point in time. Many such compliances would be tricky since the mandate is to following prevailing state practices. Liaison and constant communication with the municipal and other relevant authorities should bring some clarity as to those practices. Healthcare service providers should also take into consideration the costs of implementation of the Revised Guidelines, while executing contracts and SOWs with their service staff.

– Charu Lata (Associate) and Yogesh Mahamunkar (Associate)