Covid 19 infections in India stand at 8.6 million with over 1,27,000 deaths. Anticipated new wave of corona coupled with changing weather is showing sudden spurt in numbers all over with various epicentres including Delhi touching new highs daily.
India, the large and diverse nation with over 1.4 billion population was among the initial nations to announce a complete lockdown to contain pandemic. However its struggle to contain the pandemic continues while witnessing the fastest outbreak of corona in the world.
Prolonged lockdown has helped the nation with added tertiary care facilities, gaining access to medical equipments such as ventilators and oxygen plants, increased testing number and innovations like pooled testing and efforts to develop and manufacture vaccine.
At the same time the unplanned, unscrupulous and prolonged lockdown attracted wide criticism due to low or no gains to control the spread of virus and much to lose on almost all fronts including economy.
Experts have gone to the extent of disputing the government data about corona infections and deaths for being far from reality. The real number of corona infections is visibly managed by avoiding compulsory testing instead of the adopted method of voluntary one. Similarly, the Government reports CFR (case fatality rate) nearing one percent mark which is much below the reported rate when compared to other countries. The major reason assigned to low death rate in India is due to non attribution of deaths to corona infection and practically avoidable death registration system which does not overrule the possibility of hidden or unregistered deaths due to corona.
To keep the optimism up, recognition of success is imperative especially in the present situation of despair with pandemic tolls making new highs every day. But too much hope while clouding the reality is actually hampering the needed vital health initiatives.
India is clearly facing a dangerous period. Besides the spread of corona infection, a parallel crisis of proper disposal of biomedical waste such as used masks, PPE kits, gloves, shoe covers, needles syringes, blood bags, test kits and others is posing serious threat furthering the infection.
The situation has worsened with relaxation in lockdown as people move out with face shields, masks and gloves. While the use of face shields, mask and gloves by masses is necessary to contain infection, its use has created a dearth of medical disposals and equipments for health workers and other necessary services engaged to fight corona.
This non institutional use of medical equipments and disposals by general public has also created a spread of covid medical waste in the localities and environment and increased use of refurbished, discarded and infected masks and gloves.
Central Pollution Control Board (CPCB), the statutory body responsible for control and monitoring of pollution in India discloses the generation of approximately 18,000 tonnes of biomedical waste in four months after relaxation in lockdown.
CPCB was vigilant enough to realise the need of real time monitoring of covid related medical waste for which a mobile application ‘Covid19BWM’was developed in May this year. The application captured generation of 183 tonnes per day (TPD) of covid related biomedical waste for the month of September 2020 alone.
Waste management and scientific communities are finding ways to access the negative impact of medical waste disposal on human health and the environment. After relaxation in lockdown nothing substantive was done to control the spread of medical waste. There is a lack of clear strategy regarding the standardisation, procedures, guidelines and strict implementation of medical waste management related to COVID-19. This is worsening the situation with increased corona cases along with pathogens spread and transmit diseases.
The state governments made wearing face mask compulsory to prevent the spread of corona infection. Rajasthan is the first state in India to make law for mandatory use of mask. But all such half hearted efforts to contain the infection are proving hazardous not only to human health but also to the environment. The compulsion of masks has been implemented without disclosing the quality of mask to be used and avoiding the use of disposable medical masks.
Governments and authorities have even failed to pronounce and specify guidelines for use and disposal of used masks which should have been categorised as hazardous waste by proper legislation. As a result they are being disposed of by people as regular household waste or at public places creating a high risk to others.
World Health Organisation (WHO) guidelines for use and disposal of masks specifically define the type of mask based on possible exposure of virus, the place of living, visit and the work one does. WHO and other similar organisations have suggested the use of washable fabric masks unless someone belongs to any particular risk group. Wearing a disposable medical/ surgical mask is only recommended for people above 60 years of age with medical conditions and who are unwell or are looking after an ill family member.
All such guidelines and suggestions have been overlooked by the authorities in their hastily drawn decision to make the use of mask compulsory. It even misses the procedure of disposal after use for the same. Consequently, millions of contaminated materials including face shields, masks and gloves are undergoing the irreversible process of becoming hazardous and infectious waste prone to cause environmental and health problems solely due to lack of foresightedness of the leaders and babus.
Sanitation workers and rag pickers are most vulnerable to risk of handling the unscientific disposal of discarded masks, gloves and other medical waste from homes emerging as potential sources for the spread of this highly contagious virus.
Besides the corona pandemic, the all time pandemic of human greed for profits and selfishness is sweeping the globe. India is also not immune to such opportunists whose greed for profits is causing an irrational amount of dismay and negligence.
Due to lack of proper legislation and irrational development of medical industry, there is an increased demand for medical protection equipments and disposals in India. This has evolved as a huge market for discarded medical equipment, including disposable facemasks, gloves and PPE kits during the pandemic.
Recently 3.8 million pair of refurbished single-use surgical gloves was recovered by police in Navi Mumbai sourced from various hospitals. At another instance, the Bihar health department has cracked several gangs involved in selling of used face shields, masks and other disposals.
The booming black market of used PPE kits, face masks and surgical gloves is posing a serious health hazard to people who scramble for cheap coronavirus protection at the time when India is battling the pandemic.
While medical health and other essential service professionals are coping with unavailability of PPE kits, the unplanned disposal of medical waste is calling for an urgent action before it is too late.
To curb the menace, there is an urgent need to create biomedical waste community/ mobile incinerators at accessible locations with massive awareness campaigns about proper segregation of waste to be conducted periodically. If immediate actions are not taken, the Covid infection coupled with improper handling of biomedical waste will crumble the already exhausted heath system with a sharp rise in covid and other infections.
Ritesh Sharma is activist and legal consultant, the views expressed are personal.
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