By Shreya Asopa| May 26, 2021
Bengaluru: The outbreak of the Covid-19 pandemic has caused an exponential increase in biomedical waste. As per the data from the Central Pollution Control Board (CPCB), peak generation of 250 tonnes of covid biomedical waste was reported in May. In 2019, India generated 610 MT of biomedical waste per day. During the pandemic, the waste has increased up to 750 to 800MT per day. While the CPCB has issued guidelines to manage the waste, pandemic has aggravated the situation.
Growing Biomedical Waste
Every day Dr. Raghavendra B. K works round the clock in the ICU. Dr. Raghavendra serves as an Intensivist at People Tree Hospitals, Meenakshi, Bangalore. He finds the burden of biomedical waste has increased tremendously during the covid-19 pandemic. “A 100 bedded hospital usually generates around 100 kgs of waste per week. But after the pandemic, the hospital is generating 300 to 400 kgs every week. And rather than the weight, it is the bulk of Personal Protective Equipment (PPE), N95 masks, amongst others.”
“The number of hospital staff has reduced by 50 percent and, patients are around 300 percent during the pandemic,” Dr. Raghavendra explains that despite following the Standard Operating Protocols (SOP), the burden for waste management has increased due to shortage of hospital staff.
The 1998 Biomedical Waste (Management and Handling) Rules were amended and enforced over the years. With the advent of the pandemic, the CPCB has issued new guidelines for the covid-19 biomedical waste in addition to the existing practices under the 2016, BMW rules.
According to the Karnataka State Pollution Control Board (KSPCB), Bangalore generated 250,624.56 kg of biomedical waste between March 2020 to 2021. Months into the pandemic and, the cases are still rising.
There is a huge demand for surgical instruments and other medical essentials among people. Divakara Kulal M, the owner of fast surgical, notices that the current demand is like a ‘tsunami’. He said,” We have a heavy requirement due to covid. Not even hospitals, but other people are also purchasing surgical equipments directly from shops. After the pandemic, we have seen an 80 percent increase in demand for face masks, oximeter, infrared thermometers.”
Karnataka’s Health Minister K. Sudhakar, tweeted that over one crore of RT-PCR test kits will be procured to ramp up testing in the second wave. The demand is not only for test kits but also for PPE kits. S. Suttarwala runs a shop that sells PPE kits. He said, “A lot of people who were not into manufacturing masks and gloves jumped into this industry.”
As per the Niti Ayog report, in the pre covid era, India virtually produced no PPE kits however it can now manufacture 450,000 PPE kits per day. These essentials are also bought by the common residents. This has led to a severe waste management crisis affecting the environment as well as those who are in the vicinity.
Naveen Kumar, a dry waste collector from R. R Nagar, Bangalore, said, “We do not receive syringes from all the houses. There are only certain households where a person is treated at their home. Some residents follow the norms. While some mix the waste.” At times he has to segregate domestic biomedical waste from dry waste that can be a potential hazard for him.
The CPCB has issued guidelines for handling and disposal of waste for home isolation patients. As per the guidelines, waste from houses of quarantine patients should be collected by a dedicated vehicle in a double-layered bag.
The waste collector should also wear three-layered masks and be trained for waste disposal. Basvaraju, a pourakarmika who collects waste from residents, struggles to handle the waste due to a lack of protective equipment. “Some households were not segregating the waste, so we asked them to separate waste. We have not been receiving safety equipments, however some kind people are donating it.”
The resident welfare associations are vigilant towards the segregation of waste. Priti Nair, a core member of the Rustambagh Association for Welfare (RAW) is actively working towards implementing biomedical rules and helping the residents. “We need to do more in terms of biomedical waste as most of our residents are moving crowds. We are circulating guidelines towards medical waste and, in separate buildings, we have installed medical waste bins. We are also fining the residents who do not segregate waste.”
Cost of Waste
Biomedical waste generation is not only impacting the environment but is also burdening medical institutions economically. Karnataka is spending nine times more on covid waste compared to the cost of disposing of one kg of general biomedical waste.
“Fortunately, in Bangalore, there are about four agencies that manage biomedical waste. These plants have efficiently managed the waste,” said Dr. R Ravindra, Former president of, Private Hospitals and Nursing Homes’ Association (PHANA). “The only issue we had was that cost went up ten times, so the hospitals had to pay quite a bit to the waste disposal facilities. The rates were fixed at Rs. 58 per kg for disposal of covid biomedical waste whereas, before covid we were paying Rs. 6 to Rs. 8 for regular biomedical waste per bed per day.”
The waste must be segregated as per the color-coded bins to reduce the burden on the entire chain associated with the management and handling of waste. Dr. Sandhya, Nodal Officer from BBMP, ensures that the waste is scientifically disposed of and the monitoring agencies are following the guidelines. “If the CBWTF do not follow the guidelines then they could be fined up to rupees one lakh. It is also essential that the hospitals are segregating the waste based on color code.”
While the CBWTF plants are struggling with logistics costs, Dr. Vinit Anand, president of Shushrutha Biomedical Waste Management Society has found sustainable solutions. “A lot of doctors believed since we are responsible for the waste, we need to handle it. So, instead of giving it to the third-party vendor, we decided to established our CBWTF plant. When we used to charge Rs.3 when the other CBWTF plants were charging Rs. 7 to Rs.12.” Although, just like other CBWTF, they too are facing challenges in incinerating PPE kits. He said, “PPE kits contain polypropylene which makes them hard to incinerate and, it also impacts the instruments and machine in the long run.”
There are 198 Common Biomedical Waste Treatment and Disposal Facility (CBWTF) plants in India. As per the CPCB, the cumulative incineration capacity of CBWTF in the country is 815MT/day. On the national outlook, the incineration capacity is adequate but the capacity has been exceeded in many states.
Finding Sustainable Solutions
As per 2016 rules, biomedical waste has been classified into four categories instead of ten to improve the waste segregation at the source. Despite amendments, the dearth of implementation is a concern. In January 2021, the National Green Tribunal (NGT) directed the CPCB to ensure strict compliance with biomedical waste rules.
“The overall capacity for treatment of biomedical waste is adequate for the country. Although, when we consider individual states, then many have exceeded their capacity,” informed Youthika Puri, an environmental engineer at CPCB while addressing a webinar. “In states like Assam, Kerala, Odisha, Pondicherry, the capacity utilization of existing common biomedical waste treatment infrastructure has exceeded by 75 % and, they need to look at alternative options.”
Experts say biomedical waste if, not disposed of properly, can lead to the spread of vector-borne diseases and contamination of air, water, and soil. “If a small amount of biomedical waste is mixed up with the wet and dry waste, then it can create havoc in the entire food chain,” said Divya Tiwari, CEO of Saahas NGO, an environmental organization practicing sustainable waste management solutions.
“The government needs to intervene as the cost to manage biomedical waste is more compared to wet and dry waste. This is because in biomedical waste, the quantity is small and, the vendors are fewer so, the logistics are high.”
She also said, “In cities, there is a lack of surprise checks in the hospitals that supply waste to biomedical facilities, and if we look into smaller towns and rural areas, there is nothing. Biomedical waste poses health and environmental hazards, so it is important manage it appropriately to contain and prevent future infections.”