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Covid 19 Vaccine Wastage in India – How Kerala managed Zero Wastage of Covid vaccine?

Covid 19 Vaccine Wastage in India – How Kerala managed Zero Wastage of Covid vaccine?

Relevance

  • GS 3 || Environment || Environment & Ecology || Pollution

Why in news?

  • Kerala is the only state to have ensured zero COVID-19 vaccine wastage, with Andhra Pradesh being a close second at just 1 percent slippage, according to the data released by the central government.

What is vaccine wastage?

  • Vaccine wastage is an expected component of any large vaccination drive, and a vaccine is procured from the maker with an estimated wastage. For each vaccine type, the wastage has to be within recommended limits.
  • High vaccine wastage inflates vaccine demand and increases vaccine procurement and supply chain costs.
  • It is directly linked to vaccine usage, which is the proportion of vaccines administered against vaccines issued to a vaccination site.

Directions from NGT regarding Bio-medical Wastage

  • Recently, the National Green Tribunal (NGT) has observed that the segregation of Covid-19 biomedical waste from general garbage is a must to avoid further contamination adversely affecting public health.
  • The directions came on a suo­ motu matter about scientific disposal of Covid-19 waste.
  • It was observed that segregation of Covid-19 from general waste is a must to avoid additional load on Common Biomedical Waste Treatment and Disposal Facilities (CBWTFs) incinerators and also to avoid further contamination.
  • In India, Biomedical Waste Management Rules, 2016 deal with waste generated in infectious diseases like Covid-19.

What is Medical waste/Bio-Medical Waste?

  • Medical waste is a subset of wastes generated at health care facilities, such as hospitals, physicians’ offices, dental practices, blood banks, and veterinary hospitals/clinics, as well as medical research facilities and laboratories. Generally, medical waste is healthcare waste that may be contaminated by blood, body fluids, or other potentially infectious materials and is often referred to as regulated medical waste.
  • Biomedical waste comprises human & animal anatomical waste, treatment apparatus like needles, syringes, and other materials used in health care facilities in the process of treatment and research.
  • This waste is generated during diagnosis, treatment, or immunization in hospitals, nursing homes, pathological laboratories, blood banks, etc.

Management of Medical waste/Bio-Medical Waste

  • Biomedical waste must be properly managed and disposed of to protect the environment, general public, and workers, especially healthcare and sanitation workers who are at risk of exposure to biomedical waste as an occupational hazard.
  • Steps in the management of biomedical waste include generation, accumulation, handling, storage, treatment, transport, and disposal.
  • National waste management policy
    • The development and implementation of a national waste management policy can improve biomedical waste management in health facilities in a country.
    • Disposal of this waste is an environmental concern, as many medical wastes are classified as infectious or bio-hazardous and could potentially lead to the spread of infectious disease.
  • The most common danger for humans is an infection which also affects other living organisms in the region. Daily exposure to the wastes (landfills) leads to the accumulation of harmful substances or microbes in the person’s body.
  • A 1990 report by the United States Agency for Toxic Substances and Disease Registry concluded
    • that the general public is not likely to be adversely affected by biomedical waste generated in the traditional healthcare setting.
    • They found, however, that biomedical waste from those settings may pose injury and exposure risks via occupational contact with medical waste for doctors, nurses, and janitorial, laundry, and refuse workers.
    • Further, there are opportunities for the general public to come into contact with medical waste, such as needles used illicitly outside healthcare settings, or biomedical waste generated via home health care.

Effects of medical waste

  • Impact on earth
    • Improper management of health care waste can have both direct and indirect health consequences for health personnel, community members, and the environment.
  • Toxic emissions
    • Indirect consequences in the form of toxic emissions from inadequate burning of medical waste, or the production of millions of used syringes in a period of three to four weeks from an insufficiently well-planned mass immunization campaign.
  • Water contamination
    • The most serious effect that biomedical waste has on our seas is the discharge of poisons into the waters that could then be consumed by ocean life creatures.
    • Biomedical waste is not limited to medical instruments; it includes medicine, waste stored in red biohazard bags, and materials used for patient care, such as cotton and band-aids.
  • Birth defects
    • Toxins would interject into the food chain and eventually reach humans who consume sea creatures.
    • Human exposure to such toxins can stunt human growth development and cause birth defects.
  • Impact on Environment
    • The high volume of plastic use in the medical field also poses a dangerous threat to the environment.
    • According to North and Halden, 85% of disposable plastic materials make up all medical equipment.
    • Our current reliance on plastic materials is rooted in their unique capabilities to be lightweight, cost-effective, and durable while preserving the sterility of medical equipment.
    • In addition to the serious health implications of releasing harmful toxins in the environment from medical waste deposits, introducing this volume of single-use plastics can catalyze the compounding health detriments caused by macro and micro-plastics.

Biomedical Waste Management Rules, 2016

  • Objective:The objective of the rules is to properly manage the per-day bio-medical waste from Healthcare Facilities (HCFs) across the country.
  • Ambit: The ambit of the rules has been expanded to include vaccination camps, blood donation camps, surgical camps, or any other healthcare activity.
  • Phase Out: Chlorinated plastic bags, gloves, and blood bags have been phased out within two years starting from March 2016.
  • Pre-treatment: Pre-treatment of the laboratory waste, microbiological waste, blood samples, and blood bags through disinfection or sterilization on-site in the manner prescribed by the World Health Organization (WHO) or by the National AIDS Control Organisation (NACO).
  • Categorization: Bio-medical waste has been classified into 4 categories instead of the earlier 10 categories to improve the segregation of waste at source.
  • Stringent Standards for Pollutants: The rules prescribe more stringent standards for incinerators to reduce the emission of pollutants in the environment.
  • Role of State Government: The State Government provides the land for setting up common bio-medical waste treatment and disposal facilities.

Challenges and Concerns

  • The pandemic has posed a challenge in terms of scientifically disposing of produced waste, as well as a challenge for civic authorities in charge of collection and disposal.
  • The CPCB recommendations on Covid-19-related waste are not being followed by states.
  • Covid-19 facilities and quarantine homes have been accused of excessive waste segregation in several states.
  • Non-segregation of waste leads to the incineration of contaminated plastics, which emits poisonous gases and pollutes the air.
  • A spike in caseload may be triggered by an increase in residential biomedical waste and its processing without following safety protocols.
  • Without proper scientific management of such waste, it has the potential to harm patients as well as the staff and professionals involved.
  • Thousands of sanitation workers are at risk due to discarded masks and gloves, since they frequently work without safety or training to handle such hazardous material.

Technology options for ‘treatment’

  • Chemical processes-In these processes chemicals act as disinfectants. Sodium hypochlorite, dissolved chlorine dioxide, peracetic acid, hydrogen peroxide, dry inorganic chemical, and ozone are examples of such chemicals. Most chemical processes are water-intensive and require neutralizing agents.
  • Thermal processes-These processes utilize heat to disinfect and they operate depending on the temperature.
  • Mechanical processes-These processes are used to change the physical form or characteristics of the waste to facilitate waste handling or to process the waste in conjunction with other treatment steps.
  • Irradiation processes-In these processes, wastes are exposed to ultraviolet or ionizing radiation in an enclosed chamber. These systems require post shredding to render the waste unrecognizable.
  • Biological processes-Biological enzymes are used for treating medical waste.
    • It is claimed that biological reactions decontaminate the waste and cause the destruction of all the organic constituents so that only plastics, glass, and other inert will remain in the residues.

Conventions related to Hazardous wastes

Basel Convention

  • The Basel Convention on the Control of Transboundary Movements of Hazardous Wastes and their Disposal was created to protect people and the environment from the negative effects of the inappropriate management of hazardous wastes worldwide.
  • It is the most comprehensive global treaty dealing with hazardous waste materials throughout their lifecycles, from production and transport to final use and disposal.

Rotterdam Convention

  • The Rotterdam Convention on the Prior Informed Consent Procedure for certain hazardous Chemicals and Pesticides in international trade provides Parties with a first line of defence against hazardous chemicals.
  • It promotes international efforts to protect human health and the environment as well as enabling countries to decide if they want to import hazardous chemicals and pesticides listed in the Convention.

Stockholm Convention

  • The Stockholm Convention on Persistent Organic Pollutants is a global treaty to protect human health and the environment from highly dangerous, long-lasting chemicals by restricting and ultimately eliminating their production, use, trade, release and storage.

Solutions

  • An initiative from corporations and hospitals is essential to creating a healthier environment, however, there are various methods in which involve action from the general population and would contribute to a clean air environment.
  • Creating surveillance groups within hospitals- Everyone would be held accountable for misconduct and improper disposal of waste.
    • Consequences could be implemented where individuals would be required to pay a fine, or face unpaid suspension from work.
  • PPP model
    • Companies and governmental organizations should also initiate non-routine checkups and searches; this would place pressure on hospitals to ensure that waste is properly disposed of all year round.
    • Voluntary clean-ups would involve hospital staff in assuring that medical waste is not littered around the hospital or thrown into regular garbage bins.
  • Awareness campaign
    • CPCB should take further initiatives like conducting an appropriate programme on Doordarshan. All India Radio and other media platforms to create mass awareness about the correct disposal of Covid-19 biomedical waste.
  • There should be constant and regular monitoring by the central and state PCBs, Health Departments in the states/UTs, and by the high-level task team at the Central level with further coordination by CPCB.

References