Guest Blog

Medical Waste Treatment Lessons from the COVID-19 Outbreak in Wuhan

Mr Gong Wei explores the lessons we can learn about the need for adequate medical waste disposal capacity from the experiences of Wuhan and New York City.

How much medical waste was generated during the pandemic outbreak? How did the local government handle it?

It’s a very difficult question. Some reference data collected from both Wuhan medical waste emergency treatment plant and official sources such as Wuhan Environment Department is listed below:

  • Before the pandemic outbreak, the daily medical waste disposal capacity in Wuhan was 50 tons but the average output was around 45 tons. This is the capacity of an incineration plant which normally operated 24/7. There wasn’t neither enough reserved disposal capacity nor enough storage capacity for medical waste management.
     
  • After January 20, Wuhan government and China Ministry of Environment found out that the local existing facility could not meet the needs of the rapidly growing medical waste treatment. They asked for the solutions from the experts, such as waste management companies as well as waste disposal equipment manufacturers like Gient. In the following days, dozens of emergency equipment was delivered to Wuhan responding to the call of the local government and the Ministry of Environment. In the meantime, each district was required to quickly build at least one temporary storage facility with over 50 tons capacity. Moreover, one 30 tons/day capacity emergency treatment plant was in the designing process.
     
  • The output of medical waste increased to 110-150 tons per day in mid-Feb when Gient team arrived in Wuhan to build the emergency treatment plant with 30 tons capacity per day. The plant was completed and put into operation by Feb 22.
     
  • The output of medical waste kept increasing and the maximum was up to 247 tons per day on March 1, but it has progressively decreased since mid-March and back to normal in early May.
     
  • The volume of medical waste disposal in the 30 tons/day emergency treatment plant is as follows:
    • January and March: operation at 100% capacity. April: operation at 80% to 90% capacity.
    • May: operation at 50% to 60% but it will be closed by the end of May.
       
  • The changes of medical waste average density in Wuhan during pandemic times:
    • January and March: 67kg/m3
    • April: 77kg/m3; May: 85kg/m3
    • Remarks: the normal average density of medical waste in China was 120 kg/m3. It was decreased because that PPE (personal protective equipment) consumption had increased a lot. This change resulted in significant reduction of disposal capacity of the facilities by weight.

4.    Key experience and lessons of medical waste management during COVID-19 outbreak

I.    Adequate reserved capacity of medical waste treatment facilities, highly necessary.

As we have mentioned above, inadequate disposal and storage capacity of existing facilities in Wuhan was the key reason leading to large quantities of piled medical waste in hospitals and clinics. In fact, China (and most developing countries) have a very weak infrastructure for medical waste treatment.

The total disposal capacity of Bondtech autoclaves in New York State and surrounding areas reach a daily processing capacity that exceeds 500 tons/day, which is 10 times higher than that of Wuhan City, while the population of New York State only doubles that of Wuhan.

This capacity does not include treatment facilities in New York with equipment manufactured by other companies. Therefore, the medical waste in Wuhan piled up after the outbreak while New York State was able to handle it properly. Obviously, if the medical waste during the pandemic was not treated promptly and effectively, the consequences would have been catastrophic.

II.    We found that the quantity of medical waste generated in New York did not rise but declined during the pandemic. On the contrary, the quantity of medical waste generated in Wuhan increased significantly. It’s estimated that the amount of medical waste generated by Wuhan hospital during the pandemic tripled from about 0.7 kg per bed to about 2 kg per bed.

The main reason for the rise is the widespread and massive use of PPE, and the second reason is all the household waste generated in hospitals was treated as medical waste during the pandemic.

The waste from people in hospitals, including doctors and nurses, cleaners wearing protective gowns, as well as the household waste from designated isolation sites were all treated as medical waste for collection and transportation, which resulted in further medical waste volume increase.

However, according to reports from the media, some doctors and nurses in the hospitals in New York did not wear protective suits. From our US counterparts, we learned that a lot of the PPE and household waste from US hospitals was not collected and disposed of as medical waste. This is the main reason for the huge difference in the amount of medical waste generated during the pandemic between NYC and Wuhan. At present, PPE and the household waste of infectious patients are regarded as the medical waste for collection and transportation, which is listed in the latest revised standards in China. Are there any hidden dangers in US practices?

III.    Facilities need to be more intelligent and automated relying less on labour. It is an efficient way to protect labour from infection. On the other side, it is very difficult to employ skilled labour for medical waste disposal during the outbreak. The new treatment plant in Wuhan was manufactured with a fully intelligent and automated system which reduces 90% labour.

IV.    Large capacity mobile facilities as a strategic backup for a nation or a state will be highly useful and important for developing countries who do not have adequate medical waste disposal facilities. Obviously, the mobile facility is a high-cost performance solution for countries or regions that have adequate capability of managing medical waste during a pandemic. It could be a part of a national strategic backup capacity in these counties and regions in the future. Not every country or city can have as many medical waste disposal facilities and enough capacity as New York.

V.    We do not need to be afraid of COVID-19 virus. It is a normal virus for us if we properly protect ourselves. In fact, there are no further infected cases of doctors and nurses as well as other labourers working for medical waste disposal in Wuhan since March. We just need to use PPE well and pay attention to self-protection. The government needs to make a sound and firm voice. The media needs to bear the responsibility to disseminate correct information to the public. That is enough.

Thanks to my partner Ms. Elsa Brown, President of Bondtech Corporation in USA, for sharing with me relevant information on the treatment of medical waste in New York State during the COVID-19 pandemic and her valuable advices and revision to this article.

About the Author

Mr. Gong Wei, Chairman of ISWA's newest Silver Member, Gient Heating Industry Co., Ltd., a major manufacturer of medical waste treatment equipment in China. As an invited expert, Gong Wei recently participated in the review of China's latest medical waste treatment standards. During the outbreak of Wuhan from February to April 2020, he personally led the team to Wuhan, and completed the construction of a 30tons/day medical waste emergency disposal plant and another 30tons/day fully automated medical waste disposal plant.

He has the first-hand direct experience in Wuhan’s anti-pandemic efforts, and he is also a participant in the emergency treatment plan for medical waste in Wuhan.

For more information about Gient please click here.