The use of personal protective equipment (PPE), including masks, gloves, goggles and gowns, has become widespread among both the public and health professionals since the outbreak of coronavirus. However, improper disposal of used PPE, mostly by the former, and low-quality PPE is endangering both lives and the environment.
Despite being provided with PPE, over 650 doctors and 1,600 police personnel have been infected with Covid-19 in Bangladesh, so far.
Furthermore, around 14,500 tons of hazardous plastic waste was generated from the disposal of single-use surgical face masks, hand gloves, and polythene bags in communities, hospitals, and other health care facilities in a month, according to a study conducted by Environment and Social Development Organization (ESDO).
The study titled “COVID-19 Pandemic Pushes Single Use Plastic Waste Outbreak: No Management, No Protection: High Health and Environmental Risk” was unveiled after the first month of official lockdown in Bangladesh.
Bangabandhu Sheikh Mujib Medical University (BSMMU) Prof Shahidullah Shikder, a Covid-19 survivor, told this newspaper: “I came into contact with one of my patients who later tested positive for Covid-19, and so did I.
“We used ordinary surgical masks and gloves as protective gear. Those items were below standard, without a doubt,” claimed Shahidullah, chairman of the dermatology and venereology department.
“Used safety gear is disposed of properly through the hospital’s waste management department. PPE being used by patients isolated at home, outside of hospitals, may increase the risk of spreading Covid-19,” the former pro vice-chancellor of BSMMU added.
Although the virus may become inactive after a few days, used PPE has to be disposed of properly and as soon as possible, to mitigate the risk of infection for people involved in waste management, Dr Shahidullah further said.
Dr Nirupam Das, chief administrator of Bangladesh Doctors’ Foundation, claimed PPE used by doctors was not being disposed of properly, as per WHO guidelines, after treatment of Covid-19 patients.
“Used PPE items that are not properly disposed of will create a biohazard as well as have a negative impact on the environment. As a result, the people will suffer,” he said.
Dr Nirupam blamed below standard PPE and a lack of proper disposal facilities for the increasing rate of infection.
How is used PPE disposed of at hospitals?
Brig Gen Jamil Ahmed, director of Kurmitola General Hospital, claimed they were trying to dispose of used PPE by burning them.
According to the director, there are four zones for wearing PPE (donning zones) and four for removing PPE (doffing zones) at the hospital. Each pair of donning and doffing zones caters to two wards of the hospital where Covid-19 patients are being treated.
There is not much risk at the donning zones, but there is high risk of contamination if proper procedures are not followed in the doffing zones. The dangerous doffing zones are separated into two sections; a dirty zone and clean zone.
After treating Covid-19 patients, health professionals remove PPE in the dirty zone, usually with the help of a colleague. The colleague provides hand sanitizer at every step and gives directions.
“Sometimes, doctors have to remove PPE alone. For their convenience, we have arranged a full frame mirror so they can ensure there is no contact between contaminated PPE and any part of their body,” the director told Dhaka Tribune.
Used PPE is stored in a double-layer polythene bag and stored in a specified dustbin. At the end of the day, the dustbins are sealed and burned, he added.
“We are trying hard to do this job with sincerity from the very beginning,” the director further said.
He also acknowledged that the process was not fool-proof, especially with the involvement of outsiders and visitors.
“We received a complaint from the medical waste management organization Prism. An item of used PPE was mixed in with medical waste. After investigation, I found that it was an outsider who was responsible for the infringement and not someone from the hospital,” the director said.
“We don’t mix this sensitive waste with the normal medical waste. We have two separate, sealed dumping rooms for medical and ordinary waste, respectively. Day to day waste is picked by Dhaka North City Corporation (DNCC),” he added.
The additional secretary of the Health Ministry has praised the system at Kurmitola Hospital and urged everyone to follow the waste management system, Brig Gen Jamil claimed.
“In comparison, hospitals under Dhaka South City Corporation (DSCC) are yet to get proper support from the municipality waste management. We get a lot of support from DNCC. We were confident we would not get any Covid-19 patients among our hospital employees, but some of them were infected through community transmission,” the director added.
