COVID 19 WASTE MANAGEMENT PRACTICES IN A TERTIARY CARE HOSPITAL

Introduction: The world has witnessed positive environment implications of nationwide lockdowns brought down upon by Covid 19 such as cleaner rivers and clearer skies, the same is not the case with respect to solid waste management. Objective:To study the Covid 19 waste management practices and precautions taken in a tertiary care hospital. Methodology:A retrospective study from 1st April 2020 to 31st March 2021 was conducted at NIMS, Hyderabad. Direct observational study was done to assess the existing facility, manpower, workflow and practices followed. Results:An average of 252 kgs biomedical waste was generated daily. All the biomedical waste including the waste generated in covid 19 areas, Rapid antigen testing centre, RTPCR lab were segregated in separate colour coded bags and were transferred to collection room, where it was stored in different rooms based on the colour, ready to be collected by GJ Multiclave for treatment and disposal. Adequate number colour coded waste bins and needle destroyers were provided to covid areas. Also, hypochlorite solution was issued in adequate quantity. No calibrated weighing machine was available onsite in covid areas nor any biomedical waste registers were maintained in Covid wards and ICUs. Yellow bins were filled beyond 3/4th level due to PPE kits leading to spillage, but frequent collection of waste was followed. Whereas other bins were not filled beyond 3/4th level to avoid spillage. There was 100% compliance in segregating infectious sharps from non-sharps. There was 100% compliance in segregating waste in Covid ICUs and 90% compliance in the Covid wards. Double packing method was followed. On-site measures like treating PPE with hypochlorite was practiced. Storage in the facility was never beyond 48 hours. A total of 19 workers were posted in three shifts for collecting waste. Adequate PPE kits were provided to all the workers in Covid units apart from the regular safety equipment. 20:10 day rule was followed where the workers worked for 20days followed by 10 days of quarantine. Training of staff was on periodic basis. Separate lifting trolleys for covid areas were earmarked and disinfection with hypochlorite was practiced. Workers posted underwent routine RAT once a month and a quarantine of 15 days was given to the tested positive workers. Conclusion:On an average 252 kgs of biomedical waste generated per day. 100% compliance was observed in segregating biomedical waste in Covid ICUs and 90 % compliance in the Covid wards. On site measures like treating PPE kits with hypochlorite solution was practiced. Covid waste was transported in closed containers. Stored waste was disposed within 48 hours of collecting from wards. Regular training of health workers posted in wards improved waste management.