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India’s environment and health authorities are racing to tighten norms to dispose of syringes, needles and other potentially hazardous material, bracing for a tsunami of biomedical waste from mass covid-19 vaccinations beginning 1 May.

With the coronavirus explosion overwhelming India’s health infrastructure, hospitals across the country are already struggling with waste disposal, and things are expected to only get worse.

“We issued guidelines for waste disposal earlier in January when the government was planning to start covid-19 vaccination. But with all adults covered now, the number of vaccinations will also be more. As we need more stringent and specific guidelines for vaccination waste, we are working on the revised guidelines for a safer environment," Dr T.K. Joshi, a member of the Central Pollution Control Board (CPCB) task force on pollution and health, said in an interview.

Health ministry guidelines issued in January had mandated “One needle, One syringe, Only one time", among others, for safer disposal of used material.

“Inspections of biomedical waste generation plants have been halted due to the high number of cases. Covid-dedicated hospitals have had major problems in disposal of their waste; now the vaccination would further increase this problem," said Joshi.

According to the environment ministry, nearly 146 tonnes of bio-medical waste is generated per day in the country due to diagnostic activities and treatment of covid-19 patients; however, there has been no accurate data on syringe disposals. India has already administered close to 140 million covid-19 vaccine doses so far.

“With the opening-up of vaccination for all above 18 years, the volume of infectious waste generated from the vaccination clinics will increase manifold, as will the danger of reuse of the syringes, highlighting the urgent need for appropriate disposal of used syringes. Already the environment (sewage system, lakes, rivers) is overwhelmed with the increased use of biocides (sanitizers, disinfectants and antibiotics) which are aggravating the already severe burden of the invisible epidemic of antimicrobial resistance (AMR) in India," said Jyoti Joshi, head of South Asia, Center for Disease Dynamics, Economics and Policy.

A research article published in Heliyon scientific journal cautioned that greater generation of biomedical waste is inevitable during the pandemic outbreak, and its safe handling, treatment and disposal of waste must be prioritized for minimizing contamination of land, water and air.

A study by the Centre for Ecological Economics and Natural Resources, Institute for Social and Economic Change-Bangalore, and Bioaxia Pvt. Ltd called for evaluating the entire biomedical waste management infrastructure and making necessary investments for expansion to improve the capacity and coverage during covid-19 pandemic.

The study said stringent monitoring mechanisms, operational and functional efficiency of common bio-medical waste treatment facilities and transparency aspects are other important elements, where constant focus from the relevant authorities is required to ensure safe and proper disposal of biomedical waste.

“The government will need to get ahead of monitoring and enforcement role to help the pharmaceutical industry scale up rapidly on both production and sustainability," said Laveesh Bhandari, director, Indicus Foundation, an organization working towards the environment and sustainable livelihoods.

“Municipalities across India need to scale up the disposal infrastructure. For effluent control from the pharmaceutical sector, industry commissioners at the district level need to work with individual pharma units and remove all hurdles in effluent treatment," he said.

State pollution control boards and pollution control committees have authorized 202 common bio-medical waste treatment facilities to collect and dispose of biomedical waste, including covid-19 waste.

Further, there are about 18,178 captive disposal facilities installed by individual healthcare facilities for pre-treatment and/ or final treatment of biomedical waste.

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