Medical waste from Covid-19 quarantine sites

South Africa’s number of confirmed cases of Covid-19, the coronavirus that is shutting down countries and bringing economies to a standstill around the world, is unfortunately likely to continue to rise.

Quarantining is an important public health tool being used by governments around the world, including here in South Africa, to reduce and slow transmission of this disease. While in other countries, suspected and confirmed patients are quarantined at home, here patients are cared for in dedicated health facilities.

One important aspect of this type of care, which may not always be considered, is how the highly infectious waste should be safely handled. A vast amount of medical equipment and materials are used in caring for these patients, much of which will come into contact with infected bodily fluids. This material cannot be simply disposed of in the nearest dump.

Fortunately, South Africa already has in place an established hazardous waste management system that’s compliant with global standards and has had its competence tested by previous outbreaks of other viruses. Thashnee Budram from Averda, integrated waste management provider to government and industry, explains the steps taken to manage hazardous medical waste, which are now being applied to the waste resulting from the Covid-19 quarantines.

She says that hospitals will consult with waste management experts like Averda to ensure that their internal safe operating procedures (SOPs) are sufficiently up to date and applicable to the risk at hand. With Covid-19, as with other viral outbreaks, extreme measures are taken to ensure safety.

This kind of high-risk waste should be packaged in multiple layers of thick plastic and boxes, and sterilised twice during the process. Assigned vehicles will then transport the waste to one of eight hazardous waste sites around the country.

Averda is currently carrying out all the incineration for quarantine sites around South Africa, its healthcare incinerator in Klerksdorp has the capacity to incinerate up to 28 tonnes of waste per day, more than twice that of other incineration facilities in the country.

The vehicle is tracked by GPS as it travels to the incinerator site and is not permitted to stop en-route. The receiving team is notified of the vehicle’s arrival in advance and incinerator staff clear the loading bay of people. Only a small number of specialist staff stay on hand in full personal protective equipment (PPE) suits to unlock and offload the cargo which is immediately incinerated.

The process that Averda has established at the Klerksdorp site for dealing with such cases is based on the company’s previously established standards in preparation for Ebola (of which there were no infections within South African borders) and Congo fever. Averda was also responsible for the incineration of the majority of waste relating to the listeriosis outbreak of 2018.

“We have handled waste like this on numerous occasions, with the same SOPs as we are using for Covid-19. We are in communication with the Department of Health and the Department of Environmental Affairs and we report to them on a monthly basis offering advice and training if and when they are setting up new quarantine sites,” says Budram.

While hospitals are already equipped and their staff trained to deal with the realities of handling high-risk medical waste, other sites, such as hotels and airports will need to use waste management SOPs and services like Averda’s as they are pressed into service to deal with the emergency. The Ranch Resort, Protea Hotel in Polokwane is being used as the quarantine site for South African citizens who returned from Wuhan, the epicenter of the outbreak. Budrum is clear: “We have the expertise and disposal facilities we require, but all South Africans will need to pull together to meet the challenge of this disease"