The novel coronavirus, or COVID-19, officially has been deemed a pandemic. It is disrupting events within and outside of the solid waste and recycling industry, it has closed schools in certain parts of the country and it is causing overall chaos and confusion as it quickly spreads across the U.S.
When it comes to managing the medical waste—and even residential waste—generated by COVID-19, stakeholders in the waste and recycling industry are closely monitoring COVID-19 outbreaks and developments.
Medical waste management provider Stericycle has announced that its regulatory and safety teams have been monitoring the outbreak of COVID-19, particularly developments made in infection control related to the proper management of medical waste generated during treatment of patients infected with the virus. Stericycle is managing waste generated during treatment of COVID-19 in healthcare facilities across the country, including quarantine sites.
Regulated medical waste will be produced from the COVID-19 outbreak, which may include needles, sharps, material contaminated with bodily fluids (like gauze, gloves or gowns) and pathological wastes. These wastes are regulated federally by the Occupational Safety and Health Administration (OSHA) for safe handling and the Department of Transportation for transportation as well as at the state level for the management and treatment of these materials before disposal.
Typically, state regulations require segregation of regulated medical waste from ordinary solid waste and a special treatment process to render it non-infectious before final disposal, explains Selin Hoboy, vice president of government affairs and compliance at Stericycle.
Coronavirus is a group of viruses named for the way they look under a microscope (“corona” meaning “crown”). The novel (or new) coronavirus, identified in 2019 during an investigation into an outbreak in Wuhan, China, causes the coronavirus disease 2019 (COVID-19). The first case of COVID-19 in the United States was reported on January 21.
According to the U.S. Centers for Disease Control and Prevention (CDC), risk of catching COVID-19 is higher for people who are in close contact with someone who already has the disease. The virus is thought to spread mainly through respiratory droplets (not truly airborne) produced when an infected person coughs or sneezes. It also may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose or possibly their eyes, but this is not thought to be the main way the virus spreads.
However, OSHA states that without sustained human-to-human transmission, most American workers are not at significant risk of infection. Exposure risk may be elevated for some workers, including those involved in solid waste and wastewater management.
The CDC has determined that medical waste generated in the treatment of COVID-19 patients and patients under investigation (PUIs) be managed in accordance with routine procedures.
According to CDC, waste generated in the care of PUIs or patients with confirmed COVID-19 does not present additional considerations for wastewater disinfection in the U.S. Coronaviruses are susceptible to the same disinfection conditions in community and healthcare settings as other viruses, so current disinfection conditions in wastewater treatment facilities are expected to be sufficient.
CDC also states that medical waste coming from healthcare facilities treating COVID-2019 patients is no different than waste coming from facilities without COVID-19 patients. CDC’s guidance states that management of laundry, foodservice utensils and medical waste should be performed in accordance with routine procedures. There is no evidence to suggest that facility waste needs any additional disinfection, according to CDC.
“Based on Stericycle’s ongoing dialogue with the CDC, medical waste from COVID-19 should be managed as a Category B waste, following the treatment and disposal methods used for most other potentially infectious medical waste materials,” notes Hoboy. “When following proper treatment protocols, this virus can be killed with normal medical waste treatment methods prior to disposal.”
Stericycle has updated its coronavirus-related packaging guidelines for regulated medical waste and sharps. Guidelines include:
- Generators are responsible for packaging waste for transport to treatment facilities. Stericycle drivers do not package waste.
- Each bag must be hand tied by gathering and twisting the neck of the bag and using a tie or hand knot to secure the bag, and each container must be securely closed.
- Closed bags must not be visible once a secondary container (box or reusable tub) is closed.
- Improperly packaged containers or damaged containers will be denied pickup or returned to the generator.
“Healthcare facilities should ensure their waste management providers are following proper procedures for managing the waste and have ample capacity and contingency plans to ensure continued medical waste management service should the number of patients in the United States increase dramatically,” says Hoboy. “Recent news reports from China have indicated that there is a backlog of medical waste requiring treatment; healthcare facilities in the U.S. should work with their waste management providers as a preventative measure.”
Stericycle will host a webinar for healthcare professionals on March 25 at 1 p.m. CT to provide additional details for the proper management and disposal of medical waste generated during the treatment of coronavirus.
“Stericycle is closely monitoring the developments of COVID-19 and will continue to work to protect communities, healthcare workers and the environment around the globe in mitigating the risk of COVID-19,” says Cindy Miller, Stericycle CEO. “With our 30 years of experience in this field, Stericycle has become a trusted partner in supporting the healthcare community with its most complex medical waste management needs. As we did with Ebola, MRSA and other infectious agents, Stericycle will continue to ensure the safe and compliant disposal of medical waste during this pandemic.”
Waste and Recycling Industry Guidance
At this time, no special precautions to protect waste workers from COVID-19 are recommended when handling municipal solid waste. But industry associations have offered guidance and continue to urge their members to refer to CDC guidelines, take proper steps to protect workers and continue to stay updated on changing conditions.
The National Waste & Recycling Association’s (NWRA) Healthcare Waste Institute published a COVID-2019 FAQs document to address safe handling of waste during this outbreak. NWRA is also holding a Managing COVID-19 Waste Webinar on March 19 at 1 p.m. ET, where NWRA will be joined by Stericycle’s Hoboy.
The Solid Waste Association of North America (SWANA) also released COVID-19 guidance for its members. SWANA recommends some of the following strategies for waste and recycling industry employers:
- Actively encourage sick employees to stay home and separate sick employees.
- Perform routine environmental cleaning in the workplace. Wipe commonly used surfaces like telephones and handles with disinfectants.
- Advise employees before traveling to take certain steps.
- Check the CDC’s Traveler’s Health Notices for the latest guidance and recommendations.
- Advise employees to check themselves for symptoms of acute respiratory illness before traveling.
- Ensure employees who become sick while traveling notify their supervisor and promptly call a healthcare provider for advice if needed.
- Employees who are well but who have a sick family member at home with COVID-19 should notify their supervisor and refer to CDC guidance for how to conduct a risk assessment of their potential exposure.
- If an employee is confirmed to have COVID-19, employers should inform fellow employees of their possible exposure to COVID-19 in the workplace but maintain confidentiality as required by the Americans with Disabilities Act.
In a message to its members, the Institute of Scrap Recycling Industries (ISRI) also urged members to refer to CDC resources and to stay up to date on changing conditions.
“The coronavirus is a topic that is on everyone’s mind. Taking measures to prevent the spread of the virus is vital to ensuring the safety and wellbeing of those in all of our communities,” stated ISRI. “This involves the work of every company, manager and employee. One question that has arisen is if there's an increase risk due to processing aluminum cans. While the typical PPE [personal protective equipment], especially puncture resistant gloves, will provide basic protection, keep in mind that these are also surfaces that need to be cleaned on a regular basis. In fact, PPE such as face shields and protective eyewear, should be cleaned frequently due to the close proximity of an infection pathway (the eyes). While you are cleaning the PPE, don’t forget the handles of tools, equipment controls, the pen that everyone uses to sign in with, etc.”