The rising tide of confirmed Covid-19 cases in India has administrators focussed almost entirely on containing the infection and preventing mortality.
But away from the public eye, there is a “spreader” that is worrying doctors and waste management experts more. And that’s the home-generated biomedical waste, as more people with Covid-19 or suspected of infection are advised to isolate themselves at home.
New element of risk
Home quarantine has added a whole new risk element to waste-management as the infection now threatens to cascade across waste-collectors and municipal workers and from them to their families, cautions Ajay Mishra, Founder and CEO of Biocrux India, a waste-management equipment company, on the domino effect.
There are World Health Organization guidelines on separating home-based medical waste. And closer home, the Central Pollution Control Board and the Indian Council of Medical Research too have norms for handling home medical waste that State authorities say are being followed. But, as BusinessLine found, in many parts of the country, the problem is its implementation.
States like Tamil Nadu seem to fare well with systems in place for daily waste collection from home isolated families, right across to tracing the journey down to waste disposal. Kolkata was less systematic, with garbage-pickers left to their own devices. Plans are afoot, say administrators there, to outsource this task and bring in solutions like “specialised bins” to dispose masks, gloves, head-covers, sanitisers, etc.
The national capital had residential areas that were meticulous in handling and disposing home medical waste, contrasted by others that were less aware. In Telangana, those under home quarantine had problems with medical waste disposal as garbage-pickers feared going into gated communities. In fact, this could be true of any city.
In Bengaluru, attention is being paid to protect waste-pickers. But that came only after the Karnataka High Court directed the State government to take special measures to protect pourakarmikas (civic workers) while they collect waste from houses of persons on home quarantine. Kerala has separate disposal systems but expects to bring in greater clarity soon on this, as challenges are anticipated during the monsoon.
And in Mumbai, faced with the tallest task in tackling rising Covid cases, doctors worry about the teeming skyscrapers and guidance, if any, to resident associations on how to tackle their medical waste and protect those collecting and segregating it. There is concern of masks getting washed and reused, there is little knowledge on how PPEs should be disposed, are they shredded, destroyed or recycled, asks a waste-treatment expert. There’s also the issue with incinerators, with Pune having just one. So the civic body sends its Covid-19 biomedical waste to other cities including Mumbai, Satara and Ahmednagar.
Coverage for cleaners
As cases rise and more people get home quarantined, the medical waste generated from residential and containment areas will only surge. This augurs badly for “safai karmacharis”, or sanitation cleaners, who are not covered by insurance schemes, and even if they are under a State-driven one, chances are they are not aware.
The New India Assurance, for instance, provides accidental death insurance coverage of ₹50 lakh each for close to 22 lakh health workers in government hospitals under the Pradhan Mantri Garib Kalyan Yojana. But this covers healthcare workers, medical sanitary workers, ward boys, etc. Not sanitation workers outside the purview of healthcare.
In housing societies, the cleaning staff are usually on contract under a housekeeping agency, making the possibility of having a health insurance cover that much more diminished.
With inputs from TE Raja Simhan, Abhishek Law, Shobha Roy, V Rishi Kumar, Anil Urs, Vinson Kurian, Garima Singh, Radhesham Jadhav, Rutam Vora and Rahul Wadke