MANILA should properly dispose of 16,800 tons of infectious medical wastes produced in the past two months of battling the coronavirus disease 2019 pandemic, or risk overwhelming its medical transport and disposal systems, according to the Asian Development Bank (ADB).

The Manila-based multilateral lender said medical transport and disposal infrastructure around hospitals in China’s Hubei province, where the virus was first detected, were overwhelmed after infectious medical wastes surged seven times to 240 tons a day.

“Other countries will face similar challenges,” ADB said in a brief posted on its website at the weekend. “Few cities have the capacity to deal with the expected excessive amounts of waste. Governments should consider dealing with excess waste as soon as possible.”

ADB expects Manila, home to 14 million people, to produce 280 more tons a day of medical wastes or a total of 16,800 tons in 60 days, the highest among five major cities in the region.

Jakarta is expected to generate 12,750 tons in 60 days, Bangkok 12,600 tons, Ha Noi 9,600 tons and Kuala Lumpur 9,240 tons.

Local governments can project the potential rise in the volume of medical wastes daily by multiplying the number of estimated infected patients by 3.4 kilos.

It said the experience in Hubei, China showed that its transport and disposal systems were the first to be overwhelmed when medical wastes surged.

“It is critical that additional waste management systems are put in place to help reduce the further spread of COVID-19 and the emergence of other diseases,” ADB said in the report.

China’s peak management and treatment campaign lasted more than 60 days in Wuhan City, where the novel coronavirus is believed to have started, ADB said.

Other countries will experience different emergency timelines depending on policies and predicted infection curves, it added.

Intermediate sorting of waste will result in higher infection rates and dispersal of infected waste, ADB said.

“The risk of infected waste being handled multiple times needs to be avoided,” it said. “This risk is particularly high with informal sector workers.”

Safe transport requires vehicles that can be sterilized, trained drivers and waste collectors, dedicated routes, and vehicle and waste tracking systems,” according to the report.

“Training must be conducted for crews who will be exposed to household infectious medical waste,” it added.

ADB said sanitary landfills, medical incinerators and medical autoclaves are used to deal with pre-pandemic waste amounts.

Other resources including mobile incinerators, industrial furnaces and cement kilns could be assessed for use if existing systems are overloaded and capacity is limited, it added.

“Some cement kilns and industrial furnaces may be used as temporary disposal facilities,” ADB said, noting that China had successfully made use of cement kilns for this purpose.

Governments can also use secure facilities as temporary storage of excess infectious wastes, ADB said.

Government should reschedule the collection of solid wastes and set aside available assets for infectious medical waste management.

Meanwhile, ADB discouraged recycling of wastes to prevent infected domestic and medical wastes from reaching households.

“All municipal waste should be treated as non-recyclable and disposed of through incineration or sanitary landfill,” it said. “Landfill sites with informal waste picking will need increased management and security,” it added.

“Ensure that transport and disposal systems implement duty of care, waste tracking and labelling, disposal unit licensing, record keeping and emissions monitoring,” ADB said. — B.M. Laforga