May 28, 2020

How to Manage Waste from COVID-19 Patients

Proper waste management is important at any time, but it has become even more critical during the COVID-19 outbreak as the volume of contaminated materials that may require careful handling, packaging and treatment continues to grow.

Since our knowledge of the virus is continuously changing, our perspective on what constitutes safe and effective waste management is evolving as well. In this uncertain time, it is wise to stay abreast of any new requirements and double-check that your current waste management strategy aligns with the latest guidance.

How to Dispose of Waste from Coronavirus Patients

According to the Centers for Disease Control and Prevention (CDC), the medical waste generated in the care and treatment of COVID-19 patients, or those who are suspected to have the virus, is no different than other regulated medical waste. So, healthcare organizations should manage COVID-19 waste according to routine procedures. This relatively broad recommendation leaves room for interpretation and sometimes confusion.

It’s important to remember that even though the CDC is an essential resource for COVID-19 guidance, it is not a regulatory body. In fact, there are no regulatory bodies at the federal level that govern medical waste disposal. Consequently, to fully ensure compliant handling of COVID-19 waste, healthcare organizations need to look to their states. As of today, there are about a dozen states that have issued specific guidance regarding COVID-19 waste management. The Stericycle COVID-19 knowledge center has a list of these states with links to their requirements.

What is Regulated Medical Waste?

Given that COVID-19 medical waste is no different than regulated medical waste, it can be helpful to revisit the definition of regulated medical waste to gain an appreciation of what types of materials this includes.

Although every state has a different definition, regulated medical waste generally includes any item contaminated with blood, bodily fluids, or other potentially infectious materials. Examples of regulated medical waste includes bandages, gauzes, and other visibly contaminated items, as well as contaminated sharps, such as needles, syringes and scalpels. Depending on the item, you should use red regulated medical waste bags or specially designed sharps containers for disposal.

Personal Protective Equipment Disposal

One question that is often asked during COVID-19 treatment is whether the personal protective equipment (PPE) worn by healthcare workers is considered regulated medical waste. The answer to this question, like much of the discussion of COVID-19 waste, depends on the state. For example, New Jersey indicates PPE and cleaning materials used in the care of COVID-19 patients should be treated as regulated medical waste. New York, however, says viewing these items as regulated medical waste is neither “practical or necessary.”

If after consulting your state guidelines, you are still unsure how to handle PPE, you may opt to overclassify the items, treating them as regulated medical waste even if they are typically solid waste. Note that if you opt to go that route, you need to be sure you’re following all of your state’s requirements on the disposal, packaging, and treatment of regulated medical waste as these rules are designed to keep waste generators, handlers and the public safe.

COVID-19 Testing Center and Laboratory Waste Management

Initially, there was some concern that waste generated in laboratories and testing centers was more dangerous than standard regulated medical waste and there was even some thought that this waste was similar to that of Ebola waste. However, after conversations with the CDC and other industry experts, it was determined that lab and testing site waste can be safely managed in the same way as any other biohazardous waste generated in these settings. Currently there is no evidence to suggest that this waste needs additional packaging or disinfection procedures.

That said, labs should check the chemicals used in coronavirus testing to make sure they are not considered hazardous chemical waste. And if they are, make plans to manage that waste accordingly.

Depending on the nature of tests conducted at a testing site, there may not be a lot of regulated medical waste. However, this may change going forward as new tests emerge that involve needles or other sharps. If you are setting up a testing site, plan for some degree of regulated medical waste and make sure you have processes in place for proper disposal. Also, first-time waste generators should check state regulations to verify they are following requirements for generator registration and storage.

COVID-19 Waste Management Guide

Because the response to COVID-19 is constantly evolving, it can be beneficial to have a quick way to check whether you are managing COVID-19 waste in the most appropriate manner. Here are some considerations to guide current and future waste management decisions:

  • Look at your state regulations to see if you are a generator they regulate.
  • Confirm if the waste you generate meets the definition of regulated medical waste.
  • Check if your state has issued any additional guidance on COVID-19 waste management and what that entails.
  • Don’t forget to assess any chemical components to the waste, such as cleaning agents, disinfectants, laboratory reagents. If a chemical is considered hazardous waste, does it have additional disposal requirements from the Environmental Protection Agency? Also, does the chemical inactivate the virus and does that impact how the waste stream can be managed?
  • Finally, be sure to check with your waste vendor and disposal facility to see if they have additional requirements. Some vendors do because of the states in which they operate or because they are doing what they think is best to preserve the safety and health of their workers.

To stay up-to-date on the latest developments regarding COVID-19 waste management, visit Stericycle’s Coronavirus (COVID-19) Knowledge and Resource Center.

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