Just one Ebola patient treated at a U.S. hospital will generate eight 55-gallon barrels of medical waste every day.
Protective gloves, gowns, masks and booties are donned and doffed by all who approach the patient’s bedside and subsequently lost. Disposable medical tools, packaging, bed linens, cups, plates, tissues, towels, pillowcases and whatever which is utilized to clean up after the individual must be thrown away.
Even curtains, privacy beds and screens finally must be treated as contaminated medical waste and disposed of.
Dealing with this assortment of pathogen-filled debris without tripping new infections is an authorized and logistical challenge for each U.S. hospital currently preparing for a possible trip by the virus.
In California and other states, it’s an even worse waste-management nightmare.
While the U.S. Centers for Disease Control and Prevention recommends autoclaving (a kind of sterilizing) or incinerating the waste as a surefire way of destroying the germs, burning waste is effectively banned in California, also prohibited in several other states.
“Storage, transportation and disposal of this waste will be a significant issue,” California Hospital Association President C. Duane Dauner warned Sen. Barbara Boxer, D-Calif., in a letter a week.
Even some countries that generally allow incineration are throwing up barriers to Ebola waste.
In Missouri, the state attorney general has sought to bar Ebola-contaminated debris by a St. Louis incinerator run by Stericycle Inc., the country’s largest medical waste disposal company.
Due to restrictions on burning, California hospital agents say their only option seems to be trucking the waste over public highways and incinerating it in another country — a prospect which makes some environmental advocates uneasy.
Rules for transportation
Under national transportation guidelines, the substance would be designated a Class A infectious substance, or one that is capable of causing death or permanent disability, and might require special approval from the Department of Transportation, hospital agents state.
“We fully expect that it is coming our way,” Bayer said of this virus. “Not to create any sort of scare, but just handed the makeup of the population and the hub that we are. It’s very possible” It can’t survive a 1,500-degree scorching in a incinerator, or the prolonged, pressurized steam of an autoclave. “It’s killed by bleach, by autoclaving, by an assortment of chemicals.”
But, CDC guidelines note that”chemical inactivation” has yet to be standardized and could activate worker safety regulations.
California health officials lately tried to reassure residents that the state’s private and public hospitals were up to the job and were actively training for the possible coming of Ebola.
“Ebola does not pose a significant public health risk to California communities at the current time,” explained Dr. Gil Chavez, an epidemiologist and deputy director at the California Department of Public Health. “Let me tell you why: Current scientific evidence specifies that individuals can’t access Ebola through the atmosphere, food or water. … The Ebola virus does not survive over a few hours on impervious surfaces”
It was uncertain if California officials saw the waste issue as a possible issue.
Although one third of the state’s private hospitals and”a few” of its public hospitals reported to Boxer’s office that there could be problems complying with the CDC’s incineration recommendation, along with many others, a state public health official told reporters he was not aware of any conflicts.
“Here’s what we’ve heard from the CDC: It’s OK,” Perrott explained. “But then we’ve heard from some sources, that perhaps we need to fix it somehow and then flush it down the toilet or you need to consult local authorities. It seems perhaps a bit gross, but there’s a real question about what to do with that waste.”
Dr. Thomas Ksiazek, a professor of microbiology and immunology at this University of Texas Medical Branch, has said he believes there has been a good deal of overreaction regarding Ebola medical waste.
“There are other methods to manage the waste; autoclaving would be chief among them,” Ksiazek mentioned. “The issue is, most physicians don’t use it for many disposable items. They are quite pleased to bag them up and send them into some normal medical disposal company.”
But Allen Hershkowitz, a senior scientist at the Natural Resources Defense Council, said incineration is straightforward and powerful, and must be available to hospitals to help dispose of this mountain of waste.
Hershkowitz said claims began to crack down on medical waste incineration years ago because substances which didn’t need to get burned were sent to combustors and so were emitting dangerous pollutants.
In this case of Ebola medical waste, he said California should reconsider its limitations.
“There is no pollutant that’s going to come out of a waste incinerator that’s more dangerous than the Ebola virus,” Hershkowitz said. “When you’re dealing with biological and sociological dangers, sometimes the safest thing to do would be combustion.”
But Allen Hershkowitz, a senior scientist at the Natural Resources Defense Council, said incineration is simple and effective, and should be available to hospitals to help dispose of the mountain of waste.
Hershkowitz said states began to crack down on medical waste incineration years ago because materials that didn’t need to be burned were being sent to combustors and were emitting dangerous pollutants.
In this case of Ebola medical waste, he said California should reconsider its restrictions.
“There’s no pollutant that’s going to come out of a waste incinerator that’s more dangerous than the Ebola virus,” Hershkowitz said. “When you’re dealing with pathogenic and biological hazards, sometimes the safest thing to do is combustion.”