The COVID-19 pandemic hit hard several aspects of public health infrastructure globally. In India, public health and well-being infrastructures, such as waste management, have been under tremendous stress in managing the pandemic. By focusing on biomedical waste management (BMWM), this article grounds itself in data drawn from secondary literature available in the public domain and critically analyses the policy environment and implementation around BMWM during the COVID-19 pandemic. Furthermore, the analysis uses the vantage points of existing infrastructure capacities, preparedness of the frontline workers, awareness and practices of end users. The study reveals that (a) a lack of context in policy and guidelines, in addition to the delay in policy response; (b) burdened infrastructure capacities which saw waste inflow which was several times more than their capacities; (c) minimally trained frontline workers, putting them at heightened risk and (d) a lack of coordinated risk communication efforts specifically for end users in handling biomedical waste. The article discusses these gaps in the policy design, delivery/implementation, infrastructure availability and access, along with the role of risk communication and preparing for future crises and pandemics.
AbramsE. M., & GreenhawtM. (2020). Risk communication during COVID-19. Journal of Allergy and Clinical Immunology: In Practice, 8(6), 1791–1794. https://doi.org/10.1016/j.jaip.2020.04.012
2.
BergS. H., O’HaraJ. K., ShorttM. T., ThuneH., BrønnickK. K., LunguD. A., RøislienJ., & WiigS. (2021). Health authorities’ health risk communication with the public during pandemics: A rapid scoping review. BMC Public Health, 21(1). https://doi.org/10.1186/s12889-021-11468-3
3.
ByanyimaW., LauterbachK., & KavanaghM. M. (2023). Community pandemic response: The importance of action led by communities and the public sector. The Lancet, 401(10373), 253–255. https://doi.org/10.1016/S0140-6736(22)02575-2
4.
CapoorM. R., & ParidaA. (2021). Current perspectives of biomedical waste management in context of COVID-19. Indian Journal of Medical Microbiology, 39(2), 171–178. https://doi.org/10.1016/j.ijmmb.2021.03.003
5.
Centre for Science and Environment. (2020). Managing biomedical waste in India: COVID-19 and beyond.
6.
ChandS., ShastryC. S., HiremathS., JoelJ. J., KrishnabhatC. H., & MatetiU. V. (2021). Updates on biomedical waste management during COVID-19: The Indian scenario. Clinical Epidemiology and Global Health, 11(February), 100715. https://doi.org/10.1016/j.cegh.2021.100715
7.
CPCB. (2019). Annual report on biomedical waste management as per biomedical waste management rules. Central Pollution Control Board.
8.
CPCB. (2020). Guidelines for handling, treatment and disposal of waste generated during treatment/diagnosis/quarantine of COVID-19 patients: Revision 4. Central Pollution Control Board.
9.
CPCB. (2021). Generation of COVID19 related biomedical waste in States/UTs. Central Pollution Control Board.
10.
CPCB. (2022). Guidelines for handling, treatment and disposal of waste generated during treatment/diagnosis/quarantine of COVID-19 patients: Revision 5. Central Pollution Control Board.
11.
da SilvaS. J. R., & PenaL. (2021). Collapse of the public health system and the emergence of new variants during the second wave of the COVID-19 pandemic in Brazil. One Health, 13(April), 100287. https://doi.org/10.1016/j.onehlt.2021.100287
12.
DattaP., MohiG., & ChanderJ. (2018). Biomedical waste management in India: Critical appraisal. Journal of Laboratory Physicians, 10(01), 006–014. https://doi.org/10.4103/jlp.jlp_89_17
13.
DharR., PethusamyK., JeeB., & KarmakarS. (2021). Fault lines in India’s COVID-19 management: Lessons learned and future recommendations. Risk Management and Healthcare Policy, 14, 4379–4392. https://doi.org/10.2147/RMHP.S320880
14.
DjalanteR., ShawR., & DeWitA. (2020). Building resilience against biological hazards and pandemics: COVID-19 and its implications for the Sendai framework. In Progress in disaster science (Vol. 6). Elsevier Ltd. https://doi.org/10.1016/j.pdisas.2020.100080
15.
DunlopC. A., OngaroE., & BakerK. (2020). Researching COVID-19: A research agenda for public policy and administration scholars. Public Policy and Administration, 35(4), 365–383. https://doi.org/10.1177/0952076720939631
16.
Ellis-PetersenH. (2021). ‘The system has collapsed’: India’s descent into COVID hell. https://www.theguardian.com/world/2021/apr/21/system-has-collapsed-india-descent-into-covid-hell
17.
EmmanuelJ., PieperU., RushbrookP., StringerR., TownendW., WilburnS., & ZghondiR. (2014). Safe management of wastes from health-care activities. WHO. http://apps.who.int/iris/bitstream/10665/85349/1/9789241548564_eng.pdf
18.
GanapatyeS. (2021). COVID-19 | The growing challenge of biomedical waste disposal. Money Control. https://www.moneycontrol.com/news/opinion/covid-19-the-growing-challenge-of-biomedical-waste-disposal-6492401.html
19.
GangwarH. S., & RayP. K. C. (2021). Geographic information system-based analysis of COVID-19 cases in India during pre-lockdown, lockdown, and unlock phases. International Journal of Infectious Diseases, 105, 424–435. https://doi.org/10.1016/j.ijid.2021.02.070
20.
GhoshS. (2020). Little protection for sanitation workers during COVID-19 pandemic, finds survey. The Hindu. https://www.thehindu.com/news/national/little-protection-for-sanitation-workers-during-covid-19-pandemic-finds-survey/article32550790.ece
21.
GilmoreB., NdejjoR., TchetchiaA., De ClaroV., MagoE., DialloA. A., LopesC., & BhattacharyyaS. (2020). Community engagement for COVID-19 prevention and control: A rapid evidence synthesis. BMJ Global Health, 5(10). https://doi.org/10.1136/bmjgh-2020-003188
22.
HaldaneV., JungA. S., NeillR., SinghS., WuS., JamiesonM., VermaM., TanM., De FooC., AbdallaS. M., ShresthaP., ChuaA. Q., NordströmA., & Legido-QuigleyH. (2021). From response to transformation: How countries can strengthen national pandemic preparedness and response systems. The BMJ, 375. https://doi.org/10.1136/bmj-2021-067507
23.
HsiehC. W., WangM., WongN. W. M., & HoL. K.-k. (2021). A whole-of-nation approach to COVID-19: Taiwan’s National Epidemic Prevention Team. International Political Science Review, 42(3), 300–315. https://doi.org/10.1177/01925121211012291
24.
HynesW., TrumpB., LoveP., & LinkovI. (2020). Bouncing forward: A resilience approach to dealing with COVID-19 and future systemic shocks. Environment Systems and Decisions, 40(2), 174–184. https://doi.org/10.1007/s10669-020-09776-x
25.
Independent Panel for Pandemic Preparedness and Response. (2021). COVID-19: Make it the last pandemic.
26.
IslamS., IslamT., & IslamM. R. (2022). New coronavirus variants are creating more challenges to global healthcare system: A brief report on the current knowledge. Clinical Pathology, 15. https://doi.org/10.1177/2632010X221075584
27.
IsraelsenS., & MaljiA. (2021). COVID-19 in India: A comparative analysis of the Kerala and Gujarat development models’ initial responses. Progress in Development Studies, 21(4), 397–418. https://doi.org/10.1177/14649934211030462
28.
JayarajanS. (2021). Chennai’s sanitation workers live the horrors of a broken waste disposal system. The News Minute. https://www.thenewsminute.com/article/chennai-s-sanitation-workers-live-horrors-broken-waste-disposal-system-149136?amp
29.
KhanS., MishraJ., AhmedN., OnyigeC. D., LinK. E., SiewR., & LimB. H. (2022). Risk communication and community engagement during COVID-19. International Journal of Disaster Risk Reduction, 74. https://doi.org/10.1016/j.ijdrr.2022.102903
30.
KumarA., & AgrawalA. (2020). Recent trends in solid waste management status, challenges, and potential for the future Indian cities—A review. Current Research in Environmental Sustainability, 2, 100011. https://doi.org/10.1016/j.crsust.2020.100011
31.
ManekarS. S., BakalR. L., JawarkarR. D., & ChardeM. S. (2022). Challenges and measures during management of mounting biomedical waste in COVID-19 pandemic: An Indian approach. Bulletin of the National Research Centre, 46(1). https://doi.org/10.1186/s42269-022-00847-4
32.
MoEFCC. (2016). Bio-medical waste (management and handling) rules, 2016 (Vol. 2016). The Gazette of India: Extraordinary.
33.
NITIAayog. (2020). COVID-19 in India: A SWOT analysis. http://niti.gov.in/covid-19-india-swot-analysis
34.
NITIAayog. (2021). Home-based management of COVID-19: Best practices adopted by states.
35.
OyedotunT. D. T., KasimO. F., FamewoA., OyedotunT. D., MoonsammyS., AllyN., & Renn-MoonsammyD.-M. (2020). Municipal waste management in the era of COVID-19: Perceptions, practices, and potentials for research in developing countries. Research in Globalization, 2(November), 100033. https://doi.org/10.1016/j.resglo.2020.100033
36.
RamtekeS., & SahuB. L. (2020). Novel coronavirus disease 2019 (COVID-19) pandemic: Considerations for the biomedical waste sector in India. Case Studies in Chemical and Environmental Engineering, 2(May), 100029. https://doi.org/10.1016/j.cscee.2020.100029
37.
ReddyB. V., & GuptaA. (2020). Importance of effective communication during COVID-19 infodemic. Journal of Family Medicine and Primary Care, 9(8), 3793. https://doi.org/10.4103/JFMPC.JFMPC_719_20
38.
SeervaiS., & ShahA. (2021). India’s leadership failure collapses health system COVID-19 surge. The Commonwealth Fund. https://www.commonwealthfund.org/blog/2021/indias-failure-leadership-collapses-health-system-covid-19-surge
39.
SmithR. D. (2006). Responding to global infectious disease outbreaks: Lessons from SARS on the role of risk perception, communication and management. Social Science and Medicine, 63(12), 3113–3123. https://doi.org/10.1016/j.socscimed.2006.08.004
40.
SuleimanyM., MokhtarzadehS., & SharifiA. (2022). Community resilience to pandemics: An assessment framework developed based on the review of COVID-19 literature. International Journal of Disaster Risk Reduction, 80. https://doi.org/10.1016/j.ijdrr.2022.103248
41.
TetiM., SchatzE., & LiebenbergL. (2020). Methods in the time of COVID-19: The vital role of qualitative inquiries. International Journal of Qualitative Methods, 19, 1–5. https://doi.org/10.1177/1609406920920962
42.
VargheseN. E., SabatI., Neumann-BöhmeS., SchreyöggJ., StargardtT., TorbicaA., van ExelJ., BarrosP. P., & BrouwerW. (2021, April). Risk communication during COVID-19: A descriptive study on familiarity with, adherence to and trust in the WHO preventive measures. PLoS One, 16(4). https://doi.org/10.1371/journal.pone.0250872
43.
WachingerG., RennO., BeggC., & KuhlickeC. (2013). The risk perception paradox-implications for governance and communication of natural hazards. Risk Analysis, 33(6), 1049–1065. https://doi.org/10.1111/j.1539-6924.2012.01942.x
44.
WaterAid & UMC. (2020). Health, safety and social security challenges of sanitation workers during the COVID-19 pandemic in India.
45.
WHO. (2020). IHR emergency committee on novel coronavirus (2019-nCoV). https://www.who.int/director-general/speeches/detail/who-director-general-s-statement-on-ihr-emergency-committee-on-novel-coronavirus-(2019-ncov)
46.
ZhangL., LiH., & ChenK. (2020). Effective risk communication for public health emergency: Reflection on the COVID-19 (2019-nCoV) outbreak in Wuhan, China. Healthcare, 8(1). https://doi.org/10.3390/healthcare8010064
