Medical face masks keep us safe from the new coronavirus. Discarding of soiled masks improperly, however, not only harms the environment, but also people. Our carelessness can come back to harm us with a vengeance.
Before the Covid-19 pandemic, medical face masks were used primarily by public health personnel. Now, the public also needs these single-use masks to protect themselves every single day. Imagine the mountains of soiled masks littering the environment at the moment. Imagine the public health risks if people come into contact with this potentially hazardous waste.
Just how many masks are used and discarded a day in Thailand? As of early April, Thailand could produce 1.56 million medical masks per day. About 0.8 million of them are allocated to hospitals and the rest are available to the general public.
Given wide complaints from healthcare workers and the public about the scarcity of disposable face masks, assuming that all 1.56 million of them are used up and discarded every day, that means the amount of soiled masks discarded in Thailand is double the per-pandemic figure. This is a conservative estimate because the real demand for masks during the pandemic much exceeds the country's production capacity.
On the plus side, the great demand shows the public's strong awareness of self-protection through frequent hand washing and the wearing of face masks. Credit must go to the effective public awareness campaigns and clear messaging.
What is still missing, however, is an extensive education campaign on proper disposal of soiled masks. Meanwhile, there are no convenient disposal points in public places. The other key factor is a lack of awareness on how to properly dispose of soiled face masks.
At present, the Bangkok Metropolitan Administration (BMA) and the Ministry of
Natural Resources and Environment have conducted public awareness campaigns on the safe disposal of soiled medical masks. Their advice: Put used masks in plastic bags, tie the bags tightly and clearly label them "medical masks" so garbage collectors under local governments can sort them for proper waste treatment.
In Bangkok, the hotbed of the coronavirus, the BMA only provides special red bins for used medical masks at its branch offices. Apart from City Hall, the red bins are available at 50 district offices, 69 BMA medical service centres and 11 BMA general hospitals.
Clearly, the government's measures to prevent environmental pollution from the deluge of single-use face masks are not extensive and rigorous enough. As the debris piles up, proper disposal of soiled masks is not mandatory, while the number of special bins is too small to respond to public needs. What's more, the bins are located in places that are not convenient for the general public to dispose of their masks. And outside of Bangkok, there is no designated facilities to dispose of soiled face masks. This calls for further action by local governments.
The environmental nightmare ahead is clear. But it also comes with public health hazards.
The single-use surgical masks use non-woven fabrics made from polypropylene plastic. The wires that make the masks fit the wearers' faces are also made from plastic or aluminium. Both are non-biodegradable. Discarding a large amount of them randomly takes a heavy toll on the environment, as has already happened in China and Hong Kong.
In Hong Kong, dirty face masks have washed up on the beaches of Soko Island during the Covid-19 outbreak, aggravating the problem of marine plastic pollution.
The careless disposal of soiled masks which may contain the virus also pose disease transmission threats. Since the new coronavirus can infect through contact, garbage collectors face a high risk of getting the virus if the contaminated masks are discarded with normal waste. Improper treatment of used masks such as piling them up and leaving them exposed in the open air may also enable the virus to spread.
China has conducted extensive campaigns on the proper use of masks and enforced strict regulations on how to dispose of them safely. In Shanghai, for example, those who discard of used masks in the wrong bins will face a fine of 200 yuan or 1,000 baht. Their social credit rating will also be cut. Businesses that violate the regulations will be fined 50,000 yuan or 250,000 baht.
Yet China is still facing a grave problem. The overwhelming quantity of infectious waste exceeds the country's capacity to process it. During the peak of the pandemic in Wuhan this past February, the city produced more than 200 tonnes of medical waste, which was more than four times the capacity of the city's medical waste incinerators.
Thailand must be more proactive to avoid medical waste pollution. For starters, state agencies at all levels must join forces to raise public awareness on the need to discard of face masks properly. They must also walk the walk by providing enough red bins at convenient public places to facilitate easy and safe disposal of soiled masks. The locations must be regularly frequented by people so as not to add an extra burden on the public.
Similarly, private businesses including condominiums must provide separate bins for used masks with clear labels. They must be placed where people can see and access them easily. Both state agencies and the private sector must educate people in their own organisations about the necessity of the safe disposal of masks and inform them about the locations of the red bins with maps. Illustrations should accompany the red bins showing the proper way to discard of the masks.
Apart from safe disposal, the transport and treatment of infectious waste must strictly follow the 2002 ministerial regulations on infectious waste treatment. The government must assess whether the current capacity of firms which transport and treat medical waste is enough to cope with demand and, if not, how to increase capacity.
Throughout Thailand, there are only 25 companies offering treatment of infectious waste. While the pandemic is engulfing the entire country, only 10 local administrative bodies have medical waste incinerators. This is worrying.
It is not currently possible for the country to cope with the overwhelming quantity of medical waste. But rapidly increasing capacity to fill the gap is also not possible.
A practical, short-term solution is to promote the use of reusable cloth masks as protection against the virus. This would not only save surgical masks for healthcare workers, but also significantly reduce the amount of contaminated waste to be processed.
With public cooperation in switching to cloth masks, providing enough public bins to dispose of used masks, effective waste sorting and more incinerators for infectious waste treatment, Thailand can avoid the pollution and health risks from contaminated used masks.
If not, the pandemic fallout will haunt us for a long time to come.
Kannika Thampanishvong, PhD is a Senior Research Fellow (TDRI) and Wichsinee Wibulpolprasert, PhD is a research fellow at the Thailand Development Research Institute. Policy analyses from the TDRI appear in the Bangkok Post on alternate Wednesdays.