As we pass the one year anniversary of the COVID-19 outbreak in the US, it is astonishing to see how dramatically life has changed. Just look at the streets of New York City: once bustling with life even at odd hours of the night, they are now sparse after midnight and in daylight, pedestrians walk with their heads down with only their eyes visible peeking out over their masks. The biggest change to the average person’s daily life, which has now become second nature, is the use of Personal Protective Equipment, or PPE. In the past, PPE was primarily associated with those who worked in the healthcare industry. But now, every day the average person uses one or more masks and may also use gloves. Single use masks and gloves are made of microplastics and are not biodegradable-- an environmental nightmare. Thus, an unintended consequence of the pandemic has been the surge in waste as people discard single use PPE. Further, another more recent addition to COVID-19’s detrimental environmental impact is due to the vaccine rollout, as the process has generated immense waste from vials to syringes. Where is all this waste going? What are countries doing with this waste? And what will happen if we continue to generate waste at this alarming rate?

When PPE waste is generated by the general public during the COVID pandemic, it is treated as a regular solid waste stream (municipal trash), meaning they end up mainly in landfills or open dumps, sometimes even just as litter on the streets. This is a huge problem considering the sheer volume of PPE waste; if the global population adheres to a standard of one disposable face mask per day after lockdowns end, the pandemic could result in a monthly global consumption and waste of 129 billion face masks and 65 billion gloves. Once these masks and gloves find their way into the environment via landfills and dumps, they begin fragmenting into microplastics that can kill aquatic biomes and permeate into drinking water. This may be especially harmful to countries with long, heavy rain seasons (such as in East Africa, where the rainy season lasts from May to October) which can heavily pollute the freshwater and marine environment with microplastics. A French environmental NGO even found enormous amounts of surgical masks when sampling the Mediterranean seabed around the resort town of Antibes in June of 2020. 

However, there are several alternatives available. For example, reusable cloth masks have proved to be just as effective at preventing COVID-19’s spread in public settings. In addition, scientists are looking into more environmentally friendly alternatives to polypropylene, the harmful plastic which masks are made of. One example is research looking into creating masks made of wood fibers, which are fully biodegradable. In addition, the pandemic has sparked ingenuity from everyone as people work to create face masks from all sorts of materials, from food waste and flowers to polymers found in sugarcane. Although these are not intended to be for medical use, they can certainly reduce the enormous amount of plastic waste generated by single use masks.

Another alternative is incineration. Primarily used for medical PPE waste, incineration effectively gets rid of all waste by burning it. Although the process can release harmful gases into the environment, in a controlled environment, incineration can actually be quite beneficial. Waste to Energy (WTE) facilities are specifically designed to burn waste and convert it into energy for urban use and with the use of air pollution control (APC) devices, can ensure that emissions are environmentally safe. But the plants are difficult to install, hard to maintain, and can hinder further technological innovation because they last for so long that they prevent incentive for improvement. 

Although incineration may be the way to effectively remove all traces of used PPE, perhaps it is also simply a solution to a larger problem we have created by utilizing single use PPE in the first place. By placing a greater emphasis on reusable cloth masks and more research on biodegradable masks, we may be able to transition away from needing to use incineration altogether. At the moment, single use masks may seem more convenient to us, but it isn’t just a matter of convenience when the effects of their use will be long lasting, and amplified by just how many people use them.

Another way the pandemic has generated waste is due to the vaccine rollout. The normal process of handling waste begins when hazardous or infectious medical waste is put in sharps containers. It is then picked up from healthcare facilities and transported to processing centers to be sanitized with high-pressure steam before being sent to landfills alongside other trash. Along with the needles and syringes, glass vaccine vials go into sharps containers, as they can’t be recycled. 

Countries such as Bangladesh were already struggling considerably with medical waste management and the pandemic only exacerbated the existing problem. Moreover, the stringent conditions on the vaccine’s storage has only added to this strain. If the vaccine thaws, it must be used within a specific time frame or else it will be discarded. This has led to many surplus doses to be discarded. Pounds of COVID-19 vaccine discards that are not melted down into bricks as part of waste management systems are instead thrown away and may just end up in landfills.

One way we can reduce waste from vaccines is changing how vaccines are administered. The pandemic has sparked an interest in research and development for vaccine administration, which has given rise to new alternatives. Enesi Pharma Ltd. of Oxfordshire in England is developing a device that painlessly implants a vaccine-imbued tube of sugars smaller than a grain of rice under the skin. Other technologies in development for delivering vaccines beyond Enesi’s dissolving implants include microneedle patches, electrical-pulse systems, nasal sprays and even pills. These alternatives could help reduce waste from the vaccine’s distribution, as well as avoid freezing chain logistics, which can save the longevity of the vaccine.

With this being said, for the present moment none of these have been approved by the government for widespread use and until then, it seems the benefit of the vaccine outweighs any concerns about the type of medical waste that is being generated. But, something we can control is the waste generation from PPE. Although it may require some shifts to perhaps a less convenient alternative, the long term benefits of avoiding single use PPE among the general public will be worth it in the long run.