Gangtok, June 9: Due to the pandemic, face masks have become such an important accessory to citizens and often in its absence, the face feels uncomfortably empty and one is reminded to return home to retrieve it when people start passing dirty looks or chastising for forgetting to wear it.

In Sikkim, face masks have been made mandatory by the Land Revenue and Disaster Management Department.

On May 10, a fine of Rs. 300 was declared if anybody was found flouting the mandatory regulations. Additionally, the State Executive Committee implemented the Sikkim Public Health and Safety (COVID-19 Regulations, 2020 under which it states: “It shall be compulsory to wear face cover or mask in all public places and workplaces.”

The Central Pollution Control Board (CPCB) of India on March 21, had revised guidelines for the waste management and disposal of masks. It dictates that the used masks (including triple-layer mask, N95 mask, etc) or anything containing the fluids of COVID-19 patients, healthcare workers treating the patient are considered biohazard waste and have to be discarded and collected in separate ‘yellow colour coded plastic bags’ (suitable for biomedical waste collection).

They have to be handed over to the waste collector engaged by the common biomedical waste treatment facility (CBWTF) operator at the doorstep and should be incinerated.

Despite classifying face masks under biomedical waste, garbage segregation by Sikkim’s residents still dismal Dr. Baroon Subba, Additional Director of Clinical Estd. Biomedical Waste, Sanitation, NQASP & NTCP, Sanitation and FW Department, informs that waste which includes face masks, from COVID-19 patients, healthcare workers treating the patient, waste from quarantine facilities around Gangtok, are all being treated at STNM Hospital, Sochayghang where they are incinerated. The waste from other quarantine centres in other districts is being dealt with by District Hospitals which each have an incinerator.

While the waste from COVID-19 Centre and quarantine centres are being dealt with by Sanitation FW Department, the Gangtok Municipal Corporation (GMC) workers safai karamcharis are responsible for bringing the waste from quarantine centres in and around Gangtok to STNM Hospital, Sochayghang.

Not only is the GMC transporting the waste from quarantine centres in Gangtok, but they are also dealing with the disposal of the general public’s face mask. Hem Kumar Chettri explained that the GMC safari karamcharis collect the waste, segregate the face masks which are then buried in a deep burial at Martam’s landfill. 

face masks disposal
GMC’s waste collectors

The GMC Commissioner has appealed through SC to the general public to segregate the masks beforehand so that it’s not mixed with the other waste. This little act could save a safai karamchari the health risk and pains of having to segregate everything themselves, the same could be applied to sanitary napkins, anything with body fluids, during the pandemic and during normal times as well. 

Pritam Pany, CEO and Founder of Voyage, an independent private social enterprise working in the space of zero waste and sustainability with the vision of achieving Zero Waste Himalaya, recounted how he had seen a face mask thrown out of a window into another’s balcony, and that it is not a rare sight.

Pany says that the best the Government and the public can do is segregate their waste into three categories – dry, wet and ‘rejects’ like the sanitary waste. In the COVID-19, he says, all face masks and waste with bodily fluids should be put into the third category, and the Government should put a separate drum in the garbage collecting trucks and should also have the same in roads and curbside collection for such wastes. Pany admits that this will be a very difficult task, but with waste training, it can be implemented.

As for sanitizer bottles which are single-use plastic bottles, Pany suggests that since even in Sikkim sanitizers are being produced by companies like Mount Distilleries, the manufactures can set up collection bins for used sanitizer bottles, which can be sterilized, sanitized and filled up again, so that the same bottles remain in circulation, rather than dumping everything in landfills, which will not only help the environment but will also protect everyone like safai karamcharis.

He says, “I’ve been working in Gangtok for five years, and the fact is very few people care about the environment, but now with the pandemic, there is a direct correlation between health and waste so now to some extent people are sensitized. We must understand this face mask goes somewhere; it doesn’t just disappear. If the general public’s face mask waste was also incinerated it would be well and good, but the face mask disposed of by the public is taken to Martam’s or 32 Mile’s landfills where they are buried.

“In the landfills there are almost 50 Sikkimese ragpickers who go inside the landfill to pick up scraps to sell, causing them to be directly exposed to Gangtok’s poison. Every Sikkimese is contributing toward the ill health of safai karmacharis and rag pickers. Let’s care about other people’s health also than just selfish.”

WWF Coordinator of Sikkim, Laktsedhen Theengh says “We realized how fast-paced lives we live, and only after the pandemic hit us did, we realize that and the lockdown also showed that humans are the problem.”

She adds that while banning the entry of tourists there was a decrease in waste generated, but now the waste being generated is riskier. She believes that due to the State making face masks mandatory people are buying disposable and one-time-use masks, since the cost only isn’t that high, but if we look at the mask closely, we can tell that it is plastic, which brings us to square one.

She says, “The careless disposal of masks is not just harming the environment but it is posing a deadly threat to the safai karamcharis. Though right now in Sikkim, all positive COVID-19 cases are from returnees who are in facility quarantine, but if the virus was to spread in the general public, the face masks would be a grave cause of spreading infection,” adding, “There are so many aspects we are forgetting regarding face masks, we could employ self-help groups and entrepreneurs into making masks and it’ll also help in some ways repairing the local economy.”

Laktsedhen also stressed on how the general public doesn’t need the N95 masks, which has also been instructed by both the Union’s and State’s Health Ministries. She opts that the best alternative to the disposable face mask are cloth masks or covering the mouth and nose with a piece of cloth. Like the face masks, sanitizers which come in plastic bottles is also unnecessary waste, she says, “Sanitizers are only needed when travelling for a long time, not while sitting at home where you can wash your hands. The bottles of sanitizers are increasing plastic or single-use plastic waste. It is a herculean task to make the people understand this.”

Laktsedhen while working with WWF says it made her see how humans are; if others do it, what difference does it make if I do the same, adding, “The Sikkimese concerning waste disposal are not disciplined, they’ll throw anything, anywhere, but this overdue conversation, I hope makes a difference. The Sikkimese people are not aware of how much of a difference it makes, we have been lucky so far, in other cities safai karamcharis have lost lives while handling COVID-19 waste, maybe then we will see how lives are affected by their single action.

One plastic to decompose takes 500 years, the face masks are basically plastic and now think of how many face masks are bough, used and thrown every day. In an environmental aspect and for our frontline workers, it is scary to even think of it.”

Initially, with the onset of the virus in India, most people were confused as to what face mask to wear, for how long and how often it needs to be washed changed? So, this is a comprehensive guide to not just their disposal but also the basics of face masks:

  • N95 Respirator

An N95 respirator is a respiratory protective device designed to achieve a very close facial fit and efficient filtration of airborne particles. The edges of the respirator are designed to form a seal around the nose and mouth. Surgical N95 Respirators are commonly used in healthcare settings and are a subset of N95 Filtering Facepiece Respirators (FFRs), often referred to as N95s. N95 masks like the surgical masks are used by healthcare workers, but during the pandemic is an absolute essential for medical workers involved with the treatment, testing of COVID-19 patients.

The general public does not need the N95 respirator. The State Health Department requested the public many times to not buy or use the N95 respirator because of its shortage in the healthcare sector. Since the N95 is very tight and prolonged use can cause an excess intake of carbon dioxide leading to the bursting of lungs, or fainting spells.

The N95 mask is meant for healthcare workers and according to the WHO, N95 mask can be used for many patients with the same diagnosis up to a period of 4 hours.

  • Surgical or 3-Ply mask

A surgical mask is a loose-fitting, disposable device that creates a physical barrier between the mouth and nose of the wearer and potential contaminants in the immediate environment. They are not to be shared and maybe labelled as surgical, isolation, dental, or medical procedures. Surgical masks are made in different thicknesses and with different ability to protect from contact with liquids.

These properties may also affect how easily you can breathe through the face mask and how well the surgical mask protects you. If worn properly, a surgical mask is meant to help block large-particle droplets, splashes, sprays, or splatter that may contain germs (viruses and bacteria), keeping it from reaching your mouth and nose. Surgical masks may also help reduce exposure of your saliva and respiratory secretions to others. The surgical mask won’t protect the wearer from the coronavirus. The surgical mask is not meant to be reused; it should be changed after every use.

  • Cloth Mask

While they do not provide adequate protection, it is still better for routine use than not covering your mouth and nose. For the general public, if a face mask is not available at least a piece of cloth like a scarf may be used to cover the face. Cloth masks are significantly better for the environment than the N95 respirator and the surgical masks.

For the general public, as per the US Food and Drug Administration website, the following can be followed while disposing of each type of mask:

  • For Cloth mask– Cloth masks can be properly washed, disinfected, dried and reused.
  • For Surgical mask – If the mask is dry and the layers and shape are intact, put it in a piece of paper and wrapped properly, should be handled separately from other waste to r the safai karamcharis, so that they do not need to segregate.
  • N95 respirator– When not in use, store in a sealed plastic container. While disposing of the masks, gloves should be and the masks should be labelled. Since most N95 respirators are used by healthcare workers, they are considered biohazard waste and have to be discarded and collected in separate ‘yellow colour coded plastic bags’ (suitable for biomedical waste collection). They have to be handed over to the waste collector engaged by the common biomedical waste treatment facility (CBWTF) operator at the doorstep and should be incinerated.

Read more related articles:

Biomedical waste from quarantine centres being treated as ‘domestic hazardous waste’

GMC to levy fines for non-segregation of wastes; cooperation from citizens sought

Biomedical waste management during the COVID-19 pandemic

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