On 21 February 2020, Lebanon recorded its first COVID-19 case. Since then till 30 April 2020, a total of 725 cases have been officially documented, of which 551 cases are still active. The number of COVID-19 recovery cases are 150 cases while the number of death reached a total of 24 cases. Since Lebanon’s population is approximately 6.8 million, then it can be concluded that approximately 0.01% of the population got infected by COVID-19 up till 30 April 2020. Moreover, Lebanon implemented a national lockdown policy on 16 March 2020 to prevent the outbreak of the virus. Thus, this article will provide an overview of the impact of the national lockdown on the solid waste generation in Lebanon by analyzing the quantities of waste generated during the 6 weeks prior the lockdown and the 6 weeks that followed the lockdown (period that was assessed covered the months of February, March and April 2020).
An Overview of the Healthcare Waste
COVID-19 is known to result in an increase in the amount of infectious waste per patient. The increase in Lebanon has been noted to be in the range of 3 to 4 times per patient. This increase is mainly correlated to the fact that all the waste generated by the patient at the hospital including food and clothes (including those of medical staff), are considered as infectious waste. Most of the COVID-19 cases were hospitalized in Hariri Public Hospital. Interestingly, although the quantities of infectious healthcare waste generated at Hariri Public Hospital increased (doubled), the overall national quantities of infectious healthcare waste did not increase nor did they exceed the conventional quantities. The main reasons to justify the relatively consistent quantities of infectious healthcare waste under COVID-19 on a national are:
- In parallel with the national lockdown, both the medical centers and patients avoided conducting none urgent surgeries. Thus the quantities of conventional infectious waste decreased, and the COVID-19 cases compensated for this decrease.
- Number of COVID-19 cases in Lebanon, are still relatively low with respect to the population and capacities of the healthcare system.
- Mild COVID-19 cases were quarantined and not hospitalized, thus their waste was not handled and treated as Healthcare waste. Thus, not all the quantities of waste generated from the registered cases contributed to the infectious healthcare waste.
An Overview of Municipal Solid Waste
When it comes to analyzing the quantities of municipal solid waste one should first assess the historic characteristics of the period being assessed. Usually, the period from February to April, tends to witness some increase in quantities of waste as part of the commencement of the seasonal fluctuation of waste. However, when comparing the quantities of the period of February 2020 and the first half of March 2020 up to the national lockdown with the period after the lockdown (i.e. second half of March 2020 and April 2020), one would notice a general drop in the national quantities of waste. Nevertheless this drop in quantities was not consistent throughout Lebanon, and varied between 2% and 26% between various areas. Furthermore few areas did experience slight increase in the quantities. As an overview of the variation (decease/fluctuation) in quantities of municipal solid waste, one can notice the following:
- Urban areas with big commercial sector witnessed a bigger decrease in quantities of waste
- Mixed urban and rural areas witnessed an average decrease
- Rural areas with a small commercial sector, witnessed a slight decrease and in some cases a slight increase
- The quantities of organic waste in many areas increased despite the overall decrease in the quantities of waste.
Analysis and Recommendations
Concerning Healthcare waste, although the impact of COVID-19 was relatively limited from a quantitative aspect, it should be considered as a warning sign for more advanced planning. The current infrastructure for healthcare waste in Lebanon is relatively overstretched. Luckily, the impact of COVID-19 pandemic up till 30 April 2020 was relatively small in Lebanon; however, one should not always bet on luck. Lebanon should enhance the existing healthcare waste infrastructure taking the following issue into considerations:
- Enhance the cold storage capacities at treatment facility to ensure sufficient storage capacity for at least three consecutive days. This would help in the case of maintenance shut down and in the case of sudden increase in quantities due to a pandemic.
- Force of medical facilities to have cold storage areas with a capacity for at least three consecutive days. For the same motives as per the point above.
- The treatment capacity of the existing healthcare waste treatment facilities should be enhanced. Currently facilities operate at full capacity, 24 hours a day for autoclaving. The capacities should be modified to ensure an 8 to 16 hour maximum of operation time. The remaining hours should be kept for maintenance and for operation under critical periods.
- Ensure availability of spare parts at all times to ensure quick response to any failure of equipment
- Ensure geographic distribution of treatment facilities in order to optimize operation cost and to benefit from decentralization. This would prevent from converting a regional healthcare waste crisis into a national healthcare waste crisis.
- Develop the infrastructure of other categories of healthcare waste other than the conventional healthcare infectious waste.
As for the municipal solid waste, the decrease was higher in urban commercial areas due to the decrease in the quantities of commercial waste as a consequence to the lockdown. Rural areas experienced a smaller decrease and in some cases a slight increase due to the limited impact of the shut-down on the commercial sector on these areas and to the increase in their population due to mobilization of people from urban areas to rural areas for the lockdown. Although, the overall decrease in national quantities of municipal solid waste may indicate that there is no need for additional intervention, this might not be fully true. Lebanon’s existing municipal solid waste infrastructure is relatively fragile with the following pressure points.
- 31% to 35% of the waste ends up in dumpsite, thus contamination of this waste by the healthcare waste or waste of infected people may have a severe impact on groundwater and in spread of diseases.
- Limited legislations and standards for solid waste facilities and for operating these facilities. Thus, there is no one minimum procedure being implemented to build on.
- Existing facilities are designed and operated as labor based facilities as oppose to mechanical and automated facilities. Thus, if a laborer gets infected by a disease there is a higher risk of transferring it to his colleagues, especially that solid waste facilities are fundamental elements that we cannot shut-down in light of pandemics.
- Labor health and safety measures are relatively low at most of the existing facilities. This may result in an increase in the risks of spreading diseases between workers.
Indeed luck and some smart administrative decisions prevented the collapse of the existing solid waste system under the COVID-19 pandemic. However, one should learn from this experience to develop the existing infrastructure and decrease the role of luck should the country face other pandemics in the future.