Table 9.

Assessment of healthcare/COVID-19 waste management guidelines of some countries and agencies.

Country/agency	Guidelines	Assessment
		Storage	Transportation	Disposal and treatment
World Health Organisation (WHO, 2020b)	Healthcare facilities ■COVID-19 waste generated needs to be safely collected in assigned bags, treated on-site (preferably) or off-site and thereafter disposed of safely. ■Waste produced in the waiting areas or sections of healthcare facilities can be categorised as non-hazardous and disposed of using strong black bags. ■Proper and suitable PPE must be worn by all personnel in charge of healthcare waste management. Hand hygiene must be observed after the use of PPE.	Guideline is adequate on segregation and storage at source of the waste	Lack of information on waste transportation	Lack of information
	Home quarantine/self-isolation ■Waste produced needs to be packaged, collected and disposed of using strong black bags. ■Used tissues/materials for sneezing and coughing must be disposed of in a waste bag/bin immediately, and proper hand hygiene observed.	Adequate for waste generated	Lack of information	Lack of information
South Africa (DOH, 2020)	Healthcare facilities ■Healthcare waste safely disposed of in red liners using designated single-use box sets (marked “infectious waste”) and properly sealed prior to internal collection. ■Yellow-coloured sharps container used for all sharps waste, and marked with: “Danger contaminated sharps” and bio-hazard symbol. ■Three-quarter full sealed box sets must be stored at central storage areas for collection by officers or designated service providers. ■Treatment and disposal of waste must be conducted at a licensed healthcare waste treatment and disposal facility.	Adequate, fairly detailed information provided in the guideline	Lack of information	Inadequate information provided in the guideline
	Home quarantine/self-isolation ▪Waste in contact with suspected/confirmed cases of COVID-19 must be stored in leak-proof and heavy-duty disposable plastic bags or bins. ▪Waste bag must be tied when full. ▪Full bag or bin must be stored separately and securely from other domestic waste for collection by the relevant municipality.	Adequate guideline	Lack of information	Lack of information
United States USOSHA (2020)	Healthcare facilities ■Waste suspected or confirmed to be infected with COVID-19 only requires the usual precautions applied in protecting solid waste and wastewater management workers against hazards inherent in their regular job responsibilities. ■Municipal solid waste suspected or confirmed to be infected with the virus must be managed in the same way as other non-contaminated municipal waste, although strict PPE use, administrative and engineering controls and safe work practices must be followed.	Lack of information	Lack of information	Lack of information
China (MEE, 2020)	Healthcare facilities ■Medical infectious waste produced while preventing and treating pneumonia epidemics must be packed using specialised bags or containers, and tagged with warning symbols. ■Priority must be given when collecting and disposing such medical infectious waste by the disposal units. ■Hazardous, industrial, domestic and other waste facilities for incineration of epidemic medical waste must be operated in compliance with the regulations of professional health authorities. ■The collection, storage, transfer and disposal of such medical waste must support the protection of personnel hygiene.	Adequate guideline	Lack of information	Inadequate information provided
	Home quarantine/self-isolation ■Used masks must be collected in special waste plastic bags or bins before disposal. ■Used medical masks by healthy people must be disposed of together with domestic waste.	Guideline is adequate	Lack of information	Lack of information
India (CPCB, 2020)	Healthcare facilities ■Dedicated bins and trolleys labelled COVID-19 waste should be used. ■Use of 1% sodium hypochlorite to disinfect the outer and inner surface of the bin and trolley. ■The collection bins should be colour-coded for proper waste segregation. ■General solid waste must be collected in separate bins. ■Used face shield, apron, googles, nitrile gloves and plastic coverall should be collected in red bags. ■Used mask, gown, tissues, toiletries, shoe cover, head cover and non-plastic coverall must be collected in yellow bags. ■Use dedicated vehicle to collect COVID-19 ward waste. ■Vehicle should be sanitised with sodium hypochlorite or any appropriate chemical disinfectant after every trip.	Detailed and adequate contained in the guideline	Adequate guideline	Lack of information
	Home quarantine/self-isolation ■General household waste must be collected in bags. ■Generated waste such as used face masks, tissues, gloves, syringes infected with the body fluids or blood of a COVID-19 patient must be classified as biomedical waste. ■Biomedical waste must be collected in yellow bags.	Information is adequate	Lack of information	Lack of information
European Union (European Commission, 2020)	Healthcare facilities ■Waste relating to COVID-19 patients must be managed in accordance with the EU law on waste (particularly hazardous waste and permitting requirements) and the most updated guidelines issued by the ECDC4. The national requirements for infectious waste must also be considered.	Lack of information	Lack of information	Lack of information
	Home quarantine/self-isolation ■Separate waste bag for used masks and tissues must be put in the room of the patient. The bag must be closed and not be emptied into another bag. ■Another waste bag for used masks and gloves by the caretaker and cleaner must be put close to the door of the patient's room. ■The two waste bags can be collected together and put in a general refuse bag. ■Hand hygiene must be strictly followed after handling waste bags.	Adequate and detailed information provided	Lack of information	Lack of information