China faces a mountain of medical waste

Every day in China, officials in full suits insert hundreds of millions of disposable swabs down the throat for large-scale PCR testing. Problem: The operation creates a huge amount of medical waste.

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With its zero-COVID strategy, the Asian giant is the last major economy in a bid to avoid contagion at all costs, officially to avoid overburdening its hospitals amid low vaccination rates among seniors.

In its anti-coronavirus arsenal: mandatory quarantines, local restrictions and therefore massive screenings that have become almost daily in certain locations.

From Beijing to Shanghai, via Shenzhen, the “Chinese Silicon Valley” home to many technology companies, the cities are now dotted with small prefabricated houses or tents offering free PCR tests.

Hundreds of millions of people need to be tested every three or two days or even daily.

These PCR tests, which generate an immense amount of medical waste, represent a growing economic burden on already heavily indebted municipalities, which have to spend tens of billions of euros on them.

“The amount of medical waste generated every day is almost unprecedented in human history,” said Yifei Li, an environmental researcher at New York University in Shanghai.

“The problems are already huge and they will continue to get worse,” he told the AFP news agency.

China, whose environment has suffered greatly from economic development, has tightened its air and water pollution legislation over the past decade.

The country is also aiming for carbon neutrality by 2060, an ambitious and highly uncertain target given the Asian giant’s current reliance on coal.

The generalization of PCR testing poses a new environmental challenge.

For a few dozen positive cases to be discovered every day in China, it was necessary to screen hundreds of millions of people and use an enormous mass of tubes, swabs, packaging and combinations.

If not properly disposed of, this medical waste can contaminate soil and waterways.

According to an AFP census, Chinese cities and provinces, home to a total of 600 million people, have announced some form of general and regular screening of their populations.

68,500 tons of medical waste

No national data is available, but authorities in Shanghai said last month that 68,500 tonnes of medical waste were generated during the city’s lockdown between mid-March and early June.

This corresponds to a daily amount six times higher than normal.

Under Chinese regulations, authorities are responsible for sorting, disinfecting, transporting and storing such waste before it is disposed of – usually through incineration.

“But I’m not sure that (…) rural areas are really capable of coping with a significant increase in medical waste,” Yanzhong Huang, public health expert at the Council on Foreign Relations, told AFP, one American think tank.

Some local authorities may not know how to deal with this large amount of waste, or simply dump it in landfills, said Benjamin Steuer of the Hong Kong University of Science and Technology.

When asked by AFP, the Department of Health said it had formulated “specific requirements for medical waste management” related to COVID-19.

The government requires provincial capitals and cities with at least 10 million residents to set up testing sites within 15 minutes’ walk of each resident.

But expanding regular, mandatory screening across China could cost 0.9% to 2.3% of the country’s GDP, analysts at Nomura Bank estimated last month.

For Jin Dong-yan, a professor at Hong Kong University’s School of Biomedical Sciences, these widely used PCR tests are “really inefficient and expensive,” forcing local governments to abandon other beneficial investments in the healthcare sector.

Authorities also risk missing out on positive cases because the Omicron variant spreads faster and is harder to detect, he said.

“It won’t work,” he said. “It’s like throwing millions of dollars out the window.”

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