China faces a mountain of medical waste

Every day in China, fully-suited police officers insert hundreds of millions of disposable cotton swabs down their throats for large-scale PCR testing. Problem: The operation generates a huge amount of medical waste.

With its zero COVID strategy, the Asian giant is the last major economy to want to prevent any infection at all costs, officially to avoid overwhelming its hospitals in the face of low vaccination rates among the elderly.

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In its anti-coronavirus arsenal: mandatory quarantines, localized confinements and, therefore, massive screenings, which have become almost daily in certain places.

From Beijing to Shanghai to Shenzhen, the “Chinese Silicon Valley” home to many tech companies, cities are now filled with small prefabs 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 create an immense mass of medical waste, constitute a growing economic burden for local authorities, already heavily indebted, who must devote tens of billions of euros to them.

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

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

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

The country also aims for carbon neutrality by 2060, an ambitious and extremely uncertain target given the Asian giant’s current dependence on coal.

The generalization of PCR tests represents a new environmental challenge.

For a few dozen positive cases detected every day in China, it will have been necessary to track hundreds of millions of people and use a huge mass of tubes, swabs, packages and combinations.

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

According to an AFP count, Chinese cities and provinces where a total of 600 million people live have announced one form or another of general and regular screening of their population.

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

This represents a daily amount six times greater than normal.

Under Chinese regulations, authorities are responsible for sorting, disinfecting, transporting and storing this waste before disposing of it – usually by incineration.

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

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

Questioned by AFP, the Ministry of Health indicated that it had formulated “specific requirements regarding the management of hospital waste” related to COVID-19.

The government is requiring provincial capitals and cities of at least 10 million people to set up testing sites within a 15-minute walk of every resident.

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

For Jin Dong-yan, professor at the School of Biomedical Sciences at the University of Hong Kong, these widespread PCR tests are “really inefficient and expensive” and force local governments to give up other useful investments in the health sector.

Authorities are also at risk of 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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