COVID-19: Talking Personal Protective Equipment (PPE)

Malek Sukkar, CEO of Averda, discussed key issues related to Personal Protective Equipment (PPE) in the context of Covid-19 in an interview with Swaliha Shanavas.


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Waste Management
 
June 18 2020 Malek Sukkar
 
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As the world navigates this challenging period cautiously, and people try to adapt to the changes as businesses resume and offices slowly start to function at full capacity with all precautionary measures, there are many issues that need to be addressed. Waste management is a critical service and constitutes various waste streams that need to be handled in a safe manner, especially under the current circumstances. One significant concern that has emerged during the crisis is related to the way people are handling PPE and the management of this equipment globally, with increasing amounts being used and discarded, not only by the healthcare sector, but also by the general public. Malek Sukkar addresses key questions.

What are the various categories of PPE being used on a large scale, and are these recyclable or reusable?

There are three main categories we would look at: the PPEs used by the general public, the equipment used by the medical professionals and those used in disposing and securely getting rid of this PPE. The three are quite similar in appearance, but they are quite different in the way that we would deal with them. Things have changed so much and there’s a whole class of PPE that we never saw before the pandemic, especially those worn by the general public. Earlier, except for a few countries around the world, the notion of wearing masks or gloves in daily life was not very prevalent. So, when we look at the quantities that are increasing worldwide, and will probably continue to do so for the foreseeable future, there has been a tremendous surge in the amount of PPE being used.

In general, as a result of the pandemic, the lifespan of the PPE is very short. And often it is worn for a single application after which the gown, mask or other protective equipment is discarded. A lifespan of four to five minutes is something we were not used to typically, and those PPEs would have lasted a day. It is hard to quantify, but going by the material reaching our sorting plants and disposal zones, we can say it has increased by at least 10-20-fold. Now, that does not really reflect the actual quantities, because we’ve seen a huge decrease in the regular PPE, as hospitals are not operating in the same way they were before the pandemic. That has caused us to look at the ways and means that we dispose of them; and as a result we have tried to work with our clients to try and mitigate this, but at the moment it is really not practical. As for reusing or recycling PPE, at this point in time we are so unfamiliar with the nature and the effects of the virus that I would say most of the material will be destroyed in one form or another.

Are there any guidelines that might have been developed regarding PPE in any country where Averda has operations?

We work with most of the governments that we serve and are regulated by. For instance, in South Africa we were consulted, and we were part of a select group with the department of environment that offered the current PPE annexe to the standard PPE legislation. In other countries where we operate, we have been consulted on an informal basis. We are part of the opinion forming and thought leadership in every country that we operate, if not the authors or co-authors of these legislations.

What are your observations in terms of communities and healthcare sector handling PPE particularly in Oman, UAE and South Africa?

First, it has been tremendous, the respect with which the healthcare professionals are being treated; and as a result you’ll see that their health and wellbeing are of utmost importance. We have seen an extreme adherence to PPE standards and the way that we dispose of them. We recommend a double bagging of all of the PPE that comes out of covid-19 affected areas, and it is being followed almost religiously.

What happens to the discarded PPE in general and what are the key issues faced in dealing with this equipment at present?

PPE is considered as hazardous medical waste, and from that perspective, we would recommend the incineration of this material. We don’t know how this virus behaves and would not want to be taking risks at this moment. Where we provide medical waste services, which is South Africa, Oman and UAE, we have decided that recycling or material preservation is going to take a backseat to survival at present. We are recommending total destruction of the PPE collected, and that is what we are doing.

Would that include the general waste you collect from the residential sector as well, as I don’t think all the people are segregating the PPE as yet?

Let me rephrase it. Everything we have been identifying as PPE, we have been able to destroy. Unfortunately, and exactly to your point, those areas where we have not been able to identify, we struggle, because my biggest concern every day is the health and safety of my own teams and frontliners. From that perspective, I don’t like the idea that they are collecting PPE mixed with general waste as we don’t know the kind of risks being posed. We have been encouraging all the households to separate their PPEs, put them in a double bag and place it outside, next to the household waste. And wherever we’ve been able to find them, we have been taking them straight to destruction.

Are people complying with the instructions given?

The instructions were given to everybody, but compliance has been a different story. As service providers, we do not have the ability to enforce like a regulator. Wherever we can, we have been informing the authorities for further action to encourage people to segregate. As a very specific case, for instance, we are working in Abu Dhabi with the Waste Management Centre to ensure there is a separate collection being done for PPE.

What are the precautionary measures you might have taken with regard to the use of PPE by your frontline workers to ensure their health and safety?

We have worked with WHO advisory bodies and the CDC to understand what the best practice is in terms of waste management operations during the crisis. We then took a six-month stockage process, where we now have without fail six-month worth of PPE for our people going forward. It’s been quite a challenge to secure the equipment, but we have an excellent health & safety team. They’ve been buying PPEs since early February, which at the time I thought was a bit cavalier or over the top, but they’ve proven to be visionary in that sense.

Depending on what operation one performs in the Averda frontline, a different PPE is issued everyday based on the task they are given in different areas, like outdoors or handling medical waste or at other facilities. We have a strict entry and exit procedure to and from any of our sites to ensure that employees showing any symptoms like high temperature, etc., are identified early and necessary measures taken. We also have an intrusive but essential logging process where they have to enter the details of those they were in contact with on a list and report on a weekly basis, so should there have been any contamination or infection it can be identified.

Any other comments?

It’s a very unique period, and I’m speaking from personal experience. I haven’t spent this much time at home, probably ever. It’s a time for us to reflect on our own habits, whether it’s about drinking from a glass instead of a plastic bottle, or about not using this much packaging; I think this is an immensely useful time to revisit our habits and rituals, and make sure we are living a little bit leaner in terms of material usage and so on.