Biomedical waste management of COVID-19 patient at home

The patient as well as family members should maintain respiratory hygiene. They should cover their nose and mouth with a bent elbow or a disposable tissue whenever they cough or sneeze. 

Protective face masks should be worn by both the patient as well as the caretaker. 

A major step towards keeping yourself safe while taking care of the infected patient is by maintaining hand hygiene. You should wash your hands frequently with soap and water and in absence of that, use an alcohol-based hand sanitizer which should contain at least 60% of alcohol in it. 

You should wash your hands: 

• After coughing and sneezing
• After using restroom
• Before eating and preparing food
• After having contact with the pets
• After removing masks and gloves
• After coming in contact with an infected person

All the high-touch surfaces and the surrounding area of the infected person should be cleaned with the help of 1% bleach solution, which can be prepared at home.

Read more: The right way to wash your hands to avoid coronavirus infection

Bleach solution is the most common disinfectant used to clean and disinfect the areas and things surrounding a COVID-19 infected patient.

You can make a bleach solution at home by mixing 5 tablespoons of bleach into a gallon of water (1 gallon= 3785 ml approximately) or 4 teaspoons of bleach into a one-quarter gallon of water (¼ gallon=  946 ml approximately).

Whenever you use this disinfecting solution on any surface, let it stay on the surface for at least 1 minute until it dries off on its own. 

There are various bleaches solutions available in the market which can be used to make a disinfectant:

• Sodium hypochlorite liquid bleach with 3-5% chlorine content: Add 1 part of bleach solution to 2.5 parts of water.
• Sodium hypochlorite liquid bleach with 5% chlorine content: Add 1 part of bleach solution to 4 parts of water.
• Sodium hypochlorite liquid with 10% chlorine content: Add 1 part of bleach solution to 9 parts of water.
• Bleaching powder with 70% chlorine content: 7 grams of powder in 1-litre water.

Remember a few things while making a bleach solution:

• Always wear a mask while making or using the bleach solution.
• Open the windows when you use the bleach solution in a room so that no one inhales the solution.
• Never mix ammonia with the bleach solution as it produces a toxic gas called chloramine which can lead to shortness of breath and chest pain. Many of the commercially available cleaning solutions contain ammonia.
• Prepare fresh solution every time you need as the shelf life of bleach solution is only 8 hours.

Read more: How long can SARS-CoV-2 virus survive on different surfaces?

You should take care of the respiratory waste of the COVID-19 infected patient in the following manner:

1. Tissue paper or handkerchief

The patient should either be given a disposable tissue or a reusable towel to cover their mouth and nose while coughing and sneezing. 

If the patient is using a disposable tissue, the tissue should be disposed of immediately after use in a pedal-operated closed lid dustbin which should be lined with a plastic bag.

If the patient is using a reusable towel or handkerchief, dip it into 1% bleach solution for 30 minutes, then soap and water and then dry them in natural sunlight then wash your hands thoroughly. 

2. Spittoon

A spittoon is a container in which the patient can spit out expectorants like sputum. The patient should be given a closed-lid spittoon with a 1% bleach solution in it. The patient should close the lid immediately after every use. After using it at least 10 times, the expectorated sputum should be flushed in the commode used by the patient. 

If the patient lives in a place where toilet facilities are not available then it should be buried deep in the soil and then covered properly. 

Wear heavy-duty gloves and clean the spittoon with soap and water. After cleaning thoroughly dip the spittoon into 1% bleach solution for 30 minutes to ensure adequate disinfection and then dry it in natural sunlight. Refill the spittoon with the bleach solution and give it to the patient.

Wash your hands thoroughly with soap and water afterwards.

3. Face masks

There can be two types of face masks that can be used by a patient and a healthy person: disposable and reusable. The disposable face masks can be the three-layered surgical masks which are disposed of when soiled. The reusable face masks can be made at home by joining three layers of cotton cloth together. 

Disposable masks should only be worn for 4 hours and then disposed of. It should also be disposed of if it gets wet due to droplets that shed while coughing or sneezing. It should be disposed of in a pedal-operated closed lid dustbin which should be lined with a plastic bag.

A reusable mask should be replaced with a new one if it gets wet due to droplets that shed while coughing or sneezing. Wash that mask with soap and water and then rinse it in 1% bleach solution for 30 minutes. This would ensure adequate disinfection. You should be wearing heavy-duty gloves while washing the mask.

The caretaker must have a separate set of heavy-duty gloves to clean soiled laundry and dirty dishes of COVID-19 patient.

1. Laundry

Laundry includes bedding, linen and the clothing of the patient. Dirty laundry should be carried to the bathroom in a closed basket. Do not shake dirty laundry as the virus can disperse in the air. If possible, use a different washing machine for cleaning the laundry of the infected patient. If a washing machine is not available, clean the laundry while wearing the heavy-duty gloves and a protective mask. Let the laundry dry in natural sunlight.

2. Dishes

Make the infected person eat food in their room. Once they are done with eating, dispose of the leftover food in a pedal-operated dustbin which should be lined with a plastic bag. Clean the dishes first with warm water and then with dishwashing detergent and water. If possible keep separate utensils for the infected patient.

When a patient is discharged from the hospital, you may ask for yellow coloured, non-chlorinated plastic bags which should only be used for the waste generated by the infected patient.

The waste of the infected patient should not be thrown or given to the regular municipal workers and ragpickers as it can be a source of infection to them. The normal waste of the rest of the household should be kept in a separate plastic bag. You should wear heavy-duty gloves while handling the waste of the infected patient. 

The Ministry of Health and Family Welfare of India has laid out some guidelines for urban municipal bodies, according to which the Common Biomedical Waste Treatment Facilities (CBWTFs) are engaged to pick up such waste either directly from the houses of infected patients or the quarantined houses or from identified collection points.