Management of waste from healhcare activities in context of COVID-19 epidemic

On December 31, 2019, the World Health Organization (WHO) was informed by the Chinese authorities of an outbreak of cluster cases of pneumonia, with all initially confirmed cases linked to a live animal market in the city of Wuhan (Hubei region). On January 9, 2020, a new emerging virus was identified by the WHO as being responsible for these cluster cases of pneumopathy in China. This coronavirus, temporarily designated by the WHO as "virus 2019-nCoV" (novel coronavirus), was officially named, on February 11, 2020, SARS-CoV-2 (severe acute respiratory syndrome – coronavirus 2), the agent responsible for Covid-19 disease (Coronavirus disease). On January 30, 2020, given the scale of the epidemic, the WHO declared it to be a Public Health Emergency of International Concern (PHEIC). On February 28, 2020, France reached stage 2 (isolated outbreaks) of the SARS-CoV-2 epidemic, and on March 14, 2020, stage 3 of active virus circulation.

From March 17 to May 14, 2020, the general population was confined and travel was severely restricted. The health crisis was then marked by rebounds or epidemic waves of active circulation of the virus in the population, and the introduction by the government of travel restrictions and closures of establishments open to the public.

The French High Council for Public Health (HCSP) received a referral from the French General Directorate for Health (DGS) on March 10, 2020, concerning the management of waste from healthcare activities (DAS) produced during the Covid-19 epidemic. This referral concerned questions from waste collection professionals on the management methods for this waste for healthcare and medico-social establishments, liberal healthcare professionals and patients in home isolation.

At a time of uncertainty about the persistence and infectious risk of this emerging virus in waste, the HCSP has attempted to answer a number of questions posed by health authorities. The complexity of the subject was due to the diversity of producers of healthcare waste, whether in establishments or on a diffuse basis, and to the wide variety of waste potentially contaminated by this new virus, while taking into account compliance with regulations. This article summarizes all the recommendations published by the Haut Conseil de la santé publique, from March 2020 to May 2021.