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With as many as 300 000 cases recorded in 188 countries, the United Nations’ World Health Organization has recently declared the fast-spreading COVID-19 outbreak as a pandemic. It is natural then that citizens around the globe are hastening to take every possible measure to safeguard their health against the virus. The most widespread of these precautions is the extensive use of surgical face masks. It is natural not to consider the environmental impact of these masks in the midst of the COVID-19 pandemic, but attention must be paid to an environmental problem that will far exceed that of the virus.

These masks are mainly made of non-woven fabric such as polypropylene, which is between 20 and 25 grams per square metre in density. Polystyrene, polycarbonate, polyethylene or polyester are some of the other commonly-used materials in surgical masks. While they keep out bacteria effectively (although not necessarily that of the virus), the masks are plastic-based, liquid-resistant products that have a long afterlife after they are discarded, ending up in landfill or oceans.  

Given that surgical masks are supposed to be worn for no longer than one day, their disposal- along with that of empty hand sanitizer bottles and soiled tissue papers- is leading to a massive trail of clinical waste in the environment. In Hong Kong, for example, which has been battling the coronavirus since late January, such waste has already started polluting the environment.

During a recent survey trip to Soko Islands, a small cluster of islands lying south-west of Lantau Island, Hong Kong-based environmental NGO OceansAsia found heaps of discarded single-use masks washed up on a 100-metre stretch of beach. According to Gary Stokes, founder and director of the ocean-centred NGO, which has been monitoring ocean surface trash as part of WWF’s Blue Ocean Initiative, their team has seen the odd mask here and there over the years, but this time they were spotted all along the high tide line and foreshore with new deposits coming in with each current. 

“Due to the current COVID-19 outbreak, the general population have all taken the precaution of wearing surgical masks. When you suddenly have a population of 7 million people wearing one to two masks per day, the amount of trash generated is going to be substantial,” Stokes says.

The adverse environmental impact of such clinical debris during COVID-19 are far-reaching. Once these are left discarded in an animal’s natural habitat- be it land or water- this may cause animals to mistake this trash for food, which could lead to entanglement, choking, ingestion and death.

Certain portions of the population are at risk of adverse impacts from exposure to medical waste as well, such as cleaners, garbage collectors and other people who spend a great deal of time in public spaces. Even as governments across the world are urging students to stay away from schools and universities, and white-collar employees are availing work-from-home options, those at the frontline of keeping cities clean have to go about their daily chores, making them one of the most vulnerable groups and one that is most susceptible to the virus from droplets that may linger on the masks. They may also catch other forms of infection from pathogens remaining on these discarded pieces of garbage, such as meningitis and Hepatitis B and C. 

According to the WHO’s health guidelines, soiled tissues and used face masks must be thrown only into lidded litter bins, while any medical gear used by affected patients and hospital staff must be sterilised and burnt at high temperatures in dedicated incinerators. As such, only state-of-the-art incinerators operating at 850-1100°C, with special gas-cleaning equipment, can burn these items in accordance with international emission standards. Unfortunately, however, not all regions have the capacity to properly deal with the sudden spike in clinical waste generated as a result of the COVID-19 outbreak.  

Take the case of Wuhan, for example. The Chinese city which has been at the epicentre of the pandemic and which is home to over 11 million people, is reported to have generated 200 tons of clinical trash on a single day (24 February 2020), four times the amount the city’s only dedicated facility can incinerate per day. 

With the pandemic is spreading to other parts of the globe rapidly, the spotlight will soon be on medical waste treatment management around the world and how effective their measures are. While health institutions and private waste management companies in some countries are already stepping up their coronavirus-specific decontamination services, it is also equally important for governments to step up and find solutions quickly against the environmental impact of COVID-19. At the same time, it is also each individual’s responsibility to follow the necessary guidelines while disposing of their masks and other medical gear. After all, it is only through mutual empathy and goodwill that we will see the world emerge stronger from this global pandemic.

Consumers can turn to alternative solutions to alleviate the environmental impact of mask wearing, such as reusable cloth masks. While reusable cloth masks are currently a more expensive option, as demand rises the manufacturing of this type of mask is scaling to the point of becoming increasingly affordable. Consumers and local businesses can work with municipalities to integrate reusable masks with mask-wearing ordinances. Local governments can create mutually beneficial agreements with cloth mask manufacturers by ensuring bulk purchases. Municipalities would then be able to subsidise a portion of the higher cost of reusable masks for the public’s use. Citizen action to coerce policy change, combined with the scalability of cloth mask production and subsequent lowering cost, can make sustainable mask-wearing the norm.

COVID-19 has spread rapidly around the world. At the time of writing, the death toll is at over 14 000 with over 300 000 confirmed cases around the world. The WHO has declared it as a global health emergency, as it did with Swine Flu and Ebola. As the effects of it are made more apparent, how is the climate crisis linked to the spreading of disease? 

The climate crisis is threatening human lives through not only the increasing frequency and severity of natural disasters, but also the increasing rates of diseases and pathogens. In 2016, an anthrax outbreak in Siberia, Russia was shown to have been triggered by an unusual heat wave that thawed the permafrost in the area and with it, a reindeer carcass infected with anthrax decades previously. The outbreak killed more than 2 000 reindeer and hospitalised more than 100 people, mainly nomads in a settlement called Salekhard, close to the Arctic Circle. Anthrax is caused by Bacillus anthracis, a deadly bacteria that causes large lesions on skin; victims usually die from other secondary infections. It is highly transmissible as it appears as an air-borne spore and can be transmitted from animals to humans. 

Global Climate Change and Emerging Infectious Diseases

Changing temperatures and rain patterns have increased the emergence of other new and old infectious diseases. Mosquito-borne diseases such as Malaria, Zika Virus, Yellow Fever and Dengue Fever pose the largest threat to humans; the WHO says that temperature increases of 2 to 3 degrees Celsius would increase the number of people who are at risk of contracting malaria by 3-5%, or several hundred million people. 

The wetter and warmer climates, primarily in African countries, allow mosquitoes to better survive in previously dry seasons. The changing conditions have also allowed mosquitoes to survive in places of higher elevation where they previously would have perished. Other vectors of diseases such as rodents and bats have become more active and able to spread their associated diseases to more places. The warmer climate has also altered the flowering patterns of trees and grass, increasing pollen levels in the air, resulting in the rise of hay fever. 

Humans regulate their body temperature by sweating; studies have shown that under business-as-normal scenarios of future greenhouse gas emission rates, temperatures in Southwest Asia and the Gulf regions will reach a wet-bulb temperature of 35 degree Celsius, rendering these areas uninhabitable. At this temperature, sweating is inhibited, which causes overheating and heat stroke. Other heat-associated respiratory and cardiovascular diseases, like heart failure, can severely affect vulnerable populations, especially during heatwaves; the European heatwave of 2003 caused more than 70 000 heat-associated deaths, as recorded by the WHO. Hot temperatures also lower immunity and make humans more susceptible to disease.

The Bubonic Plague, also known as the Black Death, killed almost 60% of Europe’s population in the 14th century. It has still not been completely eradicated and occasionally reemerges; the latest onset of the Plague happened in 2017 in Madagascar which killed 171 people and when four people were diagnosed with the Plague in Northern China in November 2019

The plague is caused by the bacterium Yersinia pestis, found in fleas and then transmitted to rodents and small mammals. According to Tignor and colleagues, historians and epidemiologists suggest that climate change drove the rodents to flee from the dried-out grasslands in Asia westward to more populated areas in Europe. The spreading of the Plague is believed to have been accelerated by the Mongol conquest to Europe which happened in the 13th century when horses carried infected fleas. 

A study found that outbreaks generally follow periods of warm and/or wet conditions that are favourable for vegetation growth, and thus for increases in rodent population density. 

As people travel further and more frequently, the spread of disease can reach a different continent in less than a week. In 2003, the Severe Acute Respiratory Syndrome coronavirus (SARS) outbreak lasted for four months and affected more than 8 000 people around the world, killing 774. Researchers found that the vector of the virus was horseshoe bats which are common in the Yunnan province in China. The area was identified as a natural reservoir of the syndrome, which was first spread by people coming into contact with the animals through eating and handling them at a bush meat market in Guangzhou.

The Ebola virus outbreak in Western Africa from 2013-2016 that killed more than 11 000 people was also caused by the handling of bats. 

Scientists have suggested that climate change plays a role in Ebola outbreaks. Dry seasons followed by heavy rainfalls that produce an abundance of fruits have coincided with outbreaks. When fruit is plentiful, bats and apes may gather together to eat, providing opportunities for the disease to be transmitted between species. Research has also showed that half of the Ebola outbreaks are directly linked to bush meat consumption. 

Timeline: History of Disease

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In 2019, the African Swine Fever impacted the pig farming industry in China, as well as those in Poland, South Africa, North Korea, Mongolia, Cambodia and Vietnam. The virus originated in Africa in the early 1900s and spread to Europe, then Asia. Spread from ticks, warmer winters have allowed virus-borne ticks to survive and spread. 

Although the virus cannot infect humans, more than 40 million pigs have been killed in China, either from the disease or preventative culling. The surge in pork prices has resulted in more people consuming bush meat

Most bush meat is from the wild. Hunting wild animals can upset the balance of ecosystems and cause an ecological disaster; decreasing predators causes a surge in populations of prey. 

Earth.Org, disease, climate crisis, link
Chart illustrating how an increase in the population of rodents and increasing bush meat trade might have caused the recent deadly coronavirus outbreak. Source: Author. 

As the climate crisis worsens, humanity will see the reemergence of diseases and pathogens thought to have been eliminated. It is imperative that governments implement policies that reduce greenhouse gas emissions, or humanity will face illnesses that it is not prepared for. 

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