UNDER THE MICROSCOPE
As a heath professional, I recognize the importance of face masks in health care, which was most evident during the pandemic. But the pandemic is over. Presently, Covid-19 is treated as an endemic disease, with low rates of hospitalization and death similar to the flu. The SARS-CoV-2 virus has evolved to a milder form causing less serious disease while becoming more transmissible, which is what makes it successful as viruses go. Vaccination has also raised herd immunity.
But many hospitals are still requiring masking. Even if it’s not required in others, many still wear masks when going to hospitals fearing they might get infected. This fear is no longer reasonable considering current circumstances. Fear brings about stress which causes unhealthy physiologic conditions such as hypertension, high blood sugar levels, and increased heart and respiration rates. It also causes high levels of inflammation, itself a driving force in causing cardiovascular diseases like heart attacks and strokes.
Our infectious disease specialists are in charge of dictating if we need to mask up or not. I hope they will consider their decisions in the light of present circumstances and consider the link between health and the environment. It should not just be on their appreciation of their subspecialty or individual health but more of public health, which is intimately tied to the state of our environment, as well as the impact of fear on individual health.
Nowadays, though I am a senior but without significant co-morbidities, I have reduced my wearing of disposable masks to hospitals that still require them, if only to show people that we should no longer fear getting sick of Covid-19. That is not to say we should no longer wear masks, but that face masks should be used judiciously. Now, if I were to get a cough or a cold, I would wear a face mask to avoid infecting others, no matter if the bug I carry is deadly or not. It is simply a matter of decency to not infect others.
If you must wear face masks, either because you are sick or just fear getting infected as a senior or one with co-morbidities, please consider wearing cloth masks which can be washed and reused. Let us set aside disposable face masks and save them for future use, as a pandemic might come along sooner than we think.
Now, let’s consider the impact of healthcare waste on the environment. During the pandemic, San Lazaro Hospital alone generated 10,000 kilograms of infectious medical waste monthly. That’s just one hospital. For the year 2020, the total infectious waste generated by healthcare facilities amounted to 88,878.7 metric tons. This included personal protective equipment (including masks), dressings, swabs, blood bags, urine bags, syringes, test tubes and human tissues removed during surgery. Imagine how much infectious medical waste has been generated since then and up until today.
My personal perspective on medical waste is with the management of laboratories which generate lots of medical waste in the form of disposable test tubes, cuvettes, culture media in plastic dishes and syringes, spent reagents, needles, human blood and tissues, blood bags, urine, body fluids and feces. These are all infectious waste and must be treated and sterilized before disposal. In 2015, I gave talks on laboratory waste management and advocated a more environmentally friendly approach to laboratory testing to both laboratory practitioners (pathologists and medical technologists) as well as companies dealing with medical laboratory equipment and reagents.
The problem is, only 29 percent has been properly treated and disposed of, although the waste has already been hauled from the hospitals. The rest still go to landfills untreated and pose health hazards to scavengers.
It can’t be denied that much of our garbage end up in our rivers and oceans, with plastic waste that do not decompose and end up contaminating our food supply with microplastics, posing another health hazard. Disposable face masks with elastic bands still intact, also pose choking and strangulation hazards to birds and marine life.
It is time to think of striking a balance between health and the environment. Pandemics, or just plain infectious diseases are more serious in the elderly and the immunocompromised, but environmental crises affect everyone, young and old, sick or not. With health risks much reduced, the balance must tilt toward saving our environment. In fact, environmental disasters bring with them a huge number of deaths and illnesses. Evacuations from disaster areas force a large number of people to crowd into shelters, bringing with it the possibility of air- and water-borne infectious diseases. Coupled with low vaccination rates, it can bring about outbreaks and even full-scale epidemics. This will bring us full circle to wearing masks and other personal protective equipment, which produces more healthcare waste. It becomes a vicious cycle of our own making.