Environmental Impact and Countermeasures during the Global

COVID-19 Pandemic

Yuanyuan Huang

, Guilan Gao

1,† b

, Shuai Chen

1,‡ c

, Yaoguang Guo

and Lian Duan

2,3 e

School of Environmental and Materials Engineering, Shanghai Polytechnic University, Shanghai 201209, China

School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai 200093, China

Key Laboratory of Eco-geochemistry, Ministry of Natural Resources of China, Beijing 100037, China

Keywords: COVID-19, Environmental Pollution, Wastewater Treatment, Waste Disposal.

Abstract: Outbreak of the Coronavirus Disease 2019 (COVID-19) has been sweeping the world, which both changes

our lifestyle and affects the environment. In this paper, environmental effects and countermeasures of

COVID-19 has been evaluated. Negative effects of COVID-19 contain potential environmental risks of

medical waste, lack of targeted testing indicators, potential risks of antiviral drugs antibiotics, while positive

effects include reduced air pollution and improved environmental standards. Further, refining the detecting

and discharging standards of wastewater to increase testing programs of hospital wastewater and rainwater

treatment for SARS-CoV-2 RNA and its activity, as well as enhancing clinical waste disposal capacity

because of the exposed problem of inadequate treatment system and insufficient capacity, are raised as the

countermeasures to weaken the negative effects of COVID-19.

INTRODUCTION

In late 2019, patients caught SARS-CoV-2 could be

found around the world. Because SARS-CoV-2 is

highly contagious, the number of confirmed cases

increased significantly in a short term and became a

major public health emergency around the world

(Guan et al. 2020). According to the World Health

Organization, as of August 16, 2021, there were 207,

173, 086 confirmed cases worldwide. (WHO

Coronavirus (COVID-19) Dashboard 2022).

The incubation period of Coronavirus Disease

2019 (COVID-19) is about 1-14 days, and it is

characterized by fever, fatigue, and dry cough.

Besides, some patients are accompanied by

symptoms such as nasal congestion, runny nose, sore

throat and diarrhea. (Shao et al. 2020) Mild patients

present with low-grade fever and mild fatigue

without manifestations of pneumonia, while severe

or critically ill patients present with moderate to low

fever, or no pronounced fever. (S, Z et al. 2020).

There are about 215 countries where COVID-19

patients have been found to date. At the end of

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January 2020, WHO declared the COVID-19

outbreak a Public Health Emergency of International

Concern (PHEIC) and on 11 March 2020 it was

declared a global epidemic. (world health

organization 2019).

Physical isolation, personnel control and

international travel restriction affect lives both at

home and abroad. Consumption and the pattern of

trade in services based on offline contacts have also

led to the disruption of the global industrial chain.

After the unremitting efforts of the governments and

people, the rapid growth of the number of cases in

several countries was quickly under control. By

contrast, the PHEIC is far to end all over the world.

At present, the Novel coronavirus mutant strain

Delta, which is circulating in the United States and

other countries, has recently affected many provinces

in China. It spreads at an amazing speed and has

stronger self-replication ability. COVID-19 has had

enormous influence on the politics, economy,

environment, and so on, of all countries in the world.

Further, according to the WHO “COVID-19 Clinical

Management: Living Guidance”, among the general

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Huang, Y., Gao, G., Chen, S., Guo, Y. and Duan, L.

Environmental Impact and Countermeasures during the Global COVID-19 Pandemic.

DOI: 10.5220/0011165100003444

In Proceedings of the 2nd Conference on Artiﬁcial Intelligence and Healthcare (CAIH 2021), pages 58-63

ISBN: 978-989-758-594-4

treatment measures for COVID-19 patients, the

treatment of antiviral drugs (α-interferon, lopinavir,

ritonavir, ribavirin, chloroquine phosphate and

arbidol) is an important part. To deal with the

infection problem of severely ill patients, antibiotic

treatment is needed as a supplement (Guan et al

2020). In addition, In the stool of COVID-19

patients, we detected the SARS-CoV-2 virus. What is

mentioned above means that the sewage in the

hospital is very likely to be contaminated by antiviral

drugs, antibiotics and SARS-CoV-2 (Holshue et al.

2020). Therefore, it is urgent to assess the potential

risks of sewage and medical waste generated by

hospitals admitted during the COVID-19 epidemic.

To date, more than 30,000 papers have been

reviewed related to COVID-19, covering

countermeasures (Vatcheva, Sifuentes, Oraby,

Maldonado, Huber, Villalobos 2021, Rocklov,

Sjodin, Wilder-Smith 2020), environmental impacts

(Ambika, Basappa, Singh, Gonugade, Tholiya 2021,

Ankit, Kumar, Jain, Deovanshi, Lepcha, Das,

Bauddh, Srivastava 2021), and so on. Among these,

the influence of COVID-19 on the environment must

arouse our intention. Based on the current prevention

and control situation of COVID-19, this paper puts

forward the research focus and direction in the future.

As of the end of this article, only 6 months after

reaching 100 million cases, the cumulative number

of COVID-19 cases worldwide exceeded 200

million. More than 4.2 million new cases and more

than 65,000 new deaths were reported, this week

alone, a slight increase from the previous week.

(Figure 1) (world health organization 2021).

Figure 1: COVID-19 cases reported weekly by WHO

Region, and global deaths, as of 8 August 2021.

ENVIRONMENTAL EFFECTS

OF COVID-19

2.1 Negative Effects

2.1.1 Potential Environmental Risks of

Medical Waste

The production of medical waste has increased

dramatically, with the outbreak of COVID-19, as

showed in Figure 2. At the peak of the epidemic,

hospitals in Wuhan generated six times more medical

waste than in the early days of the epidemic. The

daily production of medical waste is roughly

equivalent to the weight of an adult blue whale,

which can reach 240 tons (Calma 2020). Further, as

the development of the COVID-19 epidemic, the

production of medical waste has increased sharply.

For example, the rapid consumption of masks,

gloves, goggles, insulation and protective clothing

has contributed to the explosive growth of global

medical waste (Yue et al. 2015). According to WHO,

76 million gloves, 89 million masks and 1.6 million

goggles need to be used for COVID-19 treatment,

and this growing demand has created a huge waste

(Teymourian, Teymoorian, Kowsari, Ramakrishna

2021).

Figure 2: Medical waste generation in China.

2.1.2 Lack of Targeted Testing Indicators

There are differences in the sewage generated by

various departments in the hospital. The sewage

discharged from infectious wards, laboratories,

operating rooms, intensive care units, intestinal

outpatient clinics, medical device disinfection

rooms, and disposal rooms may be contaminated by

SARS-CoV-2. Hospital sewage, especially sewage

from the treatment of infectious disease patients,

needs to be treated strictly before discharge because

it contains various microbial pathogens and viruses

(

Liu, Zhou, Chen, Zheng 2010). Coronavirus,

however, is the most difficult of human respiratory

viruses to detect, and its presence is not detectable in

Environmental Impact and Countermeasures during the Global COVID-19 Pandemic

most conventional virology diagnostic laboratories

(

Mackie 2003).

2.1.3 Potential Risks of Antiviral Drugs and

Antibiotics

Antiviral drugs are mainly used to treat diseases

caused by a viruses. Because they are not fully

absorbed by the body, they are detected in the

wastewater treatment system after a series of

digestion and metabolism (Jain, Vyas, Pandit, Dalai

2013). Nevertheless, since wastewater treatment

systems cannot completely remove antiviral drugs,

there are certain risks to the environment, threatening

ecosystems and human health. (Fick, Lindberg,

Tysklind, Haemig, Waldenström, Wallensten, Olsen

2007).

Antibiotics have been widely used to protect

human health and promote livestock and poultry

breeding. Although the “New Corona virus

Pneumonia Diagnosis and Treatment Plan (Trial

Seventh Edition)” issued by the National Health and

Medical Commission of China does not mention

specific antibiotic treatment measures, antibiotic

treatment is needed as an auxiliary when dealing with

infection problems in severely ill patients. According

to Zhong et al. (Guan et al 2020), 57.5% of the 1,099

COVID-19 patients studied received

intravenous

antibiotics. Most antibiotics are water-soluble, about

30% to 90% of antibiotics enter the environment in

the form of excrement, posing a potential risk to

human health and the safety of the ecosystem (Wang

et al. 2016). At the same time, microbial resistance

caused by antibiotics is difficult to eliminate from the

environment due to its persistence and horizontal

gene transfer. It has been listed by the WHO as one

of the three major threats to human health (Zhu,

Johnson, Su, Qiao, Guo, Stedtfeld, Hashsham, Tiedje

2013).

2.2 Positive Effects

2.2.1 Reduced Air Pollution

Over the past few months, scientists at the Royal

Netherlands Meteorological Institute have been

using Tropism instrument on the Copernicus

Sentinel-5P satellite to monitor air pollution in

Europe.

Figure 3 shows nitrogen dioxide concentrations

from March 13 to April 13, 2020, compared with the

average concentrations in March-April 2019. Milan

and Rome fell by around 45%, while Paris saw a

sharp drop of 54% - in line with strict containment

measures in Europe as a whole. (ESA 2020).

The decrease in data is mainly due to strict

regulations on nitrogen dioxide in the European

transport and industrial and energy sectors.

Excluding over large cities where human activity has

not yet fully resumed, pollutant concentrations may

return to near normal levels from July to August

2020(ESA 2020).

Figure 3: Nitrogen dioxide concentrations over Europe in

2019 (a) and 2020 (b) (ESA 2020).

China has imposed strict traffic restrictions and

self-quarantine measures to prevent the further

spread of SARS-COV-2. These measures have led to

significant changes in air pollution, with nitrogen

dioxide concentrations in Wuhan and China reduced

by 22.8 μg/m3 and 12.9 μg/m3, respectively

(Zambrano-Monserrate, Ruano, Sanchez-Alcalde

2020). Figure 4 shows NO

values across China from

January 1-20, 2020 (before epidemic prevention) to

February 10-25 (during epidemic prevention period).

According to NASA scientists, the reduction in

concentrations was particularly pronounced

near Wuhan, but eventually spread across the country

(NASA 2020).

2.2.2 Improved Environmental Standards

In response to deal with the tremendous growth in

clinical waste generation, several international

organizations, such as the World Health

Organization, the Basel Convention, the European

Centre

for Disease Control and Prevention and the

CAIH 2021 - Conference on Artiﬁcial Intelligence and Healthcare

Figure 4: NO2 emissions in China before (a) and after (b)

lock down(ESA 2020).

United Nations Environment Programme, have

issued guidelines or reports on the proper

management of medical waste and household-

generated waste.

Some governments already have national

legislation for medical waste. In addition, many

countries immediately issued new policies,

guidelines, and programs to address the outbreak of

COVID-19. On February 24, 2020, China released a

work

plan for comprehensive treatment of medical

waste, requiring every prefecture-level city in China

to build at least one standard medical waste disposal

factory by the end of 2020. The plan also requires

that by the end of June 2022, every county in China

should have established a complete system for

medical waste collection, transfer and disposal, so as

to completely solve the problem of insufficient

medical waste disposal capacity nationwide, and

finally realize smooth, safe and reliable disposal

(Liang, Song, Wu, Li, Zhong, Zeng 2021).

3 COUNTERMEASURES

3.1 Refining Waste Water Testing and

Discharge Standards

At present, China has formed a relatively complete

hospital sewage detection and treatment system.

Take Wuhan as an example, the newly built

Huoshenshan Hospital and Leishenshan Hospital

both have complete sewage treatment systems. Using

the mode of sewage diversion discharge in

contaminated and clean areas, each enters the pre-

sterilizing pool independently to avoid the spread of

the virus from the contaminated area to the clean area

through the drainage system, the process is shown in

Figure 5. Guo et al. (Guo et al. 2020) tested the air

and surfaces of Huoshenshan and Leishenshan

hospitals, examined the distribution of SARS-CoV-

2, and found that the positive rate of SARS-CoV-2

aerosol transmission near the outlet was 35.7%,

respectively, ICU medical staff shoe sole positive

rate of 50%, medical staff walking back and forth

resulted in the pharmacy floor positive rate of 100%

and the locker room floor has 3 weak positive results.

The

results of this study suggest that the virus may

spread outdoors through exhaust vents and the soles

of medical staff, with a certain probability of entering

the rainwater system.

Figure 5: Waste water treatment processes of Huoshenshan Hospital and Leishenshan Hospital.

Environmental Impact and Countermeasures during the Global COVID-19 Pandemic

However, at present, China's medical sewage

discharge implementations, including Hospital

Sewage Treatment Engineering Technical

Specifications (HJ 2029-2013) and Medical

Institutions Water Pollutant Discharge Standards (GB

18466-2005), have not yet put forward specific

requirements for anti-viral drugs and antibiotic

concentrations, and need to be timely assessment and

update. At a critical time for epidemic prevention and

control, it is recommended to increase these testing

programs before and after COVID-19 patients receive

hospital sewage and rainwater treatment, especially

for RNA and its activity in SARS-CoV-2. In addition,

it is recommended to strengthen the disinfection of

medical sewage and hospital rainwater to ensure the

complete eradication of SARS-CoV-2 and its RNA.

3.2 Improving Medical Waste Disposal

Capacity

When the COVID-19 broke out, the production of

medical waste increased dramatically, and the city of

Wuhan increased by 370%, The local medical waste

disposal capacity is seriously inadequate, the relevant

departments quickly work overtime to install new

high-temperature steam sterilization machines and

run at full capacity every 24 hours (except during

maintenance), and continue to remove the medical

waste stock (Klemeš, Fan, Tan, Jiang 2020). In

addition, Hubei Province makes full use of medical

waste disposal capacity of Wuhan's nearby cities to

accelerate the disposal of excessive medical waste in

Wuhan. China’s medical waste disposal facilities

have been running smoothly since March 10, 2020,

and can dispose the daily generated medical waste

(Zhou, Chen, Li, Guo, Liu, Yang 2018).

Although strengthen regional collaboration and

strict medical waste transfer processes is helpful to

the medical waste disposal, it is necessary to speed up

the improvement of the overall treatment capacity of

medical waste in China, due to the exposed problem

of inadequate treatment system and insufficient

capacity. At the same time, the potential risk of virus

transmission in the process of medical waste transport

is worthy to pay attention. The organization,

classification, packaging, registration, storage,

protection, transshipment, disposal and eventual

whereabouts of medical waste should be standardized

management to form a long-term mechanism to

reduce the environmental and occupational risks of

the whole process of medical waste disposal.

4 CONCLUSIONS

Measures including closed management, establishing

hospitals, restricting mass gathering are of significant

value on controlling the spread of COVID-19. Both

negative effects, containing potential environmental

risks of medical waste, lack of targeted testing

indicators, potential risks of antiviral drugs

antibiotics, and positive effects, including reduced air

pollution and improved environmental standards are

generated from the COVID-19. Further, refining the

detecting and discharging standards of waste water as

well as enhancing clinical waste disposal capacity are

raised as the countermeasures for further beat

COVID-19.

ACKNOWLEDGEMENTS

We gratefully acknowledge the financial support from

Natural Science Foundation of China (52070127),

Shanghai Natural Science Foundation

(20ZR1421100), Cultivation discipline fund of

Shanghai Polytechnic University (XXKPY1601),

Key Laboratory of Eco-geochemistry, Ministry of

Natural Resources (ZSDHJJ201902).

COMPETING INTERESTS

The authors declare that they have no competing

interests.

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