Healthcare Waste Institute’s FAQs Regarding COVID-19

March 13, 2020

The Healthcare Waste Institute (HWI) developed this FAQ to provide information about the evolving Coronavirus Disease 2019 (COVID-19) outbreak first identified in Wuhan City, Hubei Province, China.

What is COVID-19?

Coronavirus is a group of viruses named for the way they look under a microscope (“corona” meaning “crown”). The novel (or new) coronavirus, identified in 2019 during an investigation into an outbreak in Wuhan, China, causes the coronavirus disease 2019 (COVID-19). The first case of COVID-19 in the United States was reported on January 21, 2020.

According to the U.S. Centers for Disease Control and Prevention (CDC), risk of catching COVID-19 is higher for people who are in close contact with someone who already has the disease. The virus is thought to spread mainly through respiratory droplets (not truly airborne) produced when an infected person coughs or sneezes. It also may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads. However, OSHA states that without sustained human-to-human transmission, most American workers are not at significant risk of infection.

The federal government continues to evaluate the transmissibility and severity of COVID-19 virus.

Q: What general precautions should be taken to protect worker safety?

A: General precautionary measures should include avoiding touching your eyes, nose, and mouth with unwashed hands and washing your hands with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available. In addition, wipe down surfaces with disinfectant; and sneeze or cough into your shoulder/arm or a tissue.

OSHA also states that workers use appropriate engineering and administrative controls, safe work practices, and personal protective equipment (PPE) to prevent worker exposure.

Q: How should household waste that comes from a home where a patient with COVID-19 be managed?

A: Based on discussions with the CDC, waste from households can be managed as they typically would be for the flu. No special precautions are necessary.

Q: How should waste that comes from an office or retail outlet where a patient with COVID- 19 be managed?

A: Waste from commercial businesses and retail entities can be managed as they typically are unless directed by their local health department.

Q: How should regulated medical waste (RMW) from COVID-19 be managed?

A: OSHA guidance for waste management is based on the CDC’s determination that COVID-19 virus is not a Category A infectious substance (as per DOT/CDC listing; considered a Category B infectious substance which when discarded is considered regulated medical waste).

OSHA states that workers and employers should manage waste contaminated with COVID-19 virus as they would other regulated medical waste. OSHA also states that workers use appropriate engineering and administrative controls, safe work practices, and PPE, such as puncture-resistant gloves and face/eye protection, to prevent worker exposure to medical waste, including sharps and other items that can cause injuries or exposures to infectious materials.

Q: Should sharps containers (single-use and reusable) from COVID-19 be put into red bags?

A: HWI recommends using single-use containers for COVID-19 patients. While regulations do not require reusable sharps containers to be placed into red bags, some healthcare waste companies have adopted such procedures. As such, healthcare facilities should check with their healthcare waste provider for any special protocols. Single-use sharps container protocols follow standard protocols for closing, overpacking and shipping for treatment and
disposal.

Q: Should PPE from COVID-19 be put into red bags? What about general waste from patients such as used tissues?

A: Only grossly contaminated PPE should be placed into red bags. Patient trash such as used tissues may be disposed of into regular trash (municipal solid waste) unless otherwise directed by your local health department.

Q: Are there any special efforts that need to be made to disinfect surfaces from COVID-19?

A: The virus can easily be killed by detergents and disinfectants at regular temperatures used for washing. For a specific list of approved products, please refer to EPA’s list of registered antimicrobial products for use against Novel Coronavirus SARS-CoV-2, the cause of COVID19. See these links:

Q: Does waste from patients with COVID-19 need to be separated from other infectious waste?

A: Although not required, HWI recommends that COVID-19 waste be identified in order to protect their workers in the event a bag needs to be opened for some reason. Be aware that healthcare waste companies may adopt special provisions specific for their companies and the safety of their employees during this time. It is best to check in frequently with your waste handling company during this time.