How to make face masks safer amidst Coronavirus hazard?

Increased volumes of face masks

There is growing acceptance among global community that face masks can play a role in reducing the infection rate for COVID 19. In Kenya, it is mandatory for everyone to wear a mask while in a public place. This has created a huge market for face masks which are now being introduced to the community daily in millions of pieces.

Both single use and multi use masks are offered for sale. The cost of masks determines peoples choice of masks, and a preference has been noted for single use plastic masks as they are considered cheap and convenient.

Challenges with face mask disposal

Disposal of the single use plastic masks is however considered a major challenge due to the following reasons.

1. These masks are light and can easily be dispersed by wind and water to many ecosystems including drylands, forests, rivers, lakes and oceans.
2. In the ocean, these single use masks behave like plastic bags or other food wrappers and are likely to be eaten by aquatic organisms such as sea turtles, fish and other animals since they mistake it as food.
3. The elastic band in masks can trap and entangle aquatic organisms and could kill them through starvation.
4. Poor disposal of the face masks may lead to increase in the number of COVID 19 infections, as there is increased possibility that these masks are also contaminated.

Gaps in addressing the face mask challenge

There is a glaring gap between information given out to people on need to use face masks and how to safely dispose used masks. It has been observed that people are discarding used masks with regular waste or dumping them in the environment. Hence there is a growing risk that improper disposal of single use masks could contribute to spreading the infection they are designed to protect against. Equally, there is a possibility of an ecological degradation when masks litter the environment.

COVID 19 waste management advisories

Just after the first case of COVID 19 case was reported in Kenya, the National Environment Management Authority (NEMA) released an advisory letter to the Ministry of Heath challenging them to ensure proper disposal of used masks. The Ministry of Health responded by releasing a national advisory on management of face masks in diverse places such as rural areas, commercial centres, isolation centres and residential areas among others (see https://www.mazingirasafi.com/2020/04/28/avoid-transmitting-covid-19-through-face-masks/).

What happened after the issuance of advisories on management of face masks by the Ministry of Health provides us with useful lessons to guide our progress in used masks waste management. Walking around the country, one is likely to see face masks lying in very unexpected places such as on grass, forests, rivers, storm drains and many other places. What could have gone wrong after issuance of the advisory?

Challenges in implementation of COVID 19 advisories

Although caution was thrown in management of face masks, several interventions are still missing, making realization of intent of the advisories a far fetched fallacy. Some of the areas with glaring deficiencies include the following:-

1. Most of the places mentioned in the advisory such as ccommercial centres and public places have so far not installed requisite infrastructure for proper disposal of used masks. There are no additional bins or the recommended yellow color coded polythene bags. Hence people continue to discard used masks in normal waste bins as there is no other option available.
2. Public health officers have not designated sites where public could drop their segregated face mask waste. Hence the public continue to dispose the masks in the normal household waste bins. This is a health hazard as it is infectious waste and could lead to infection of the waste handlers.
3. An elaborate collection system for the face masks is still missing. The local public health facilities should have expanded their scope of operation to include waste collection from commercial centres, public places and residential areas since this is medical waste meant to be disposed at designated drop off points as established by local public health officers.
4. It was expected that after the advisory, there would be a reorientation of public awareness to strike a balance between the need to wear a mask and to dispose the same appropriately. However, the messages remained skewed to wearing of masks, with no inclusion of waste management.
5. Waste handlers require special training on how to handle waste potentially contaminated with the infectious COVID 19. This is a major gap as there is a potential risk of increased infections.

It appears that the only place where used masks are managed appropriately is in medical facilities. The Environmental Management Coordination Waste Management Regulations 2006 prescribe that medical waste should be carried away to an incinerator using NEMA licensed vehicles. The routine enforcement of these regulations enhanced the readiness for medical facilities to manage COVID 19 contaminated waste.

How can face mask waste management be improved

It is not disputable that face masks are good in reducing probability of contracting COVID 19. However, how we dispose the used mask is becoming equally important as potential for spreading the virus is high with poor waste management. The national and county governments can reduce the risk of face masks becoming vessels of COVID 19 transmission by investing in the following measures:-

1. Enhance public awareness on how to properly use and dispose the face masks.
2. Install appropriate color coded bins in public places for disposing used masks such as commercial centres, public parks etc.
3. Designate drop off points for the used masks especially in public places and residential areas.
4. Provide waste transport services for the waste collected at designated points using NEMA licensed vehicles.
5. Develop biohazard protocols for face masks management and train waste handlers to follow them.

Members of the public can help reduce risks posed by face masks by taking the following measures:-

1. Avoid leaving used masks in undesignated places.
2. Avoid littering the environment using face masks.
3. Dispose used mask in a yellow colored polythene bag and seal it when three-quarters full.
4. Drop sealed yellow colored polythene bags with face masks at the nearest disposal site designated by the local public health officer.
5. Create awareness to colleagues, peers and neighbors on appropriate waste management.

Every day, we are updated on increasing numbers of COVID 19 infections. We cannot rule out that some of these infections could be due to improper disposal of face masks which end up contaminating our environment. Each of us use a mask daily and it is everyone’s responsibility not to infect others by ensuring that masks are only disposed at designated places.