Biohazard to breakthrough: India’s pandemic waste story

The COVID-19 pandemic not only overwhelmed public health systems but also led to an unprecedented increase in biomedical waste (BMW). Items such as personal protective equipment (PPE) kits, syringes, face masks and testing materials created enormous pressure on India’s waste management infrastructure.

Despite these challenges, India responded with a combination of timely policies, technology-driven tools, and strong institutional efforts. This article presents an overview of how India managed the biomedical waste surge during the pandemic. It highlights changes in policy, gaps in infrastructure, on-ground challenges, and the adoption of innovative technologies and business models to address the crisis.

Biomedical waste: Precarious inheritance meets pandemic surge

India has faced difficulties in managing biomedical waste for many years. Problems such as poor segregation, lack of treatment capacity, and weak enforcement of regulations were already present before COVID-19. The Biomedical Waste (Management and Handling) Rules, first introduced in 1998 and revised several times, have helped, but implementation has been inconsistent.

The pandemic significantly worsened the situation. From January 2020 to May 2021, BMW generation increased by more than 15 times in some regions. In Delhi, for example, per-bed waste rose from 500 grams to 4 kilogrammes per day. On a national scale, COVID-related BMW added nearly 100 tonnes daily to an already overburdened system.

Policy sprint: Adapting in real time

Indian regulatory bodies acted quickly. The Central Pollution Control Board (CPCB) issued specific guidelines for COVID-19 waste management in March 2020. Soon after, they launched the COVID19BMW mobile application to monitor waste generation, segregation, and disposal in real-time.

This app allowed different users — waste generators, handlers, and treatment facilities — to log waste data using a common platform. Within one year, over 8,000 healthcare facilities and nearly all 200 treatment centers were registered on the system.

The National Green Tribunal also played a crucial role by issuing orders to strengthen monitoring and enforce compliance with safety and emission standards.

Ground realities: Infrastructure imbalance, treatment gaps

India has over 260,000 healthcare facilities, but waste treatment capacity has not kept up. In 2018, daily BMW generation stood at 608.4 tonnes, but the treatment capacity was only 492.6 tonnes. This left nearly 20 per cent of the waste untreated, posing a serious environmental and health risk.

While states like Maharashtra, Kerala and Karnataka generated large quantities of BMW, many northeastern states and island territories such as Lakshadweep lacked basic waste treatment infrastructure. These regions often relied on deep burial, an outdated and unsafe method.

However, some positive developments occurred. For example, the facility operated by Medicare Environmental Management Pvt Ltd in Ghaziabad, Uttar Pradesh, significantly increased its capacity during the pandemic to support over 2,500 healthcare establishments.

Waste composition & trends: Shift between waves

One notable observation was the change in waste composition between the first and second waves of the pandemic. In the first wave, the sudden rise in disposable PPE usage and poor segregation led to higher waste volumes. By the second wave, hospitals were better trained, and more aware of proper waste segregation practices, especially separating general waste from biomedical waste.

Although the number of COVID-19 cases increased during the second wave, BMW generation did not rise at the same rate. This improvement was largely due to better protocols, efficient PPE management, and consistent use of the COVID19BMW app.

Technology toolbox: How India treats its medical waste

India employs several methods to manage biomedical waste, each with its own advantages and limitations:

• Incineration is effective for destroying hazardous waste but is expensive and emits harmful gases.

• Autoclaving and microwave disinfection are widely used for plastics and non-liquid waste due to lower environmental impact.

• Chemical treatment is suitable for liquid waste but raises concerns over secondary pollution.

• Irradiation, vitrification and inertisation are niche methods with high costs and limited scalability.

New technologies such as Plasma Pyrolysis, Sharp Blaster and PIWS-3000 have been given provisional approval by CPCB. These systems aim to reduce emissions and offer better efficiency, but they require more field validation.

Below is a clear, at-a-glance comparison of the different technologies discussed, helping readers understand comparative assessment based on prominent factors.

Comparative preferential ranking of various BMW handling and valorisation technologies 

Hidden warriors

Due to the overwhelming volume of waste during the pandemic, the government allowed Treatment, Storage and Disposal Facilities (TSDF) — normally used for industrial waste — to treat COVID biomedical waste. Although not ideal, these facilities helped prevent illegal dumping and open burning.

Strict conditions were enforced. TSDFs had to obtain special authorization, implement continuous emission monitoring, and report data via the COVID19BMW app. They also had to follow safety protocols for staff and ensure proper PPE usage.

Road ahead: Lessons learnt & opportunities ahead

India’s experience managing biomedical waste during the pandemic offers several important lessons:

• Data-driven tools are essential: Real-time monitoring through digital platforms like the COVID19BMW app helped improve coordination and compliance.

• Proper segregation is critical: Separating biomedical waste from general waste at the source reduced processing burdens.

• Innovation must be supported: New technologies, especially those developed locally, need institutional backing to scale.

• Small healthcare facilities need help: Flexible collection models and regulatory support are needed to ensure safe waste management in remote areas.

• Sustainability should guide future strategies: While incineration remains necessary, efforts should be made to adopt low-emission and environmentally friendly alternatives.

Conclusion: Cautiously optimistic future

India’s approach to managing biomedical waste during the COVID-19 crisis showed both its challenges and its capacity for rapid adaptation. The pandemic exposed long-standing gaps but also led to the adoption of better policies, digital solutions, and new technologies.

If India continues to build on these gains — by strengthening infrastructure, supporting innovation, and reducing regional disparities — it can become a leader in safe and sustainable biomedical waste management.

As new health emergencies may emerge in the future, effective waste management will be as important as treating the disease itself.

Atun Roy Choudhury is the technical head of Unison i3x Pvt Ltd, Hyderabad. Neha Singh is manager, Unison i3x Pvt Ltd. Jitesh Lalwani is assistant professor, School of Business, Woxsen University, Hyderabad. Chandana N is assistant professor, Centre for Emerging Technologies for Sustainable Development, Indian Institute of Technology Jodhpur, Jodhpur. Mohammad Mehdizadeh is researcher, Department of Agronomy and Plant Breeding, Faculty of Agriculture and Natural Resources, University of Mohaghegh Ardabili, Ardabil, Iran. Views expressed are the authors’ own and don’t necessarily reflect those of Down To Earth.