Emergency Management of Medical Wastewater in Hospitals Specializing in Infectious Diseases: A Case Study of Huoshenshan Hospital, Wuhan, China

Abstract

Medical wastewater originating from hospitals specializing in infectious diseases pose a major risk to human and environmental health during pandemics. However, there have been few systematic studies on the management of this type of wastewater management. The function of the Huoshenshan Hospital as a designated emergency field hospital for the treatment of COVID-19 has provided lessons for the management measures of medical wastewater, mainly including: (1) Modern information technology, management schemes, and related standard systems provided the legislative foundation for emergency management of medical wastewater. (2) The three-tier prevention and control medical wastewater management system ensured the discharged wastewater met water quality standards, especially for the leak-proof sealed collection system of the first tier, and the biological and chemical treatment technology of the second tier. (3) The establishment of an effective three-tier medical wastewater quality monitoring accountability system. This system was particularly relevant for ensuring continuous data monitoring and dynamic analysis of characteristic indicators. (4) Information disclosure by government and public supervision promoted successful implementation of medical wastewater management and control measures. Public questionnaires (n = 212) further confirmed the effectiveness of information disclosure. The results of this study can act as methodological reference for the emergency management of wastewater in designated infectious disease hospitals under similar situations.

Water supply emergency preparedness and response in health care facilities: A systematic review on international evidence

“…The formalization of the cooperation into plans and/or agreements is recommended to link governmental authorities, water suppliers, other health care facilities, communities and patients with health care facilities in the preparedness and response phase ( 19 , 25 , 28 , 30 , 43 ). Adopting sustained measures to ensure availability of emergency water supply can ease thought appropriate emergency and security legislation ( 28 ).…”

“…Health care facilities need to be part of the emergency water supply plan of a municipality and considered when planning the distribution of water supply and should prepare according to the emergency water supply plan and capability of the local government ( 20 , 29 ). Likewise, health care facilities and water suppliers should engage one another in their respective service areas to develop effective emergency operation plans for healthcare facilities, for example through regular disaster management meetings or memorandum ( 25 , 28 , 30 ). After the Great East Japan Earthquake, dialysis centers of the Fukushima Prefecture for example proposed a law to the local government to guarantee them priority over a certain amount of water in case of emergency.…”

“…As an alternative, after Hurricane Ike, water from the hospital's physical therapy swimming pool was used to flush the toilets. In the construction of a hospital to face COVID-19 in China, wastewater treatment was prioritized, as a result a leakproof sealed collection system with high-density polyethylene anti-seepage was installed to ensure water quality standards in discharge water ( 25 ).…”

“…Emergency operation centers are of critical importance to coordinate operations and management of the infrastructure during and after a water crisis ( 31 ). In a Chinese COVID-19 temporary field hospital, an online communication platform, gathering different expert groups, was implemented to provide online technical guidance for the management of water and wastewater ( 25 ). Lack of coordination can have significant impact, particularly on the ability to respond quickly to an emergency.…”

“…To a lesser extent, other health care facilities which are not affected by the outage or impairment, the community in which the hospital structure is located, and social networks are also mentioned as essential to enhance networking responsiveness and communication plans (23,37,41). The formalization of the cooperation into plans and/or agreements is recommended to link governmental authorities, water suppliers, other health care facilities, communities and patients with health care facilities in the preparedness and response phase (19,25,28,30,43). Adopting sustained measures to ensure availability of emergency water supply can ease thought appropriate emergency and security legislation (28).…”