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How Many Years Has the Pandemic Set Back Environmental Sustainability?

Just a week before the World Health Organization labelled COVID-19 a “public health emergency of international concern” a panel had sat down to discuss the ways in which the NHS could carve out a greener future in line with global attempts to achieve net zero carbon emissions.

Regardless of the global pandemic, being able to put a timeframe on such a feat for an organisation of the size of the NHS was always going to be particularly difficult.

In How to achieve a net zero carbon NHS during a pandemic (2021) scholar Emma Wilkinson details how, despite the rapidly developing virus that so heavily impacted the healthcare service, they still committed to achieving net zero by 2040 in a decision made in October 2021, referencing the inextricable link between the climate crisis and ill health.

A united approach against climate change

During COP26 in Glasgow, it was agreed that all UK health services would commit to becoming net zero. They were joined by 47 countries globally who agreed similar ambitions. Considering that 4.6% of the world’s greenhouse gas emissions come from health systems, these commitments were significant.

When announcing the NHS’ decision to partner with the worldwide scheme supported by the COP 26 Health Programme, further reference was made to the association between driving down emissions and improving public health by Health and Social Care Secretary Sajid Javid: “The impacts of climate change represent the biggest public health challenge of this century, which could be felt around the world through greater water and food insecurity, extreme weather events and increased infectious diseases.”

Mr Javid went on to add: “As a health community, we cannot simply sit on the sidelines – we must respond to climate change through urgent action, with global collaboration at its core.”

The UK Government has pledged considerable support so far. More than £330 million was invested in climate-smart healthcare and low carbon hospitals for NHS England. The devolved administrations have also committed to supporting net zero. NHS Scotland is due to have all small and medium vehicles operating at net zero by 2025, low carbon heating is to be used across all NHS new builds in Wales, while Health and Social Care Northern Ireland will emphasise their influence on supporting the supply chain to reduce their carbon emissions. These are just some of many announcements that have been made.

That said, however, how much of this is going to be playing catch up thanks to the events of the pandemic?

In this article, we take a look at the impacts of the pandemic on the NHS’ ability to reach net zero.

Pandemic pollution galore

NHS Scotland figures released in May 2021, some 14 months into the pandemic, revealed that 1 billion items of PPE had been used. The figures, which account for items used between 1st March 2020 and 5th May 2021 detail 664.8m gloves, 190.9m Type IIR masks, and 187.1m aprons. The volume of PPE being used were so large that an additional £7m in NHS contracts were awarded to deal with the waste.

Findings collated by a group of researchers in the US and China and published in December 2021 detailed how the world has created approximately 8 million tonnes of pandemic plastic waste since the beginning of the pandemic, of which a significant amount has now made it to the sea. What the report by Peng, Wu, Schartup et al (2021), published in the Proceedings of the National Academy of Sciences of the United States of America, did reveal, however, was that despite the volumes of PPE and other disposable items used by European and North American nations, such as the UK & the US, which were hit hardest by the pandemic in terms of number of cases, relatively little pandemic plastic waste was created.

On the other hand, despite having had had 30% of total global cases as of August 2021, Asia was responsible for 72% of global plastic discharge.

Rizan, Reed, & Bhutta (2021) wrote in Environmental impact of personal protective equipment, published in the Journal of the Royal Society of Medicine“the carbon footprint of PPE distributed during the study period totalled 106,478 tonnes CO2e. The estimated damage to human health was 239 DALYs (disability-adjusted life years) and impact on ecosystems was 0.47 loss of local species per year.”

Disposing of waste

Perhaps one of the most challenging aspects of the pandemic and the ensuing sustainability impacts was the fact we hadn’t negotiated such an event in just over a century, and were now doing so in at a time when we both used far more disposable medical equipment and were so conscious of our environmental impact.

PPE: Polluting Planet Earth (Dean, 2020) reported that if each individual were to wear a single-use face mask every day for an entire year, more than 66,000 tonnes of unrecyclable plastic waste would be produced. Tragically, there is no system in place yet for the environmentally friendly disposal of single use face masks that are potentially contaminated – the vast majority go to landfill.

The NHS labels waste as either infectious, offensive, or municipal – used PPE usually falls under the category of infectious or offensive and must be disposed of in a way that prevents infection. This usually involves burning at an offsite incineration plant.

There is controversy surrounding the burning of waste – while on one hand, it is used to heat local buildings and provide electricity (municipal waste contributed 2% of UK energy in 2018), incineration has also been criticised for releasing harmful gases and requiring the use of materials for burning that could otherwise have been recycled.

The true impact of the pandemic on sustainability

Unsurprisingly, it’ll be some years before we can accurately quantify how the pandemic has impacted global, domestic, and the NHS’ quest for net zero. That said, there have been a number of learnings and of course, failings.

More sustainable mask options, including reusable, washable alternatives are certainly something we expect to receive considerable investment over the coming years. Similarly, it is estimated that UK manufacturing would have reduced the carbon footprint of PPE by more than 12% while reusing gowns and gloves could have contributed a further 10% reduction.

That said, however, we successfully managed to adopt digitalisation during the pandemic, which considerably reduced travel requirements within primary care – balancing in some respects the environmental failures.

There are a number of different takeaways from the impact the last two years has had on the environment but, for now, the healthcare sector can reflect, learn, and issue new healthcare contracts to suppliers who believe they can help the system reach net zero successfully.

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