Despite the significant negative socio-economic impact of the COVID-19 pandemic, lockdown of cities and enforcement of social distancing across the world have brought some relief to the environment, evidenced in better air and water quality as well as reduced greenhouse gas emissions. However, the environmental picture of this pandemic is not all bright and encouraging.

A recent survey by Ontario Waste Management Association shows that the household garbage over the period of March 9th to April 13 has increased by 5% compared to the same period in 2019. There are also multiple reports of the increase in hospital waste, as much as six times at the peak of the outbreak in comparison to the time before the crisis. In addition, concerns over littering due to improper disposal of gloves and masks are growing in different municipalities, and as the new normal with the COVID-19 threat may widely require compulsory mask wearing, not only littering but also the landfilled waste generated due to single-use masks will further pollute the environment.

In this article, we briefly discuss the relevance of the 5R strategy with respect to the efforts aiming to combat COVID-19. At the early stages, the urgency of minimizing the health risk and addressing the supply shortage for personal protective equipment (PPE) might have hindered a holistic and environmentally conscious approach. However, as we are planning a long-term strategy for the current and possible future pandemics, considering other factors in developing solutions are more feasible and deemed necessary.

While N95 respirators, a type of mask that can filter at least 95% of airborne particles, are designed for single-use, recent studies have been conducted to understand the impact of various decontamination methods on material, fit and seal performance of these masks with the goal of developing guidelines for their reuse. For example, it has been reported that treating N95 with vaporized hydrogen peroxide allows for three reuse cycles before the masks lose their efficacy. This path of studies need to be continued and expanded on all personal protective equipment as well as related single-use devices, such as breathing circuits, to thoroughly identify opportunities for reuse without compromising health and safety. In addition, manufacturers of these equipment and devices can play an important role by bringing design for reusability in their practice to expand the potentials of their products for challenging times as the one we are experiencing with COVID-19. Also, when it comes to public health, the potential efficacy of non-medical masks to contain the spread of the virus can open up more opportunities for reuse, e.g., through washing, which might not be applicable to the ones used by healthcare providers.

Innovation in materials can reduce the waste generated by disposable PPE through, for example, reducing the thickness of the final product or enhancing its durability to avoid failure during service (check glove producer Eagle for an example of such efforts). The reduction in material use can also be achieved by changing the public behavior. For example, while wearing masks have been encouraged by health officials, such recommendations for gloves have not been provided and even some have questioned wearing them in public places as a protective measure. Clearly, discouraging the use of gloves can reduce the amount of plastic waste generated.

Whereas there are already programs in place to manage the recycling of non-hazardous gloves (e.g., the RightCycle program by Kimberly-Clark for its Nitrile gloves, or the partnership between Eagle and TerraCycle), the contamination and health risks associated with gloves and other plastic PPE is preventing these products to be handled and processed for recycling. Despite this, the opportunity for improving circularity and recyclability of their packaging is not constrained.

Using bio-based, biodegradable or compostable materials in manufacturing of PPE and single-use medical devices can help alleviate the excessive use of these products during outbreak situations. For example, there has been some efforts in making gowns and other protective equipment using polylactic acid (PLA) which is a naturally sourced, biodegradable plastic. However, the potential decomposition of a material in nature or in a composting facility does not necessarily give them the credibility of a sustainable and circular product. For example, while latex gloves, which are made of natural rubber, are biodegradable, the chemical additives present in the product can be harmful to the environment.

Ventilators became a priority equipment for hospitals to treat COVID-19 patients experiencing severe symptoms. Their shortage at the peak of the outbreak stimulated the manufacturing and supply of many of these devices across the world. While the initial designs of these ventilators might not facilitate extended life, reparability and remanufacturability, designers and manufacturers can take initiatives to enhance the circularity of these devices and ensure their long-run operations.