In our continuing effort to support all initiatives to address the challenges that COVID-19 is imposing upon us, Health Care Without Harm South East Asia would like to share with our health sector partners, allies, as well as frontline health communities the following recommendations on managing related waste such as mask and PPEs.

It is with deep gratitude and profound respect to our frontline health workers that we are sharing these timely recommendations in order to ensure that the noble work they are doing at the frontlines is not impeded and breached, thus made worse, by mismanaged Covid19-related waste such as mask and PPEs.

As COVID-19 is a new virus, it should be pointed out that there is no established waste treatment process yet for waste generated in response to the virus.

Nonetheless, according to WHO, any health facility exercising best practice for infectious waste will also be able to manage waste potentially infected with COVID-19.

Yet special attention may still be given to COVID-19-related waste such as PPEs by setting-up a distinct bin for these types of waste which then gets double bagged for safe transport. Segregating waste at source should always be observed.

There is no need to burn/incinerate COVID-19 related waste since medical waste autoclaves that uses pressurized steam at 30psi at saturation time of 30 minutes are known to kill any heat resistant pathogens without need for chemicals whatsoever.

Temperature up to 135°C degrees or higher achieves microbial inactivation at 99.9% kill rate on the most heat resistant pathogens known to science including Baccillus Stearothermophilus.

Once disinfected in an autoclave, COVID-19-related waste, like any other hospital solid waste that underwent autoclaving, can then be treated as regular municipal waste. All technologies, whether autoclave or microwave should be validated and regularly tested.

Incinerators as well as incinerators-in-disguise like pyroclaves, gasification, pyrolysis, plasma arc, apart from being overly expensive, produce deadly dioxins and furans that further harm people's health instead of protecting it.

After disinfection from autoclave, waste can be sent for disposal or recycling. Any PPE that could potentially be reused should be cut to pieces.

For example, cut masks because there are reports that they are being illicitly resold. Thus, advise every staff to do this to PPEs they individually use before discarding them into appropriate bins.

Because the COVID-19 virus survives briefly in tropical temperatures, as an additional safety measure, it is recommended to label every bag of PPE waste with their collection dates and have them stored in waste holding areas for at least three days to ensure that no virus survives in the collected items.

See to it that they are in leakproof, puncture proof containers, and that storage areas are clean, secure, and protected from the elements, pests and disease vectors.

Finally, we can never over emphasize the importance of proper hand washing, especially for hospital personnel handling wastes.

Together with appropriate PPEs, washing hands make a formidable defence against the virus. Since we know that the coronavirus that causes COVID-19 is coated in lipid that dissolves in soap, which then result in the complete destruction of the virus, thus, washing hands properly with soap and water remains to be the simplest and most consistent way of preventing the spread of or getting infected by the virus.

Dr. Esperanza Cabral is the President of Health Care Without Harm South East Asia's Board. She served as Secretary of the Department of Health in the Philippines. Before her appointment as Secretary of Health, she was previously the Secretary of the Department of Social Welfare and Development.

Dr. Cabral, who is a cardiologist and clinical pharmacologist, graduated from medical school of the University of the Philippines. She extended her medical and pharmacological training at the UP Philippine General Hospital, Harvard Medical School, Massachusetts General Hospital, and the Joslin Clinic in Boston, Massachusetts.

Dr. Cabral has long served as an educator and leader in Philippine medicine. At the University of the Philippines College of Medicine, she was a professor of medicine and pharmacology. She served both as Director of the Philippine Heart Center and Chief of Cardiology of Asian Hospital and Medical Center. She authored and co-authored more than 85 scientific papers on hypertension, cardiovascular pharmacology and clinical and preventive cardiology. She educated the public as a TV show host on "HeartWatch" on IBC Channel 13 and "InfoMedico" on NBN Channel.

Paeng Lopez is Health Care Without Harm South East Asia's Healthy Energy Initiative Campaign Coordinator. He has been in the environmental movement for 25 yearssince his college days, and had worked as youth convenor, community organizer, project coordinator, and researcher for various conservation organizations.

He has built a career centered on forging alliances and coordinating networks in the Philippine environmental-, social-, and health justice circles.

Paeng obtained his Bachelor of Laws from the Far Eastern University and his Bachelor of Arts in Philosophy from the University of Sto. Tomas.