Just a week prior to the World Health Organization labelling 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 net zero carbon emissions.
Regardless of the global pandemic, being able to put a time frame on such a feat for an organisation with such sheer magnitude as 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 net zero by 2040 in a decision made in October 2021, referencing the inextricable link between the climate crisis and ill health.
During the events of 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 and considering that 4.6% of the world’s greenhouse gas emissions comes from health systems, these commitments were considerable.
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: “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.”
Health and Social Care Secretary Sajid 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 have pledged considerable support so far. More than £330 million was invested in climate-smart healthcare and low carbon hospitals for NHS England, NHS Scotland is due to have all small and medium vehicles operating at net zero by 2025, low carbon heating to be used across all NHS new builds in Wales, while health and social care in Northern Ireland will emphasis 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.
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 velocity of the items 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 researches in the US and China published in December 2021 detailed how the world has created approximately 8 million tonnes of pandemic plastic waste since of which a significant amount has now made it to the sea – what the report by Peng, Wu, Schartup et al (2021) did reveal however, was that despite European and North American nations, such as the UK & the US, who 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, were responsible for 72% of global plastic discharge.
Rizan, Reed, & Bhutta (2021) wrote in Environmental impact of personal protective equipment… “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.
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 before, particularly during a time when were so conscious about our environmental impacts.
One study 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 as of yet for the environmentally friendly disposal of single use face masks that are potentially contaminated – the vast majority going 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 exists 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 calling upon the use of materials for burning that could otherwise have been recycled.
Unsurprisingly, it’ll be a number of years before we can put an accurate number on 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. Predictions, similarly, suggest 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 reducing considerable travel requirements within primary care – balancing in some respects the downfalls.
There is 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.
Written for GHP