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ARAB JOURNAL OF BASIC AND APPLIED SCIENCES University of Bahrain 2023, VOL. 30, NO. 1, 79–91 https://doi.org/10.1080/25765299.2023.2180884 ORIGINAL ARTICLE Medical waste generation during COVID-19 pandemic in selected member countries of Arabian Gulf region; Google trend analysis a,b c d Khadija Al-Omran , Ezzat Khan and Simone Perna a b Environment and Sustainable Development, College of Science, University of Bahrain, Sakhir, Kingdom of Bahrain; School of Logistics and Maritime Studies, Faculty of Business and Logistics, Bahrain Polytechnic, Isa Town, Kingdom of Bahrain; c d Department of Chemistry, College of Science, University of Bahrain, Sakhir, Kingdom of Bahrain; Department of Biology, College of Science, University of Bahrain, Sakhir, Kingdom of Bahrain ABSTRACT ARTICLE HISTORY Received 5 November 2022 The variant SARS-CoV-2 (COVID-19) has affected the entire globe; it has caused acute respira- Revised 8 January 2023 tory illnesses and has led to massive environmental problems associated with extra medical Accepted 11 February 2023 waste and single-use plastics. Herein the total quantity of waste generated in the selected GCC countries from different sources has been calculated. The popularity of the medical KEYWORDS waste issue through using relative search volume was investigated to associate it with the Forecasting analysis; Google quantities of Waste. Data was collected from the first COVID-19 case in the respective coun- trend analysis; medical try until March 26, 2022, from the public domains, “Worldmeter”, “Our World in Data” and waste; plastic personal “Google Trends”. Autoregressive Integrated Moving Average (ARIMA) was used to predict protective equipment; the amount of CMW. The calculated values are 1107.980 kg/day from the facemask used by sustainable management; waste generation in Gulf the public, 2,554,812 kg from vaccination, 2,595,772 kg from PCR tests, also the predicted countries daily total amount of COVID-19 related Medical Waste (CMW) by the end of 2022 (December 31, 2022) to be 3667.25 kg/day. The trend in the generation of CMW has been identified in selected countries. Generally, the waste is expected to get minimized, but it is a lesson for future planning. Especially With extensive vaccination, the cases are drastically decreased, and life is resuming in the regions. 1. Introduction COVID-19 cases in mid-February. During the peak period of the pandemic, by March 2020, the amount In early 2020, the infection rate of Coronavirus raised nearly six-fold, reaching an average of 247 t/d (COVID-19) had risen to the level of a global pan- (Singh, Tang, Zhang, & Zheng, 2020). In addition, demic, with more than 675 million confirmed cases with the number of COVID-19 cases increasing, worldwide and more than 6 million deaths reported related to protective items have also increased dra- by the World Health Organization (WHO) till matically, such as gloves, masks, linens, disposable December 18, 2022 (Worldmeter, 2022). The COVID- plates, and glasses used by COVID-19 medical staff 19 pandemic has affected many aspects of life, such and patients. Thus, today a surprising and unusual as social activities, consumption, production and increase in the amount of medical waste being cre- travel patterns and also has a significant effect ated is observed. In China, until January 20, 2020, on pollution expulsion and environmental quality the national medical waste disposal level was 1164.0 (Klemes, Fan, Tan, & Jiang, 2020). The pandemic has t/d, and it reached 6066.8 t/d on March 21, 2020 led to a substantial increase in medical waste. For (Ma et al., 2020). With the COVID-19 pandemic, the instance, the pandemic has caused a surge in per- unexpected increase in medical waste production sonal protective equipment (PPE) waste and has created a serious environmental threat. It can decreased recycling activities and waste diversion significantly affect health in China and the entire due to the unknown nature of the virus (Ikiz, world (Sangkham, 2020). The unsafe and insufficient Maclaren, Alfred, & Sivanesan, 2021). In Wuhan, medical waste management pollutes the environ- China, where the first case of COVID-19 was ment and poses a serious threat to the spread of observed, the average of medical waste produced before the COVID-19 pandemic was 45 t/d (Yu, Sun, infectious diseases. It’s still uncertain, but it has been Solvang, & Zhao, 2020), which has been taken to an observed that the virus could stay up to 9 days immense amount of 110–150 t/d with an increase in on different inanimate surfaces, and the surface CONTACT Ezzat Khan ezkhan@uob.edu.bh Department of Chemistry, College of Science, University of Bahrain, Sakhir 32038, Kingdom of Bahrain. 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of the University of Bahrain. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 80 K. AL-OMRAN ET AL. thus remains infectious (Kampf, Todt, Pfaender, & In order to effectively manage this type of hazard- Steinmann, 2020). Therefore, the COVID-19 pandemic ous waste, it is essential to accurately estimate the today, with the rapidly increasing medical waste, amount of medical waste so that appropriate dis- posal methods can be determined to address the must be handled safely to ensure that it does not negative impact on the environment (Sangkham, lead to infection risk. 2020). However, the studies on the CMW in GCC Interest in public health and environmental countries are limited; where only one study was themes is vital. Public awareness, engagement, and found in literature in the Kingdom of Bahrain that endorsement are necessary to support environmen- estimated the medical waste produced during tal management plans and strategies, particularly in COVID-19 (Al-Omran, Khan, Ali, & Bilal, 2021). Herein, the long term (Ficetola, 2013). The internet plays a this study aims to estimate the amount of medical progressively vital role in popular science and sci- waste generated during the COVID-19 pandemic ence communication. Thus, Google search patterns from different sources in selected GCC countries, could be considered a source of information about such as facemasks worn by the public and front lin- general interests (McCallum & Bury, 2013; Wilde & ers, healthcare facilities, diagnostic testing (PCR) and Pope, 2013; Yang, Huang, Peng, & Tsai, 2010). vaccination, in addition to the general generated Currently, search patterns can be measured by CMW. Moreover, this is the first study that figures Google using the tool “Google Trends”. This tool out the google search volume about the medical measures how repeatedly a term is searched in waste and related terms, and compare them with Google compared to the total number of searches the quantities of generated medical waste in the five performed on Google. selected countries. In this regard, the potential of the internet was used by most countries as well as the WHO to 2. Methods and calculations enhance awareness and educational programs on COVID-19, which consequently affects the COVID-19 Different formulae are already in practice to estimate medical waste (CMW) generation rate. Also, survey- the general medical waste generated during COVID- ing the relative internet search volumes (RSV) has 19, the amount of waste produced by the surgical been considered a method to gain information facemasks worn by the general public and frontline about public interests. Google Trends is one of the workers, and the significant quantity of waste gener- most commonly used tools for this purpose (Arora, ated by the vaccination programs and conduct diag- McKee, & Stuckler, 2019; Effenberger et al., 2020). nostic tests. The collected data in this study was However, it should be noted that Google Trends is a from the beginning of the pandemic. Specifically, measure of relative search patterns (Ficetola, 2013). January 29, 2020, in Emirates, February 24, 2020, in Google Trends was applied in many studies on pub- Bahrain, Kuwait and Oman, March 2, 2020, in Saudi lic health and the environment, specifically on waste Arabia, until March 26, 2022. issues (Haider, 2016; Lacitignola & Saccomandi, 2021). It is worth mentioning that, on March 28, 2022, The Gulf Cooperation Council (GCC) countries wearing a facemask became optional in both indoor and outdoor areas in accordance with precautionary have played a prominent role in addressing the pre- measures in most of the selected countries (MOH, vailing pandemic; by performing many necessary 2022). actions and activities, which led to the generation of massive medical waste. The waste generation will continue until the end of the pandemic. This matter 2.1. Estimation of daily facemasks calls for attention to be paid to the authorities The estimated quantity of daily facemasks in GCC towards adequate and efficient waste treatment. countries is calculated by using the following equa- In GCC countries, during the outbreak, the com- tion (Equation 1) proposed by (Nzediegwu & Chang, bined actions of media-driven awareness programs 2020): and restrictive government measures have played a P UP FA AFM vital role in softening the severity of the epidemic, DFM ¼ (1) 10, 000 which affects the generation of CMW. Indeed,ifman- datory restrictive measures such as lockdowns have where DFM is the total daily facemasks, P is the minimized disease transmission as a consequence of country’s population, UP is the rate of the urban the dramatic change in the daily behaviours of individ- population, FA facemask acceptance in percentage, uals (Buonomo & Della Marca, 2020), media-driven pro- and AFM is the average daily facemasks per capita. grams have contributed significantly to maintaining Data from the public domain, the website “world responsible and respectful behaviour over time meters” (Worldmeter, 2021), were collected for the through ongoing awareness action. population size and the rate of urban population for ARAB JOURNAL OF BASIC AND APPLIED SCIENCES 81 Table 1. Estimated daily facemasks usage in the GCC countries @ 80% acceptance rate. Urban population Total daily Total facemask Country Name Population (% of total population) facemask use (pieces) for 365 days Saudi Arabia 35,193,520 84.065 236683.4607 86,389,463.16 United Arab Emirates 9,974,219 86.4 68941.80173 25,163,757.63 Oman 5,197,118 87 36171.94128 13,202,758.57 Kuwait 4,314,813 100 34518.504 12,599,253.96 Bahrain 1,742,586 89.3 12449.03438 4,543,897.55 GRAND TOTAL 59,337,355 – 411199.344 150,087,760.6 the selected GCC countries. It is worth mentioning countries was collected from the website “Our world that the term ’urban population’ refers to the num- in data” (Data, 2021). The total weight of COVID-19 ber of people living in an area that is considered an tests performed in each country was calculated using urban area by the national statistical offices. This cal- the following formula: culation is based on the urbanization ratios from the Total weight of COVID 19 test waste ðÞ kg United Nations World Urbanization Prospects as well ¼ total number of tests performed as world bank population estimates from the World test kit’s weight Bank (T. W. Bank, 2022). Following the literature (Nzediegwu & Chang, 2020), 80% is assumed as the rate of facemask 2.3. Estimation of medical waste acceptance for the GCC countries. Furthermore, based on the research (Wu, Huang, Zhang, He, & The pandemic has generated an abnormal amount Ming, 2020), it was considered that the person in the of waste, which is of greater concern for environ- general population of the country uses one facemask mentalists and respective government departments. per day; the calculated data are summarized in During the high risk of the spread of the COVID-19 Table 1. pandemic, several groups in different parts of the The weights of daily facemasks in each of the world have conducted studies on medical waste selected countries were calculated (weight of a single generated. For example, the Asian Development surgical facemask DFM), where the weight of a sin- Bank (A. D. Bank, 2020) reported that the quantity of gle surgical facemask is 2.85 g, as reported in the lit- medical waste caused by COVID-19 increases with an erature (Al-Omran et al., 2021). increase in the number of infected people at a con- stant rate; for instance, the CMW increases by 3.4 kg/day with each infected person, as shown in 2.2. Estimation of waste generated from Eq. 2. vaccines and PCR-Tests Amount of CMW ðkg=dayÞ It was determined that the weight of the vaccine set ¼ Number of infected persons 3:4 (2) required for one individual per dose is 8.24 g (glass vial ¼ 1.59 g, syringe ¼ 5.82 g, and alcohol swab ¼ Different studies have applied this equation to 0.83 g) (Al-Omran et al., 2021). This weight value estimate the CMW in Asian countries (Purnomo, (8.24 g) was utilized to calculate the total weight of Kurniawan, & Aziz, 2021). This equation is used in vaccination wastes in the GCC countries. Besides, the current study to estimate the amount of CMW in data on the number of given vaccines in the GCC GCC countries. Where the number of infected per- countries up to March 26, 2022, was collected from sons in the selected countries was collected from the website “Our world in data” (Data, 2022a). the website “Our World in Data” (OurWorldinData, Therefore, the total weight of vaccine-related waste 2021). is determined using the following formula: We employed advanced time series forecasting Total weight of vaccine waste ðÞ kg techniques to forecast the amount of CMW, the Autoregressive Integrated Moving Average (ARIMA) ¼ total number of vaccinations model that has been used widely in COVID-19 epi- weight of items in a single kit demic analysis (Cihan, 2021; Maheshwari, Yadav, The total weight of waste resulting from diagnos- Chandra, & Rai, 2020). IBM SPSS Statistics Version 23 tic tests for COVID-19 was also calculated. The software was used for the data analysis. weight of the test kit’s items used per individual of the PCR test was determined as 12.52 g (a plastic 2.4. Google trend bottle of a chemical preservative ¼ 11.30 g, nasopha- ryngeal swab ¼ 1.23 g) (Al-Omran et al., 2021). Also, Google Trends is a tool that Google introduced to the total number of tests performed in GCC the public in May 2006 to support studying trends 82 K. AL-OMRAN ET AL. GulfInsider, 2020; Jazette, 2020; Observer, 2021; UAE, 2021), which prompted people to wear facemasks daily during all outdoor activities. Though surgical facemasks (disposable facemasks) were mainly designed for the protection of the healthcare staff, in the current situation, they are commonly used in society. The public has extensively used facemasks during infectious diseases like the SARS epidemic in 2003, pdm H1N1 in 2009, and the existing COVID-19 pandemic (Elachola, Ebrahim, & Gozzer, 2020). It is pertinent to mention that the facemask decreases the transmission risk of the COVID-19 virus from an infected person to a healthy one (Eikenberry et al., 2020). Furthermore, it has been estimated that the international monthly requirement for facemasks is about 89 million in response to the current pan- Figure 1. Weights of daily facemasks usage in kg in GCC demic (WHO, 2021). Various countries’ production countries. capacity has also increased, considering the current founded on searches to Google Search (Rech, 2007). demand. For example, China’s daily production cap- Google Trends provides search volumes that reveal acity was raised to ca. 15 million in February 2020 the relative popularity of a search term within a des- (Xinhuanet, 2020). Therefore, the global market for ignated region and time (any time between 2004 facemasks comprising surgical and respirator masks and the present) (Google, 2022). This analysis allows is expected to increase by around 23%. Precisely, an the relative popularity of specific search terms in a increase from approximately 14.6 billion in 2019 to particular category, place, and time range, providing 33.4 billion in 2023 is expected to be achieved how the terms are popular at a particular time point. (MedicalResearch, 2020). Accordingly, the use of The relative popularity is known as a Relative Search facemasks is increasing day by day in GCC countries Volume (RSV), producing an index with a scale of 0– in the prevailing situation. Since the consumption of 100 (100 representing the highest relative popularity) facemasks is directly related to a country’s popula- (Havelka, Mallen, & Shepherd, 2020; Peng, Li, Rong, tion, it is therefore important to know the total Chen, & Chen, 2020). population of these countries. Basic information Google Trends has been used for environmental (arranged based on the countries’ population size) and health research (Effenberger et al., 2020;Havelka about the selected countries is presented in Table 1. et al., 2020;Jaricet al., 2020; Lacitignola & Saccomandi, The calculated total facemasks on a daily and yearly 2021;Penget al., 2020). The trends and patterns of basis for the selected countries, and as expected, Google search queries can be investigated through increased with the increased population. Table 1 indi- Google Trends (Arora et al., 2019). In this study, the cates that among the selected countries, the most sig- Google Trends tool (www.google.com/trends)was nificant number of facemasks used by the general used to access data on internet user search activities in public is found in Saudi Arabia, with more than 86 mil- the search queries for the search terms “medical lion per year. This is because Saudi Arabia has the high- waste,”“Facemask,”“COVID-19 vaccine” and “COVID- est population size of more than 35 million, followed by 19 testing.” The retrieved data on internet search the UAE, Oman, Kuwait, and Bahrain, with annual quan- queries were on a weekly basis, and it was from the tities of facemasks around 25, 13, 12, 8 and 4 million first week that the pandemic started in each selected per year, respectively. The total calculated weights of country until the week of 20–26 March 2022. facemasksin kg/day ineachcountry is graphically rep- resented in Figure 1. It can be noted that the face- mask’s weight in Saudi Arabia is the highest where it 3 Results and discussion reaches 674.548 kg/day, followed by United Arab 3.1. Estimation of daily protective disposable Emirates (196.484 kg/day), Oman (103.090 kg/day), facemask Kuwait (98.378 kg/day), and Bahrain (35.480 kg/day). The coronavirus spread has led the GCC countries to take strict measures towards facemasks to be worn 3.2. Estimation of wastes generated from in public places and during outdoor activities as a COVID-19 vaccination precaution. The GCC governments have issued laws At the beginning of 2021, the COVID-19 vaccination to impose penalties and fines on violators for not wearing a facemask (Bahrain, 2021; EUTERS, 2020; campaign was started worldwide and is still ongoing. ARAB JOURNAL OF BASIC AND APPLIED SCIENCES 83 Figure 2. The COVID-19 vaccine doses administered in GCC countries, including boosters. Source: (Data, 2022a). Thus, efforts have been intensified to increase vac- 3.3. Estimation of wastes generated from cine production to reach the desired level of immun- COVID-19 diagnostic tests ization of all people against COVID-19 and to satisfy In March 2020, the WHO and the Global Emergency the global demand for vaccines. All countries world- Committee called for the early testing of coronavirus wide seek to vaccinate as many people as possible to prevent the virus’s spread (Sohrabi et al., 2020). to eliminate the COVID-19 pandemic. On the other Polymerase chain reaction (PCR), precisely Real-Time hand, that could generate a large amount of waste PCR (RT-PCR), is used to detect the presence of cor- that may negatively impact the environment onavirus in tested individuals. A swab is needed to (POLITICO, 2021). Hence, vaccination activities could collect a sample from the individual’s nose or mouth cause another environmental anxiety by raising med- (nasopharyngeal swab) or lungs; the sample is put in ical waste. With the acceleration in vaccination a plastic tube with chemical preservatives. The PCR development and immunization campaigns, a signifi- test is applied by collecting a quick sample from the cant increase in glass, rubber, and plastic quantities throat or nasopharynx using a long cotton swab into is anticipated (Phadke et al., 2021). It was reported the throat or nostril (Times, 2021). Single-use plastic that the predicted burden would be massive, par- is used for this process which is 100% disposable ticularly in low-income and developing countries (Tang, Schmitz, Persing, & Stratton, 2020). The that don’t have proper resources for waste manage- COVID-19 diagnostic tests produce enormous quanti- ment and would harm the environment and financial ties of plastic waste; environmental scientists are sector in the short and long term (UCLA, 2014). concerned about the adverse environmental impacts Large national campaigns for COVID-19 vaccination of the current pandemic. It was reported that the have begun, and they continue to preserve the people’s estimated PCR test generates about 37.27 g of plastic health by raising their immunity to afford the highest per test (Celis et al., 2021). As of August 2020, an levels of health security in these countries (MOH, 2021; estimated amount of 15,439.59 tons of plastic waste Online, 2021). In the GCC countries, governments have was generated globally only from the COVID-19 tests provided various types of vaccines and have encour- by PCR. Most plastic residues from COVID-19 diag- aged people to get vaccinated. Until March 26, 2022, nostic tests (around 97%) are disposed of through the number of fully vaccinated people, including the incineration due to their hazardous nature to booster, is continuously increasing in the GCC countries, humans (Celis et al., 2021). as displayed in Figure 2. The GCC countries are keen to use the latest tech- It was mentioned earlier that the total weight of nologies to diagnose and treat the coronavirus to necessary items for an individual’s vaccination for limit its spread, facilitate examination methods, and one dose is 8.24 g (0.00824 kg). Based on that and make them available to everyone. Therefore, the the accumulated number of vaccinated people, the GCC governments provide different COVID-19 test total weights of the generated waste from vaccin- facilities at several points in the country and make ation in the selected countries are calculated as them accessible to all citizens and residents in all detailed in Table 2. regions through random campaigns and centers The total number of given vaccines with two doses (Arabia, 2021; Netherlands, 2021). These centers and booster was 103.35 million, generating 2,554,812 kg mostly use PCR tests for coronavirus detection, (2,554.812 tons) of waste in the selected GCC countries which is the most popular and reliable test globally. until March 26, 2022 (regardless of the latest data avail- However, as long as the tests continue to be run ability date). It can be noticed that Saudi Arabia produ- until the complete eradication of the virus is ces the highest accumulated amount of waste achieved, there will be an increase in medical plastic concerning vaccination which reached 1,506,684 kg. waste, leading to adverse environmental effects. 84 K. AL-OMRAN ET AL. Table 2. The calculated waste generated from COVID-19 vaccination for two doses, including boosters. Vaccinated Total vaccine Country Name individuals (million) waste (kg) Saudi Arabia 60.95 (Febrauary 28, 2022) 1,506,684 United Arab Emirates 24.18 (March 4, 2022) 597,729.6 Oman 6.99 (March 22, 2022) 172,792.8 Kuwait 7.81 (March 24,2022) 193,063.2 Bahrain 3.42 (March 23, 2022) 84,542.4 GRAND TOTAL 103.35 2,554,812 Total vaccine weight (kg) ¼ 3 vaccinated individuals 0.00824 kg. Data retrieved on March 26, 2022, from: https://ourworldindata.org/ grapher/cumulative-covid-vaccinations?country=BHRSAUOMNKWTARE Table 3. Weights of waste generated by COVID-19 test in GCC countries, till March 26, 2022. Total number of COVID-19 Total weight of Country Name tests performed (million) PCR tests’ waste (kg) United Arab Emirates 146.60 1,835,432 Saudi Arabia 41.48 519,329.6 Oman 1.99 (March 12, 2022) 24,914.8 Figure 3. Graphical representation of the number of daily Bahrain 9.5 (March 25, 2022) 118,940 COVID-19 cases and calculated CMW amount in kg/day in Kuwait 7.76 (March 12, 2022) 97,155.2 GCC countries until March 26, 2022. GRAND TOTAL 207.33 2,595,772 Total weight of COVID-19 tests ¼ number of COVID-19 tests performed x 0.01252. Generally, in all countries, the amount of CMW is Data retrieved on March 26, 2022, from: https://ourworldindata.org/ decreased. But in Oman, the amount of CMW fluctu- grapher/full-list-total-tests-for-covid-19?time=earliest.latest&country= BHRSAUKWTARE ates, and it changes dramatically on a daily basis. Generally, it’s clear that there is strict implementa- As mentioned previously, the weight of the test tion of policies to curb the virus spread in GCC kit used per individual equals 12.52 g (0.01252 kg). countries, such as travel restrictions and lockdowns Consequently, the total weights of waste generated within the specific country. As a consequence of from COVID-19 tests in the selected country are cal- these policies, there were significant reductions in culated in Table 3. The table reveals that the diag- the number of COVID-19 cases and the amount of nostic tests performed in GCC countries until March CMW. Moreover, the number of cases is inversely 26, 2022 (regardless of the latest data availability associated with the number of individuals being vac- dates) are 207.33 million, generating around cinated. As can be noticed, vaccination plays a vital 2,595,772 kg (2,595.772 tons) of waste. The highest role in reducing the cases and, in turn, reducing the quantity of this type of waste is generated in UAE amount of medical waste that is generated by the (1,835,432 kg ¼ 1,835.432 tons). virus. Several studies investigated the effect of vac- cination on the spread of coronavirus and indicated that vaccination could substantially impact mitigat- 3.4. Estimation of medical waste ing COVID-19 outbreaks (Moghadas et al., 2021; The numbers of newly confirmed cases and the cor- Scobie et al., 2021). As shown in Figure 5, the vaccin- responding calculated amount of CMW in kg/day in ation covers most of the population; it is evident GCC countries are visualized in Figure 3. The series that several of these countries have been declared of new daily COVID-19 cases and CMW in the graph “green” to resume normal activities in a stepwise/- fluctuate; peaks and valleys are continuously seen, gradual manner. where the values are going up and down. The num- All the calculated solid medical waste produced ber of daily cases in the GCC countries declined to during COVID-19 in the GCC countries until March 1064, contributing to around 3,618 kg on March 26, 26, 2022, is summarized in Table 4. The weight of 2022 (Figure 3). The ARIMA analysis for the quantities used surgical facemasks is 1,107.980 kg per day. The of CMW is presented in Figure 4. It reveals that the weights of waste produced by vaccination and PCR predicted daily amount of CMW by the end of 2022, tests were around 2,554,812 kg and 2,598,902 kg, on December 31, 2022, could reach 1,179.52 kg, respectively. 240.55 kg, 1,953.13 kg, 0 kg, 294.05 kg for UAE, Saudi Arabia, Bahrain, Kuwait and Oman, respectively. The 4. Relative search volume interest in medical worst cases also were predicted to be 14,309.09 kg, waste 30,618.30 kg, 26,441.61 kg, 21,869.06 kg, and 11,630.05 for UAE, Saudi Arabia, Bahrain, Kuwait and Oman, with The gulf countries have witnessed vast and varying a 95% confidence interval (C.I). amounts of medical waste during the pandemic since ARAB JOURNAL OF BASIC AND APPLIED SCIENCES 85 Figure 4. Observed and forecasted amount of CMW in kg/day with 95% C.I, until December 31, 2022. February 2020. This study demonstrates that in some The trend of the weekly RSV for the mentioned conditions, awareness and public interest in the issue four search query terms over the last two years in of medical waste can be associated with the generated Saudi Arabia is shown in Figure 6A. In the first week CMW quantities. The study performs a Google Trends of the pandemic in Saudi Arabia, the public interest analysis using the terms (“Medical waste” þ in the medical waste issue was moderate, with a “Facemask”þ “COVID-19 Vaccine”þ “COVID-19 testing”) popularity of 42% on 8–14 March 2020. After four as a search query and compares it with the trend of weeks, the popularity decreased to 17% on 12–18 the calculated weekly average CMW. The trends and April 2020. Afterwards, the interest rapidly increased patterns of Google search queries could be investi- and reached the highest peak with a popularity of gated through the Google Trends data (Arora et al., 100% between May 31 - June 6 in 2020. After that, 2019). Therefore, data from the start of the pandemic the interest level dropped and remained low until in each selected country until March 26, 2022, has the end of 2020. The RSV trend reveals that, from been obtained and analyzed. early 2021, there was a slight oscillation, but mostly, 86 K. AL-OMRAN ET AL. low popularity was observed till the end of this as it immediately dropped again and remained low study period, where it reached 9% on 20–26 March till lately, with the RSV of 5% on 20–26 March 2022. 2022. In Oman (Figure 6E), the first sign of popularity is The google trend in UAE does not differ signifi- detected in the small peak of the RSV trend, which cantly from that of Saudi Arabia. In the early stages is visible between March 29–April 4 in 2020, with of the pandemic in UAE, the public interest in med- RSV of 64%. After six weeks, on 17–23 May 2020, the interest level rapidly increased until it reached the ical waste was nearly moderate, with RSV of 42% on 2–8 Feb 2020 (Figure 6B). However, after two weeks, maximum with RSV of 100%. After that, it remained the interest level dropped to 22% on 16–22 Feb. fluctuated between up and down, and the trend of After that, and within the next five weeks, a rapid the interest took the shape of an open upwards curve with a slight oscillation for almost one year, growth in interest level could be seen, where RSV i.e. until 20–26 June in 2021, with RSV of 84%. peaked at 100% from March 29 to April 4. Then the Nevertheless, a drop in the interest level was trend gradually declined until the last week of this study, where RSV reached 13% on 20–26 March observed with lots of turmoil until it reached 18% on 20–26 March in 2022. 2022. In Bahrain (Figure 6C), the google trend is also It can be concluded that, at the beginning of the substantially similar to Saudi Arabia and UAE trends. pandemic, there was a high interest in the issue of It can be seen that the first sign of popularity is medical waste in Saudi Arabia, Bahrain, and the UAE. noticeable in the highest peak, which appears on 5– However, afterwards, there was a change; the inter- 11 April 2020, with RSV of 100%. A continuous est decreased significantly and remained low until reduction follows this in interest level until the the last week of the study period. The reason behind beginning of 2021; On 7–13 Feb 2021, there was a this change in interest could probably be because, in slight rise in interest level with RSV of 59%. But the beginning, the pandemic was a new emerging again, the interest level fell and remained low until situation, and most people were searching for infor- the end of the last week of the study period on 20– mation about the medical waste generated from 26 March 2022. Based on the google trend in Kuwait COVID-19. But later on, people may have learned (Figure 6D), it can be observed that when the pan- how to live and deal with the situation and its demic started in the country, the interest level was effects due to the prolonged nature of the emer- low, with RSV at 13% in the first week of March gency. While in Kuwait, the medical waste issue’s 2020. Then the trend of popularity goes almost par- popularity appeared lately, it appeared with the first allel with the average weekly CMW for more than significant increase in the weekly average CMW one year. This is followed up by growth in RSV, when it reached 6,096.686 kg on 20–26 June 2021. reaching 63% in the first peak for the two weeks Also, it can be observed that, despite the decrease from June 20 to July 3 in 2021; after four weeks, the in the amount of CMW, the interest was growing up interest level rose to the highest peak (100%) in until a certain point, but after that point, the interest the last week of July 2021. However, afterwards, the started to fall again. In contrast, the popularity in interest level fell sharply and remained low till the Oman was somewhat higher than in other countries end of the year 2021. Finally, at the beginning of but continuously fluctuated during the pandemic. 2022, it increased slightly to 22%, but it did last long It was found that awareness plays a significant role in influencing an individual’s behaviour and abil- ity to make decisions (Casali et al., 2013). For instance, there is a significant correlation between the awareness generated by the environmental crisis and the behaviour of individuals when it comes to the separation of medical waste (Chen et al., 2021). Knowing the extent of people’s interest and Figure 5. Share of the population fully vaccinated against whether there is a movement regarding the problem COVID-19 until March 26, 2022, Source: (Data, 2022b). of increasing medical waste generation in the Table 4. Summary of generated weights of medical waste during COVID-19 in GCC countries by March 26, 2022, in kg. Predicted CMW Country Name Facemask/day (till December 31, 2022) Vaccination PCR tests Saudi Arabia 674.548 240.55 1,506,684.00 (Febrauary 28, 2022) 519329.6 UAE 196.484 1179.52 597,729.60 (March 4, 2022) 1,835,432 Oman 103.090 294.05 172792.80 (March 22, 2022) 24,914.8 (March 12, 2022) Kuwait 98.378 0 193063.20 (March 24, 2022) 97,155.20 (March 12, 2022) Bahrain 35.480 1953.13 84542.40 (March 23, 2022) 118,940 (March 25, 2022) TOTAL 1107.980 3667.25 2554812.0 2,595,772 ARAB JOURNAL OF BASIC AND APPLIED SCIENCES 87 Figure 6. Trend of the weekly RSV for the search query “Medical waste”, “Facemask”, “COVID-19 Vaccine,”, “COVID-19 testing” and the calculated COVID-19 medical waste in kg per day since the pandemic started in the respective country till March 26, 2022. 88 K. AL-OMRAN ET AL. Figure 6. Continued. current abnormal situation is a key step. This is to herein. Still, there could be many other related terms draw people’s attention to this problem, especially that could be included in the search volume in Google the decision-makers, to keep all the dealing hands Trends to measure the interest in the issue of medical vigilant to cope with the situation. This work pro- waste quantities. Additionally, the search volumes and vides a platform for dealing with such an abnormal amounts of medical waste could be affected by con- generation of waste during a pandemic. founding factors (e.g. precautions measures taken in the selected countries and public attention to the medical waste due to media coverage). But this study did not 5. Challenges to the study consider these factors because the tool used does not The study analyzed Google searches only in the English cover these factors. Furthermore, Searching on the inter- language; therefore, the study’s results have limited gen- net for information related to medical waste terms eralizability. Moreover, the study was unable to include through Google could be a measure of interest in the any specific search volume data about gender, age or issue of medical waste quantities, or it may be for occupation in the analysis because Google Trends does another purpose, such as for consuming PPE. not offer information on user demographics. The study could not focus on investigating the interest for man- 6. Conclusion agerial positions in environmental agencies like policy- makers. The study is focused on only four terms related The COVID-19 pandemic generates enormous quanti- to medical waste during COVID-19 being calculated ties of medical waste. Therefore, this study calculated ARAB JOURNAL OF BASIC AND APPLIED SCIENCES 89 the amount of solid medical waste generated from ORCID different sources til March 26, 2022. For instance, the Ezzat Khan http://orcid.org/0000-0001-7849-6083 waste generated from the facemask used by the public in the selected GCC countries is References 1,107.980 kg/day, the vaccination is 2,554,812 kg, and from PCR test is 2,595,772 kg. Besides, the study pre- Al-Omran, K., Khan, E., Ali, N., & Bilal, M. (2021). Estimation of COVID-19 generated medical waste in the Kingdom dicted daily CMW till the beginning of next year of Bahrain. The Science of the Total Environment, 801, (December 31, 2022) to be 3,667.25 kg/day. Moreover, it investigated the public interest in med- Arabia, G. o S. (2021). Testing for COVID-19. Retrieved from ical waste using the tool Google Trend. The purpose https://www.my.gov.sa/wps/portal/snp/servicesDirectory/ of this tool was to measure how frequently the med- servicedetails/s9142 Arora, V. S., McKee, M., & Stuckler, D. (2019). 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Arab Journal of Basic and Applied Sciences – Taylor & Francis
Published: Dec 31, 2023
Keywords: Forecasting analysis; Google trend analysis; medical waste; plastic personal protective equipment; sustainable management; waste generation in Gulf countries
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