key: cord-0806241-v444kz92 authors: Klemeš, Jiří Jaromír; Van Fan, Yee; Jiang, Peng title: The Energy and Environmental Footprints of COVID-19 Fighting Measures – PPE, Disinfection, Supply Chains date: 2020-08-27 journal: Energy (Oxf) DOI: 10.1016/j.energy.2020.118701 sha: 7ebc1706bde16f49fd915f94d1431c351d10d097 doc_id: 806241 cord_uid: v444kz92 The still escalating COVID-19 pandemic also has a substantial impact on energy structure, requirements and related emissions. The consumption is unavoidable and receives a lower priority in the critical situation. However, as the pandemic continues, the impacts on energy and environment should be assessed and possibly reduced. This study aims to provide an overview of invested energy sources and environmental footprints in fighting the COVID-19. The required energy and resources consumption of Personal Protection Equipment (PPE) and testing kits have been discussed. The protecting efficiency returned on environmental footprint invested for masks has been further explored. The main observation pinpointed is that with a proper design standard, material selection and user guideline, reusable PPE could be an effective option with lower energy consumption/environmental footprint. Additional escalated energy consumption for aseptic and disinfection has been assessed. This includes the energy stemming from emergency and later managed supply chains. The outcomes emphasised that diversifying solutions to achieve the needed objective is a vital strategy to improve the susceptibility and provide higher flexibility in minimising the environmental footprints. However, more comprehensive research proof for the alternative solution (e.g. reusable option) towards low energy consumption without compromise on the effectiveness should be offered and advocated. The world population has been facing an unprecedented challenge, which has not been experienced from the time of Spanish flu [1] after the First World War. which was seen as another SARS epidemic at the beginning, escalated into worldwide pandemics. When this communication was finalised (19 August 2020) , the number of infected was reaching 23 M [2] infected with no sign of halting. Table 1 summarises the different characteristics of epidemic and pandemic diseases. The information related to COVID-19 is still subjected to changes, including the reproduction number. The rapid spreading of this novel virus stresses the healthcare system and capacity, causing around 800 k lost lives [2] as the insufficient understanding of the mutating virus hinders the effective measures to be taken at the earliest instant. The sudden outbreak induces insufficient supply in term of manpower, raw materials/resources, production rate and disruption in supply chain/logistics to fulfil the surging demand. Flattening the curve [3] has been promoted to slow down the infection rate allowing healthcare services to have better management. A series of protective measures are introduced in the effort to suppress the outbreak. COVID-19 is expected to result in behaviour and structural changes, including the impacts on the economic, environmental and energy sustainability. The effect to the economic [4] is generally apparent; however, the impacts on the energy consumption and consequently, environmental footprint [5] are yet to be fully understood. The fatality rate is the ratio of deaths to the total of diagnosed. b R o can vary according to factors such as geography, population demographics and density, where the overall number for COVID-19 is still subjected to variations. a [6] b [7] c [8] d [9] e [10] f [11] During the earlier stage of the crisis, lockdown or movement restriction at different stringency has been implemented. The implementation has been directly contributed to the cleaner environment due to the temporary limitation in mobility and the reduction of industrial activities. For example, Le Quéré et al. [12] shows the reduction in daily global CO 2 emission. Kanniah et al. [13] reported the reduction of PM, NO x , SO 2 and CO in Malaysia. Cleaner sky and cleaner river have also been the headline of different news outlets. Similar positive results to the air pollution are observed in Brazil [14] , India [15] , Italy [16] and China [17] but with an increased in O 3 due to the reduction in NO x . Adams [18] , however, suggested that J o u r n a l P r e -p r o o f there is a reduction in O 3 and NO X during the state of emergency in Ontario, Canada. Almond et al. [19] stated that a relative deterioration in air quality near the epicentre of pandemic (Hubei) is observed, concluding that the impact on pollution is ambiguous. Wang et al. [20] highlighted that the emission reduction in transportation and a slight reduction in industrial would not help avoid severe air pollution, especially when meteorology is not favourable. This suggests the crucial role of energy sectors to the environment. The longrunning impacts and the indirect impacts are still to be assessed for an overall picture of environmental sustainability. The lockdown, which directly impacts the cleaner air, is just a temporary measure. Many countries have started to lift the restriction to support the growth of the economy as soon as considered acceptable. Gilingham et al. [21] stated that the implication of COVID-19 in the long term is deeply uncertain and could be outweighed the short term "silver lining" environmental benefit. During the peak of the crisis, the environmental considerations were understandably side-lined. However, as the pandemics seem to be around for some time yet, the humankind should be fully aware that the environment needs to be kept hand in hand in this long-running battle. The presented study aims to provide an overview of the extra energy consumption that potentially increases the environmental footprint during the COVID-19 crisis. The focus is given to the activities to support the healthcare system, including the hospital consumptions to the public. One of the essential and frequently used PPE, masks, is assessed where the filter efficiency returned on environmental footprint invested is discussed. Although environmental protection could not be the priority in the most critical moment, it is still important to recognise the problem. The additional production (e.g. PPE, test kits, disinfectants) and resultant waste to be handled later as well as the supply chain/logistic issues should be alerted. The issues summarised in this study could serve as a starting point to discuss and optimise possible pathways/solutions with lower energy consumption and environmental impacts in facing a similar future crisis. The [32] . A part of the energy can be recovered, and the footprint can be mitigated if being treated appropriately. This aftermath of COVID-19, in consumption and waste management, has been still developing and is yet to be evaluated and dealt with as it is not a direct impact which could be quantified in a short run. Notes: a [33] , b [34] -in the case of shield the demand for googles are applied, c [35] , d Based on the estimation by the authors, e [2] , f [36] , g [37] 3 Masks have been an essential PPE in this crisis. It is not privileged to use masks in hospital but common/mandatory in current daily mobility. There was a serious shortage in the supply where the demand cannot be fulfilled in a short time. This highlights the importance of diversifying to minimise dependency or threats. Figure 2 summarises the selection criteria of masks and the source of environmental footprint. The approaches of washing or disinfection, times of usage and the end-of-life treatment could change the overall environmental footprint significantly. This aspect is discussed later based on Figure 3 . The main selection criterion for a mask is the protection efficiency (i.e. filtration efficiency), which is usually reported by quantitative percentage numbers. However, a high percentage does not necessarily suggest high protection from infection where the assessed size for filtration efficiency and experimental settings needs to be referred. The penetrating particle size, which is usually applied in the certification test of a mask is 300 nm (COVID-19 < 300 nm, see Table 1 ). proper usage play the key role in promoting reliability. Cloth material with combined effects of electrostatic and physical filtering by layering can enhance the filtration efficiency [38] . There has different contradiction observation on top of the reported filtration efficiency J o u r n a l P r e -p r o o f summarised in Table 3 . Smith et al. [39] summarised that there are insufficient data to conclusively suggest N95 masks are superior to surgical masks in the clinical setting, although the results for laboratory setting is positive. Lee et al. [40] suggested that filtering facepiece (FFP) respirators provide 11.5 -15.9 times better protection than surgical masks. Long et al. [41] concluded that the use of N95 is not associated with a lower risk of laboratoryconfirmed influenza compared to surgical masks. This highlights that more studies are needed to achieve a consensus regarding the efficiency of masks (including reusable mask, e.g. cloth) as well as improving the standard guideline for production and usage. Despite the initial confusing information on the use of masks in mitigating COVID-19, WHO has recently recommended the usage of three layers fabric masks for healthy people and provided the information on the filtration efficiency [42] . -- Figure 3 illustrates the environmental performance related to different choices of masks. Without the consideration of transportation, the reported embodied GHG of N95 is 0.05 kg CO 2 eq/single-use [33] , for which the main contributor is the Polypropylene (PP) materials. Allison et al. [35] reported that, based on an assessment in the UK, the high share of GHG emission embodied in surgical masks is from transportation. By considering the GHG emission of producing the masks, cloth masks have the highest emission at 0.06 kg CO 2 eq/pcs [33] or 6.92 kg CO 2 eq/pcs [35] when washing is considered. It shows the high share of GHG emission from the cleaning of masks. However, waste products can be mask. The estimation is based on the information in Figure 3 and Table 3 . showed that the sales of hand sanitiser spiked by 2,315 % on the Suning e-commerce platform during the COVID-19 pandemic compared to the same period in 2019 [46] . Similar sale surge with more than 1,000 % elevation was observed on the Taobao e-commerce platform in China [46] . In Japan, the Kao company increased the production of alcohol disinfectants by 2,000 % in April 2020 to fight the shortage [47] . The increased demand and supply of antiseptics and disinfectants were also apparent in the EU and the USA. For example, in March 2020, sales of multipurpose cleaners in the USA spiked by 166 % and aerosol disinfectants 343 % from a year ago, which disrupted the supply chains of disinfectants [48] . Due to the disease pandemic, a total of 1,963.58 t of disinfectants were used in sewage systems in Wuhan, China from 29 January to 18 February 2020 [49] . The overuse of antiseptics and disinfectants with corrosive chemical compounds for the COVID-19 control could not only pose great threat to the urban environment [50] and ecosystems [51] but also lead to massive energy waste. Energy consumption and environmental footprint are regarded as important criteria for disinfection technologies [52] . For effective disinfection of SARS-CoV-2, the conventional surface disinfectants were recommended to contain 62 -71 % ethanol or 0.1 % sodium hypochlorite [53] . Compared to non-alcoholic products, alcoholic sanitisation products are chosen as a first-line measure for infection prevention due to their high efficacy and broader spectrum [54] . America are three regions having the largest share of the global market size. Table 4 shows the historical and estimated data of the disinfection industry in China [56] . The growth rate of the market size in China, i.e. 13.7 %, as shown in Table 4 [59] . Microwave sterilisation is essentially a type pf steam disinfection process. Compared to liquid disinfection, the steam spray was regarded as more environmentally friendly disinfection benefitting from a series of J o u r n a l P r e -p r o o f merits, e.g. without chemicals and their residuals, water-saving and wide coverage where manual cleaning is not possible. Table 5 shows the comparison of cost, water use and electricity use between the chemical method and the steam method. Except for the electricity use, the steam method has advantages on the other items. During disease pandemic, the steam can be used for the disinfection of partial medical waste that do not generate toxic volatile organic compounds [52] , PPE like N95 masks [60] and public area [61] , e.g. workplace, supermarkets and public transport. The lasting impacts of the disease pandemic on energy efficiency, energy access, energy transition and renewable energy deployment remain to be investigated [65] . The ii) The expected statistics after the disease pandemic. Decision-makers face considerable challenges to keep progress to the original plans made before the disease pandemic, e.g. the Sustainable Development Goals (SDGs) targets by 2030 [66] . Along with challenges, unprecedented opportunities and motivations, e.g. the global collaboration, the regional synergy and the R&D of low-risk non-toxic disinfectants, have existed in the energy and environment sector. Liu et al. [67] • Develop a more resilient supply chain and consider the environmental footprint as much as possible. The resilience of supply chains of PPE and disinfectants needs to be strengthened to confront disruptions prompted by a disease outbreak. For a comparatively recently broken crisis without enough data available, the popular data-driven supply chain management even supported by advanced machine-learning techniques could present a high risk for adequate planning and timely supply. In such a situation, the fusion of expert knowledge may assist in promoting a more resilient supply chain. Golan et al. [69] highlighted that the common goal of supply chain modelling is to optimise efficiency and cost; however, trade-offs of efficiency and resilience is not fully addressed. Remko [70] stated that the COVID-19 crisis shows a lack of preparedness, shortcomings of current response plans. More study is required to minimise the potential risk with adequate concern on environmental performance through minimising energy consumption. Optimal allocation under resources J o u r n a l P r e -p r o o f constraints as performed by Sy et al. [71] is also important to support the emergency decision making. Diversification provides a lower risk of supply disruption and higher flexibility. The wider selection could offer the solution with lower life cycle energy consumptions as possible, even facing the life-threatening crisis. For example, bio-based PPE, e.g. mask [72] , utilising 3D printing [73] and reusable device, e.g. bronchoscopes, [74] . Liao et al. [59] assessed the different disinfection treatment for N95, including dry • Assess the burdening footprint of reusing (e.g. washing, sterilisation) Although reusable PPE or devices reduce the amount of waste, to fully understand the life cycle energy consumptions and environmental sustainability, assessment is a need. A comprehensive assessment framework and quantification method need further development. This is especially the assumption in the number of uses and the approaches of washing/sterilisation/decontamination, which are responsible for up to 90 % GHG emissions [75] . Biobased [76] and reusable PPE or devices did not necessarily offer a lower environmental impact. The circumstances/limit where the environmental benefit is no longer valid need to be clearly established. The urge for sustainable practices and reduce the energy consumption of hospital building has been an on-going study [77] . The issues become even apparent with the incident of COVID-19 where the hospital is playing the key role in protecting human health and life. Lights (36 %) and biomedical equipment (34 %) are the main electrical consumption pathways in a hospital [78] . Buonomano et al. [79] suggested that the adoption of thermostatic valves and Air Handling Unit control system could contribute to high energy savings. Waste heat recovery could also be an option toward sustainability [80] . Research in minimising the energy usage of hospital J o u r n a l P r e -p r o o f building should be encouraged. Wang et al. [81] stated that economic incentives and regulation enforcement are important in encouraging the full participation and support of hospital stakeholders. • Improve the waste sorting and enhance the technology development in handling medical waste sustainably There have been studies (e.g. Runcie et al., [82] ) suggested that the clinical and nonclinical waste is not adequately disposed of due to the lack of waste sorting awareness. Better and detailed sorting could increase the availability of different recycling and treatment options. This is especially important as it is understood that a single disposal device or equipment cannot be completely replaced. Sorting could ensure regular waste in the hospital, especially plastic waste, to be recovered as energy sources to minimise the environmental footprints. Different treatments of medical waste have been discussed by Fang et al. [83] , where incineration is seen as the most technically and economically feasible. However, it releases emission and toxic metals. Fang et al. [83] proposed the optimised pyrolysis for mixed medical waste. However, the economic feasibility is yet to be assessed. More options, especially the mobilised equipment and treatment with minimum needs of human operation, are worth for exploration. • Improve the response of waste management systems under a change in This issue has been recently discussed in Klemeš et al. [36] , which appeals to focus on topics related to disaster waste management, especially the optimisation of disaster waste management planning on the regional scale. Epidemic and pandemic crisis, e.g. COVID-19, is regretfully not likely to be isolated case. The to-date approximate estimations based on reported data of variable accuracy on the additional energy consumption or environmental footprint increase owning to COVID-19 can be assessed as: • The energy consumption due to hospitalisation = ~356 PJ (22.2 M cases, 34 % hospitalisation) • The energy consumption in plastic production of 390 M test kits (only the fast tests considered, with more rigorous the numbers will increase) = ~168 TJ • The energy consumption of shield production to fulfil the forecasted demand = 3.9 TJ/month J o u r n a l P r e -p r o o f • The energy consumption of masks production to fulfil the forecasted demand = 4.6 PJ/month • The energy consumption of gloves production to fulfil the forecasted demand = 7.0 TJ/month • The energy consumption used for ethanol production related to disinfectants in 2020 (with an extra 12.3 % growth rate in demand) = ~181 PJ • The GHG footprints of N95 and surgical masks are suggested as ~ 5 ×10 -2 -6×10 -2 kg CO 2 eq/single use. The cloth mask is having a GHG footprint of ~ 6×10 -2 kg CO 2 eq/pcs; however, by considering the usage (with washing stages) is 0.036 kg CO 2 eq/usage. • The invested carbon emissions per filter efficiency returned of the surgical mask (80 %), and emissions of cloth mask (50 %) are ~ 7.4x10 -3 kg CO 2 eq/filter efficiency and ~ 7.2x10 -3 kg CO 2 eq/filter efficiency. • The emergency transportation could increase the energy consumption by 17.1 times (e.g. plane instead of a ship) in reducing the delay of transporting the lifesaving resources. The COVID-19 pandemic has been still widely acting in the world. Its actual consequences could be fully understood after the disease pandemic only. The results in this present study serve as an initial step, summarising some references for a better assessment in the future. The effect of COVID-19 on global energy consumption can be estimated based on different penetration rates in future years. It should be noted that there are significant assumptions in estimating the resulting energy consumption and GHG emission, as stated in this manuscript. The value of this study is mainly to highlight the issues rather than pursuing accurate quantification. The quantitative data quoted in this paper should be used with caution, especially when there exist many uncertainties in the current phase. The overview and insight offered in this study, which, based on the burdening impacts of COVID-19 arises from additional demand for energy and resources, serve as a direction for corrective measures. Reusable PPE are highlighted as an option with lower energy consumption; however, a proper design standard, material selection and user guideline are needed to ensure its effectiveness. The environmentally friendly alternatives in combating infectious disease apparently have to be developed systematically, and there is an urgent need for more research. Diversifying solution is a vital strategy to improve the susceptibility to an unexpected event. It provides flexibility in optimising energy consumption and environmental footprint. If well taken, the lesson could prepare humankind more ready in preventing, containing and mitigating future infectiousness diseases without huge compromise on environmental sustainability. During the crises, the additional energy consumed were mainly J o u r n a l P r e -p r o o f offset by reductions caused by the decrease of production, travel and social activities. Although COVID-19 offers temporary environmental benefit and reduction of energy demand in some of the non-essential sectors/services during the lockdown, the impact on the structural and behavioural changes should not be underestimated. The society is now facing a period when the recovery is strongly economically supported; however, pandemic fighting measures should be still in place. A proper restructure on various existing systems, e.g. production, energy, supply chain, waste management, in new norms during and after COVID-19 is required. Influenza: are we ready? accessed 27 Coronavirus cases Flattening the curve for incarcerated populations-Covid-19 in jails and prisons What will be the economic impact of COVID-19 in the US? Rough estimates of disease scenarios (No. w26867) A review of footprint analysis tools for monitoring impacts on sustainability Resilient and agile engineering solutions to address societal challenges such as coronavirus pandemic One key figure helps countries decide when their coronavirus outbreaks are over-but scientists say it's a moving target Size distribution analysis of influenza virus particles using size exclusion chromatography Crystal structure of the severe acute respiratory syndrome (SARS) coronavirus nucleocapsid protein dimerization domain reveals evolutionary linkage between corona-and arteriviridae Middle East Respiratory Syndrome Coronavirus Ebola Virus. accessed 26 Electrical and thermal energy in private hospitals: Consumption indicators focused on healthcare activity Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) -United States Environmental impacts of takeaway food containers From mitigation to containment of the COVID-19 pandemic: putting the SARS-CoV-2 genie back in the bottle Coronavirus testing basics. accessed 26 Global Shortage of Personal Protective Equipment amid COVID-19: Supply Chains, Bottlenecks, and Policy Implication accessed 26 Plastics: Friends or Foes? The rise of the face mask: What's the environmental impact of 17 million N95 masks? accessed 26 COVID-19 pandemic repercussions on the use and management of plastics The environmental dangers of employing single-use face masks as part of a COVID-19 exit strategy Minimising the present and future plastic waste, energy and environmental footprints related to COVID-19 Case study -glove manufacturing. accessed 26 Aerosol filtration efficiency of common fabrics used in respiratory cloth masks Effectiveness of N95 respirators versus surgical masks in protecting health care workers from acute respiratory infection: a systematic review and metaanalysis Particle size-selective assessment of protection of European standard FFP respirators and surgical masks against particles-tested with human subjects Effectiveness of N95 respirators versus surgical masks against influenza: a systematic review and meta-analysis Advice on the use of masks in the context of COVID-19. Interim Guidance 5 Testing the efficacy of homemade masks: would they protect in an influenza pandemic Can masks capture coronavirus particles? -SmartAir Ministry of Industry and Information Technology: The operating rate of disinfection products is gradually increasing, and the supply can meet the demand The Hand Sanitizer Market in China -Demand after COVID-19. Looking for Lysol spray and Clorox wipes? COVID-19 wiped out disinfectants, but here's when you can buy again Xinhua net, 2020. Nearly Massive use of disinfectants against COVID-19 poses potential risks to urban wildlife Disinfection threatens aquatic ecosystems Disinfection technology of hospital wastes and wastewater: Suggestions for disinfection strategy during coronavirus Disease Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents Hand sanitisers amid CoViD-19: A critical review of alcohol-based products on the market and formulation approaches to respond to increasing demand COVID-19 impact and recovery analysis-Global Surface Disinfectants Market 2020-2024 FIRI, 2020. Research report of the disinfection industry in China 2020. Forward Industry Research Institute (FIRI) Ethanol fuel production in top countries 2019. Karcher accessed 28 Steam Tables. Steam biocleaning: The hygienic solution for healthcare establishments World Bank, 2020. Tracking SDG 7: The Energy Progress Report 2020 COVID-19 intensifies the urgency to expand sustainable energy solutions worldwide. Revisiting Chian's provincial energy efficiency and its influencing factors Trends and applications of resilience analytics in supply chain modeling: systematic literature review in the context of the COVID-19 pandemic Research opportunities for a more resilient post-COVID-19 supply chain-closing the gap between research findings and industry practice Process integration for emerging challenges: optimal allocation of antivirals under resource constraints The need for fully bio-based facemasks to counter coronavirus outbreaks: A perspective COVID-19 and the role of 3D printing in medicine Cost Comparison of Single-Use Versus Reusable Bronchoscopes Used for Environmental impact of disposable vs reusable instruments accessed 27 Life cycle assessment of bio-based and fossilbased plastic: A review Life cycle environmental emissions and health damages from the Canadian healthcare system: an economic-environmental-epidemiological analysis An end-use energy analysis in a Malaysian public hospital Dynamic energy performance analysis: Case study for energy efficiency retrofits of hospital buildings Production of waste energy and heat in hospital facilities Building energy efficiency for public hospitals and healthcare facilities in China: Barriers and drivers Sort your waste! An audit on the use of clinical waste bins and its implications Study on pyrolysis products characteristics of medical waste and fractional condensation of the pyrolysis oil The authors gratefully acknowledge financial support from the EU project Sustainable