Guotai Junan: Is the medical waste treatment capacity in the epidemic area sufficient?
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Is the medical waste disposal capability of the play epidemic area sufficient?
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Is the medical waste treatment capacity in the epidemic area sufficient?
Guojun’s environmental protection source: Guotai Junan Securities’ research on “burning eyebrows” is the word used by Zhao Weijun to describe the emergency repair of medical waste incineration facilities in 2003.
During the SARS period, Zhao Weijun served as the director of the Solid Division of the State Environmental Protection Administration’s Pollution Control Department, so he witnessed a surge in medical diseases every day when the epidemic broke out, as well as China’s centralized paralyzed medical waste treatment capacity at the time.
There are a large number of harmful substances in medical waste, including infectious viruses, germs, chemical impurities, scattered impurities, etc., which have very serious hazards, including extremely infectious and highly polluting.
For example, the positive rate of hepatitis B surface antigen is 7 in concentrated samples.
4%, while the positive rate in medical waste is close to 9.
Related research also shows that cross-infection caused by medical waste accounts for more than 20% of the total cross-infection rate.
Medical waste can easily become a source of epidemic disease. If it is not properly managed or handled improperly, it will easily lead to medical waste pollution accidents and cause major damage to the personal safety of the surrounding residents and local economic development.
In the National Hazardous Waste Inventory, health care is also listed as “No. 1 Hazardous Waste Medical (HW01)”.
▼ In the “National Hazardous Waste List”, medical waste is listed as “No. 1 Hazardous Waste (HW01)” Data Source: “National Hazardous Waste List”, Guotai Junan Securities Research Spring 2003, the race against time for medical wasteIt has become a watershed in the management of hypertension.
And 17 years later, the second act of the battle began again.
Guotai Junan’s environmental protection team recently released a research report “Outbreak promotes domestic medical waste disposal demand rapid volume-full scan of the domestic medical waste industry”, analyzes the past and present life of the medical waste treatment field, and points out-if SARS leads to the emergence of the Chinese medical waste industryExplosive growth, then the epidemic is likely to catalyze the industry into a period of rapid development again.
01The “medical waste treatment” that once burned eyebrows returned to the extraordinary period of 2003. While constructing medical waste incineration equipment, various regulations and plans for medical waste control were gradually introduced.
In June 2003, the “Regulations on the Management of Medical Wastes” were promulgated; in August, various departments formulated the “Regulations on Emergency Response to Health Emergencies”, “Control Standards for Pollution Control of Hazardous Waste Storage”, “Administrative Intervention Measures for Medical Waste Management”, “Medical HealthSupporting regulations such as the Measures for the Management of Medical Waste in Institutions; In October, the Catalogue of Medical Waste Classification was released; In December, the Technical Specifications for Centralized Disposal of Medical Wastes was issued; In December, the State Council approved the implementation of the National Hazardous Waste and Medical Waste Disposal Facilities”Planning”, the construction of medical waste disposal facilities has been stepped up in various places.
The implementation of the Administrative Penalty Law for Medical Waste Management in June 2004 violated the regulations on medical waste management.
It can be said that the policies and plans issued in that year were more than the total of the previous ten years of the development history of medical waste treatment in China.
The role of the epidemic in promoting this industry is evident.
After years of construction, the current overall medical waste disposal system has been relatively complete-as of 2018, 200 large, mid-city medical wastes have generated 81.
In July, the disposal volume was 81.
6. The rate of medical waste disposal in major large and medium cities nationwide is 99.
9%, basically all have been properly disposed of.
▼ National large and medium-sized cities ‘medical waste generation volume (units) in 2018, 200 cities’ urban waste 82 indicator data source: “2014-2019 National Large and Medium-sized Urban Solid Waste Pollution Environment Prevention Annual Report”, Guotai Junan Securities Research Note: Published over the yearsThe number of cities with different information 武汉夜网论坛 is different. 02 Under the epidemic situation, the pressure of medical waste treatment in Hubei is still underway, and the new crown epidemic that suddenly broke out in 2020 is facing a severe test of the limit of medical waste treatment capacity.
Take Wuhan, Huanggang and Xiaogan, the three cities with the most severe epidemics as an example. At present, each of the three cities has a medical waste disposal center with a disposal capacity of 50/10/5 tons / day, which is near full-load operation.
1) Wuhan: 2018 annual output of medical waste in Wuhan1.
7, the city’s only medical waste disposal center-annual disposal capacity1.
8 Wuhan Hanshi Environmental Engineering Co., Ltd. carried out incineration disposal.
2) Huanggang: In 2018, Huanggang City’s key medical and health institutions and the medical waste generated by it were 3,040 tons, all of which were handed over to Huanggang Longzhong Environmental Protection Co., Ltd. for centralized collection and disposal.
3) Xiaogan: In 2018, there were 357 medical waste generating units in Xiaogan City, with an annual volume of 1439.
29 tons, of which the comprehensive utilization / disposal of medical waste is 1432.
58 tons with a storage capacity of 3.
With a capacity of 44 tons, Xiaogan Central’s environmental medical waste disposal capacity is 1,825 tons / year, which is close to full production.
▼ Wuhan, Huanggang, Xiaogan Medical waste disposal institutions Data source: Hubei Provincial Department of Ecology and Environment, Guotai Junan Securities Research We do a simple arithmetic problem.
As of February 12, 30,000, 2616, and 2177 people were diagnosed in Wuhan, Xiaogan, and Huanggang, respectively.It is conservatively estimated that each inpatient diagnosed produces 1kg of medical waste per person per day, Wuhan, Xiaogan, and Huanggang will currently supplement 3/2 daily.
2 tons of medical waste.
Coupled with the large number of outpatient cases of suspected cases, the demand for medical waste disposal in the severely affected cities will increase significantly.
Although the newly built Vulcan Mountain Hospital is equipped with a medical waste incinerator with a daily disposal capacity of 4 tons, which will meet the medical waste treatment needs of nearly 3,000 patient beds, Hubei urban areas want to incinerate and treat the local pneumonia medical waste.There is a lot of pressure.
03 Medical waste treatment science guide So what are the specific tools for treating medical waste?
The current medical waste treatment technologies mainly include: incineration, high-temperature steam sterilization, chemical disinfection, microwave disinfection, safe landfill, isoelectric methods, pyrolysis gasification, and so on.
# Incineration: It is a thorough medical waste treatment method. High temperature conditions completely destroy harmful substances and germs in medical waste, and eventually convert them into gases and residues, allowing the emissions to be harmlessly treated; suitable for all types of medical treatment.Waste, but if the discharge is not handled properly, it is easy to cause secondary pollution.
# High-temperature steam sterilization: The United Nations Basel Convention is listed as the preferred technology for the treatment of medical residues. The latent heat released by the high-temperature steam in the cold will be used to solidify and eliminate pathogenic microorganisms and bacterial proteins to achieve the sterilization effect. Further landfill orIncineration; suitable for disinfection of infectious and damaging waste, not for the disposal of pathological waste, pharmaceutical waste and chemical waste.
# Chemical disinfection: Add a certain concentration of chemical disinfectant to the broken medical waste to decompose the organic matter and inactivate the bacteria; it is suitable for the treatment of pathological waste and liquid medical waste.
#Microwave sterilization: Pre-crushed and transformed waste is excited by microwave to generate and release steam, killing most microorganisms.
It can be used for both on-site treatment and waste transfer.
# Safe landfill: It is a kind of final disposal method for medical waste. The process is simple. Medical waste must be disinfected before landfilling, which can realize large-scale disposal.
# Plasma treatment: Use air or nitrogen as a carrier gas, pass in an electric current to ionize it, form an arc, convert the organic matter in the waste into a flammable gas, and then undergo secondary combustion to decompose all infectious substances.Completely eliminate pathogenic bacteria and various microorganisms, and can treat any form of medical waste.
# Pyrolysis / gasification: High-temperature oxidation of medical waste under oxygen-deficient conditions converts organic matter into flammable gases and eventually generates coke.
▼ The main technical data source for medical waste disposal: “Domestic Medical Waste Disposal Technology and Current Status”, and currently, gradually, incineration and high-temperature steam treatment are the most important medical waste treatment technology routes.
▼ Data source of domestic medical waste disposal status: “Technology and Current Status of Domestic Medical Waste Disposal”, Guotai Junan Securities Research Note: According to the statistics of disposal technology institutes adopted by national medical waste disposal enterprises in 2013, January 28, 2020, the first place of the Ministry of Ecology and EnvironmentTime has set a standard for the emergency disposal of medical waste in the pneumonia epidemic.
It was pointed out that as the medical waste generated by patients with pneumonitis infected by the new coronavirus is infectious, the safest and most reliable method is high-temperature burning treatment (temperature ≥850 ° C), followed by non-incineration treatment and high-temperature steam disinfection., Microwave disinfection, chemical disinfection, etc.
04 The market for medical waste and non-waste can be expected according to the statistics of the World Health Organization. The resulting medical diagnosis yields about 0.
5kg / bed / day, while the scale or area unit medical waste production is higher, about 0.
5kg / bed / day.
We can simply measure the amount of medical waste generated there-using the National Health and Family Planning Commission’s data on the number of continuous hospitalizations and outpatients each year, the conservative assumptions are: 1) the average hospitalization day is 9 days; 2) the medical waste discharge coefficient isThe average amount of medical waste generated was 0.
5kg / person / day ② The average amount of medical waste generated in the outpatient clinic is 0.
05kg / person.
* Refer to “Selection of Statistical Statistics of Medical Waste Emissions and Determination of Emission Coefficients”, “The First National Manual of Pollution Sources of Urban Pollution Emission Coefficients of Urban Living Sources, Fourth Volume”, “Solutions on Medical Hypertension Management in Hospital Outpatient Departments”According to calculations from literature analysis on the design of medical waste disposal center, etc., the number of medical waste generated in the country in 2018 was 168, and the compound growth rate from 2014 to 2018 was nearly 5%.
▼ 2014-2018 National Inpatient and Outpatient Numbers and Growth Rate Source: Wind, National Health and Family Planning Commission, Guotai Junan Securities Research ▼ We estimate that the current annual production of conventional medical waste is more than 150. Source: Wind, National Health and Planning CommissionIn terms of disposal capacity, Guotai Junan Securities has researched and submitted 407 hazardous waste business licenses for the disposal of medical waste by provinces (autonomous regions and municipalities) across the country as of 2018, of which 383 are separate medical waste facilities and 24 are simultaneouslyDisposal of hazardous and medical waste facilities.
▼ 2014-2018 annual statutory submission of medical waste permits (copy) Data source: “National Large and Medium-sized Urban Solid Waste Pollution Environment Prevention Annual Report”, Guotai Junan Securities Research ▼ and growth data source: “National Large and Medium CitiesAnnual Report of Environmental Report on Solid Waste Pollution, Guotai Junan Securities Research Note: The number of cities that have released information has changed over the years. Therefore, there is still a gap in the interaction between the amount of medical waste generated and disposal capacity, and in the future, in order to respond to the sudden outbreak of statuesIn the same sudden situation, the planning of disposal capacity must be advanced, so the industry’s prospects are still huge.
From the perspective of market participants, the listed companies that currently have medical waste projects mainly include Dongjiang Environmental Protection, Runbang, High Energy Environment, Xuelang Environment, Wanbangda, Qidi Environment, Veolia, etc., with a total disposal capacity of 11 years / year or more.
According to our incomplete statistics, there are 6 Dongjiang environmental protection medical waste disposal projects, totaling 2.
2 years / year; 7 runbang medical waste items, totaling 2.
7 digits / year; 2 high-energy environmental medical waste items, totaling 0.
5 digits / year; 2 Veolia medical waste items, totaling 4.
4 digits / year; Enlightenment Environment, Xuelang Environment, and Wanbangda Medical Waste Production Capacity scale are 0.
June / year.
▼ Reorganization of medical waste disposal projects related to listed companies Data source: Provincial Environmental Protection Department, Guotai Junan Securities Research 05 Business model of the medical waste industry Last question, the business models of medical waste treatment and general solid waste treatment may not be the same, then the relevant companiesHow did you realize your income?
In accordance with the charging standards stipulated in laws and regulations, medical waste disposal units will adopt medical waste disposal fees for medical waste generating waste units.
At present, there is no unified national medical waste disposal charging regulations. There are two types of charging modes in each place, including charging based on actual weight, charging based on beds, and charging based on whether beds are fixed. # The weight of medical waste to be disposed of according to the actual commission: The formula is: disposal cost (yuan) = weight of medical waste (kg) × charging standard (yuan / kg).
You can choose the monthly settlement or quarterly settlement method according to the actual situation, such as Beijing, Tianjin and other cities.
#According to the number of beds owned by the producer of medical waste: The formula is: the daily disposal cost (yuan / day) = bed value (bed) × charge standard (yuan / bed / day).
The calculation methods of actual beds are different, and there are mainly several categories: 1) the number of fixed beds multiplied by the utilization rate of beds, 2) the number of actual beds used, 3) the average number of beds used by the medical institution in the previous year, etc.Chongqing and other cities.
#Categorized expenses according to whether beds are fixed: Medical institutions are divided into medical institutions with fixed beds and medical institutions without fixed beds.
1) Medical institutions with fixed beds are charged on the basis of beds.
2) Medical institutions without fixed beds pay a fixed monthly fee based on the nature and grade of the medical institution, the number of patients visited, the turnover, the business area, and the number of people, such as Shanghai, Shenzhen and other cities.
In terms of charging standards, the standards vary from place to place. According to the statistics of medical waste charging standards in 55 cities, it is summarized that fees for beds are charged from 1.
8 yuan / bed / day; fees based on weight, ranging from 2-5 yuan / kg; fees based on the number of visits, from 0.
12 yuan / person.
06 Medical Waste Disposal The invisible battlefield of this epidemic On February 6, the West China Metropolis Daily video reported the entire process of medical waste disposal, making it the “invisible front-line battlefield.”
More than 10 front-line workers in the largest medical waste disposal center in Southwest China, Chengdu Medical Waste Disposal Center, are placed in various hospitals every day for disposal after recycling.
Dedicated personnel, equipment dedicated, incineration without crushing.
Because of the shortage of epidemic prevention supplies, workers wore protective clothing at work in the morning and took off until 6 or 7 o’clock. They could not eat or drink in the middle.