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Long COVID: my work with sufferers reveals that western medicine has reached a crisis point

Western medicine has always split the mind and the body. Long COVID reveals just how damaging this approach has been.

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Jan Huber/Unsplash, FAL

As I walked her up the flight of stairs to my clinic room, Victoria* barely engaged with my small talk. I glanced back at her. Above her mask, she looked strained, miserable, and I saw that her reticence was because she was ready to burst into tears. I thought one more question might have tipped her over the edge, so we continued in silence until we reached the sanctuary of the outpatient room.

The tears were not long in coming. She told me that early in the pandemic, before COVID testing was widely available, she’d had what was assumed to be a mild case of the illness. Her doctor advised her to stay at home, which was the standard advice to everyone at that early stage of the pandemic. For the next few days, she lay in bed. A week passed, then two, and then steadily the weeks turned to months.

“I had long COVID before it had a name,” she told me. Yet even after it had a name, even after she had been assessed, X-rayed, had an MRI and countless blood tests, she was little better off. And even once people started talking about it, the name “long COVID” offered no clues about how this illness was to be treated, how long it might last, or what the future would now hold for those with it. And so at each clinic appointment – “Good news! Your lung function tests are completely normal!” – Victoria began to feel more adrift. If they couldn’t find anything wrong with her, how was this ever going to be fixed?

This is a scenario that I have frequently seen over a long career working at the interface between mind and body: a place where the clean lines of diagnosis blur into the shades of grey that constitute the real world. It is an area in which medicine struggles to make sense of a person’s suffering, where patients feel neglected and abandoned, and where opinion replaces evidence. Instead of a cohesive pull towards a solution, there is confusion, uncertainty and fragmentation.

The treatment of any illness starts with a conceptualisation of the symptoms. What is causing the problem? Where are its origins? Our ability to peer into the body, to examine its organs and measure and make sense of the invisible elements in our blood, have persuaded us that illness is nothing more and nothing less than a bit of the body having gone awry.

Yet Victoria’s body had not gone wrong, at least not in any way that was apparent to the increasing number of medical specialists who had examined and investigated her. What did that say about her suffering? She began to doubt herself, as surely as she knew her family was beginning to wonder, too.

Medical purgatory

Stories like Victoria’s aren’t uncommon among the thousands of cases I have seen over the years. Not all of my patients have had long COVID, of course, but many have had one of the number of hard to define illnesses, where a person’s suffering isn’t accompanied by any abnormal test results. They inhabit that flat grey hinterland, neither one thing nor another.

My own journey to this point involved a steadily increasing understanding that medicine often does not serve patients like Victoria well. Patients referred to me had often seen several teams of hospital specialists with problems such as persistent pain, fatigue, dizziness, unexplained abdominal symptoms and seizures that were shown not to be epileptic. Following the law of diminishing returns, each round of investigations brought smaller and smaller yields, until a referral to a hospital psychiatrist became the only card left to play.


This story is part of Conversation Insights
The Insights team generates long-form journalism and is working with academics from different backgrounds who have been engaged in projects to tackle societal and scientific challenges.


A dawning realisation that things had to change struck me from early on in my career. Back then, even as a sprightly junior doctor specialising in internal medicine, I could not help noticing that many patients did not benefit from medicine as it was being practised. And so I found myself wondering if I could do more good as a psychiatrist than as a physician in a general hospital.

Eventually, I worked my way up the career ladder, specialising in the interface between medicine and mind – a field known as liaison psychiatry. More recently, I have written about my experiences of how the mind and the body are inextricably connected in a book.

I remember seeing Finlay*, a young man whose life was put on hold after he went to see his doctor complaining of dizziness. Over the following months, he was passed around different specialist departments including cardiology, ENT (ears, nose and throat) and neurology. He was subjected to dozens of investigations, all of which came back normal. He was no longer sure if he was really ill, and found it hard to make sense of his situation. His employers started to lose patience with him, and his relationship with his partner came under strain. The doctors had moved on, but Finlay was stuck. He was frustrated, scared and still dizzy, and like his referring doctors, just wanted an explanation for his symptoms that made sense.

I have lost count of the number of times a patient has wished on themselves a serious illness, even one with a poor prognosis, as long as it has clear investigative results. At least they would then be able to justify their suffering and plan for the future.

The problem is one of culture. Western culture has become so steeped in its current thinking of the human body – a simplistic mechanistic approach – that to suggest physical symptoms may not always have a direct physical correlate in the body is, for many patients, a provocation and, for doctors, something that is often not considered.

These anatomical cut outs of a man, showing muscles, bones, heart, lungs and intestines.
Man as machine: anatomical diagrams from 1900. Wellcome Collection

In some respects, this is surprising, because western culture likes to think of itself as more open, inclusive and accepting of things that fall outside the conventional paradigm. Yet this openness does not often extend to healthcare, in which medicine’s narrow view of health and illness continues to constrain its thinking.

When a doctor is unable to find a clear-cut physical cause for a patient’s illness, many will hear in this that their symptoms are not quite real, their suffering suspect. Doctors can become reluctant to even suggest that physical symptoms may not have an obvious or demonstrable physical cause, for fear of the offence that it seems to imply. One 2002 research paper, published in the BMJ, encapsulated the difficulties in the title: “What should we say to patients with symptoms unexplained by disease? The ‘number needed to offend’.”

Everything must make sense

The west’s present medical culture is a continuation of a process that began in antiquity. It is a reflection of human nature, the need to try to find order in the world, to delineate a set of rules, so that the world around us makes sense. It gives us a feeling of security. We want to explain and contain those things that frighten us, such as ill health. This, in turn, leads to a drive to simplify complex phenomena.

In some scientific disciplines, simplifying to a set of fundamental rules is a perfectly legitimate goal. By doing so, we have understood the relationship between energy, mass and the speed of light, the structure of atoms, and much of the physical world around us. But in medicine, the urge to simplify has nearly always led to overly simplistic theories. These theories explain everything and nothing at the same time.

Take, for example, the four humours theory of medicine. It began in ancient Greek times when Hippocrates and then Galen developed the idea which, almost unbelievably, became the leading medical theory for the next two millennia, with barely a challenge to its legitimacy. It explained everything.

Misalignment of the four humours – black bile, yellow bile, phlegm and blood – needed to be corrected to ensure good health, and so poultices, emetics, blood lettings and a variety of other benign, and not so benign, treatments were developed. It was a unifying theory, at once elegant, simple and persuasive. Its power was reflected in its longevity. And yet it explained nothing at all. It was nonsense accepted as truth.

Diagram showing the interaction between the four humours and all they sought to explain.
The four elements, four qualities, four humours, four seasons, and four ages of man. Lois Hague, 1991. Wellcome Collection, CC BY-NC

Our urge to simplify the complex has remained unchanged in modern times. It is only the parameters that have changed.

The current conceit is of the body as a machine. A complex machine, for sure, and one that needs a great deal of scientific effort to explain its workings. We have made substantial progress over the past half century, with a deeper understanding of the workings of the body, from microscopic cellular function to nerve cell transmission, from microbiomes to genomics. It has allowed us to understand disease processes and offer treatments that could not have been conceived of a century ago. Treatments like dialysis, which has extended countless lives, and organ transplants, which have been made possible by our understanding of the immune system to prevent rejection.

Such achievements have been an undoubted benefit to many people, and are obviously to be welcomed. Yet the understanding of the body has not translated into an understanding of illness and health. There is a ghost in the machine. Health, as experienced, is not simply a reflection of whether our bodily machine is working as it should. For many patient encounters, it’s not even close.

This is reflected in the many examples that we experience on a daily basis. We know for example that depression commonly presents with physical symptoms, such as headache or constipation, a finding that appears to be consistent across different cultures. Similarly, it is well known that placebos can improve physical symptoms – in one study improving lower back pain even when the subjects were told that they were taking an inactive placebo tablet.


Read more: It's still not fully understood how placebos work – but an alternative theory of consciousness could hold some clues


The case of psychiatry

As the west’s current model of medicine became the global standard, it began to shape the way we thought about and treated physical health problems. The potential contribution of psychiatry to physical health problems in the UK was little considered before the 1950s, with the speciality of liaison psychiatry developing in the second half of the 20th century. Even now, nearly all psychiatry is practised in the community or specialist psychiatric hospitals, rather than in acute medical settings.

In the general hospital, psychiatry is mostly to be found in the emergency department, with the focus firmly on self-harm, suicide attempts and extreme psychological distress. This means that where patients have medically unexplained symptoms, or long-term medical conditions in need of psychological care, psychiatry is often not around to help manage them.

Yet there is an ongoing need for psychiatry to address problems such as unexplained seizures or tremors, pain that persists despite a lack of any objective disease, the assessment of patients refusing life-saving treatments, and the many other problems that can have less obvious presentations, such as the long-term effects of abuse presenting with urological symptoms. All of the hospital specialities end up interacting with a good liaison psychiatry service, if it is available.

But even if psychological support is available, the problems do not end there.

For illnesses like heart disease, psychological support (for example, to improve stress management and help address mood and anxiety-related exacerbations of symptoms) is generally accepted, because the bona fides of the diagnosis are not brought into question.

Yet for illnesses like Victoria’s, where the physical basis of the diagnosis remains unclear or unknown, experience tells us that a psychological approach implies for many patients that the illness is not being taken seriously. If there is no demonstrable physical cause, then any non-medical treatment is seen as suspect, dismissive of the physical, and an implied trivialising of suffering. Western medicine has become trapped in a simplistic and one-dimensional view of illness.

Close-up photo of woman's eyes above surgical mask.
Many long COVID patients struggle with what they see as a lack of medical affirmation of their symptoms. Ani Kolleshi/Unsplash, FAL

The consequences of this current medical approach are unsustainable – and the statistics speak for themselves. Consider this: one large 1989 study in the US showed that doctors found an underlying physical cause in just 16% of cases of common symptoms, such as fatigue, dizziness, chest pain, back pain or insomnia. This is a jaw-dropping figure, almost hard to fathom, although typical of a number of studies over the 30 years since that have produced similar results in diverse settings.

In one study in London, no medical explanation accounted for 66% of patient encounters in a gynaecology clinic. In the Netherlands, just under half of all hospital medical encounters had a definite medical diagnosis to account for the patients’ symptoms. For a large number of symptoms that people see their doctor for, “no medical cause” is one of the most common, if not most common, finding for the patient’s symptoms. This is true in both primary care as well as secondary care at the hospital.

The costs of this to the NHS are eye watering. It is estimated by the King’s Fund that at least £11 billion each year is spent on poor management of medically unexplained symptoms as well as the consequences of untreated mental health conditions among those with long term health conditions.

Yet the money is far from the worst of it. It is the human costs that are the real story. Added to the protracted ill health and disability are unemployment, financial adversity, strain on relationships and an overall reduction in quality of life.

Looking beyond

Psychiatry and psychology can make a meaningful difference to patient outcomes, although they are rarely invited to do so, and there is commonly little will or resource to fund such services in any case.

This is now a real cause for concern around long COVID. We are still finding our way towards explaining what exactly this illness is. It appears to encompass a range of conditions. There are some cases showing demonstrable pathology, with abnormal blood tests and imaging, and many, like Victoria’s, which do not.

This may be because our understanding of how the body develops and perceives symptoms has its limits. But the patient’s suffering is very real, whether or not a physical cause can be shown. Whatever the cause, we know that depression, anxiety, fatigue and insomnia frequently accompany a chronic and often disabling illness. We also know that there is often no association between the severity of the original infection and the subsequent long-term disability: people with initially mild infections can suffer long-term effects.

Without addressing these issues, offering practical rehabilitation and physiotherapy, and addressing the fear and despair that patients experience when facing a poorly defined but seemingly chronic health problem, we can make the patient’s situation worse.

The starting point of any successful treatment has to be a shared understanding of the nature of the problem. We need to have an open conversation in society about the mind and body, health and illness. We need to be realistic about our current understanding of the body, celebrating the truly impressive treatments and innovations that the past half a century of medicine has brought us, and honest about the limitations.

Red cross-section of a brain against black background.
Healthy adult human brain viewed from above. © Dr Flavio Dell'Acqua, CC BY

For Victoria, the hardest part of her treatment was managing her doubt and uncertainty about what was wrong with her. After months of normal investigations and an increasing sense of feeling like she was being told that she was “not really ill”, she needed some validation of her illness –- to know that doctors believed in it. It says something about our current medical system that this needs to be said at all. Of course she was ill, just probably not within the narrow construct of illness that we currently employ.

It is possible that, one day, we will discover all of the physiological processes that go wrong, and the huge number of currently unexplained illnesses will have demonstrable abnormalities to find and benefit from crisp, targeted physical treatments. I hope so. It is a worthy – albeit, in my view, unlikely – goal.

Yet this still disregards the psychological components that all illnesses have. All illnesses have a perceptual and psychosocial component, which is to say that our experience of symptoms can be very subjective and influenced by a variety of non-medical factors. It is well known that experience of pain is influenced by our expectations, how serious we think the cause might be, our culture, our mood, even the language we use to describe pain. By addressing all these factors, psychological approaches can reduce and even cure symptoms.

When assessing a patient with medically unexplained but persistent physical symptoms, a psychiatrist needs to explore all these other factors that could be important in ameliorating the symptoms. This includes identifying any current mood disorders, such as depression, as well as anxiety disorders, which may be maintaining or exacerbating the problems. Focusing on the symptoms is an understandable but unhelpful means of perpetuating problems. This is often driven by fear of what the symptoms may represent, so an understanding of the person’s views on the illness, how serious they believe it is, whether they believe it to be controllable or not. All these are all important to elicit and address.

Psychological approaches are not meant to replace medical care, any more than they would replace insulin therapy in diabetes or cardiac drugs for heart disease. But they can complement that care. Their use is not meant to suggest the patient’s symptoms are not real, nor imply they may not have a real, physical basis.

Yet this debate has been going on for so long that I am not sure if medicine can rise to the challenge. The insatiable demand for spending on health and the relatively low priority of psychiatry, mean that outside of a few bigger centres, the kind of specialist, integrated treatments needed are not commonly available.

With an estimated 2.3% of long COVID patients having symptoms beyond 12 weeks, how long can we keep mind and body separate? We have had centuries of a mind-body split. Perhaps helping to bridge this divide will be COVID’s next surprise.

* Names and patient details have been changed to protect patients’ anonymity.


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Alastair Santhouse is the author of Head First: A Psychiatrist's Stories of Mind and Body.

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Health Officials: Man Dies From Bubonic Plague In New Mexico

Health Officials: Man Dies From Bubonic Plague In New Mexico

Authored by Jack Phillips via The Epoch Times (emphasis ours),

Officials in…

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Health Officials: Man Dies From Bubonic Plague In New Mexico

Authored by Jack Phillips via The Epoch Times (emphasis ours),

Officials in New Mexico confirmed that a resident died from the plague in the United States’ first fatal case in several years.

A bubonic plague smear, prepared from a lymph removed from an adenopathic lymph node, or bubo, of a plague patient, demonstrates the presence of the Yersinia pestis bacteria that causes the plague in this undated photo. (Centers for Disease Control and Prevention/Getty Images)

The New Mexico Department of Health, in a statement, said that a man in Lincoln County “succumbed to the plague.” The man, who was not identified, was hospitalized before his death, officials said.

They further noted that it is the first human case of plague in New Mexico since 2021 and also the first death since 2020, according to the statement. No other details were provided, including how the disease spread to the man.

The agency is now doing outreach in Lincoln County, while “an environmental assessment will also be conducted in the community to look for ongoing risk,” the statement continued.

This tragic incident serves as a clear reminder of the threat posed by this ancient disease and emphasizes the need for heightened community awareness and proactive measures to prevent its spread,” the agency said.

A bacterial disease that spreads via rodents, it is generally spread to people through the bites of infected fleas. The plague, known as the black death or the bubonic plague, can spread by contact with infected animals such as rodents, pets, or wildlife.

The New Mexico Health Department statement said that pets such as dogs and cats that roam and hunt can bring infected fleas back into homes and put residents at risk.

Officials warned people in the area to “avoid sick or dead rodents and rabbits, and their nests and burrows” and to “prevent pets from roaming and hunting.”

“Talk to your veterinarian about using an appropriate flea control product on your pets as not all products are safe for cats, dogs or your children” and “have sick pets examined promptly by a veterinarian,” it added.

“See your doctor about any unexplained illness involving a sudden and severe fever, the statement continued, adding that locals should clean areas around their home that could house rodents like wood piles, junk piles, old vehicles, and brush piles.

The plague, which is spread by the bacteria Yersinia pestis, famously caused the deaths of an estimated hundreds of millions of Europeans in the 14th and 15th centuries following the Mongol invasions. In that pandemic, the bacteria spread via fleas on black rats, which historians say was not known by the people at the time.

Other outbreaks of the plague, such as the Plague of Justinian in the 6th century, are also believed to have killed about one-fifth of the population of the Byzantine Empire, according to historical records and accounts. In 2013, researchers said the Justinian plague was also caused by the Yersinia pestis bacteria.

But in the United States, it is considered a rare disease and usually occurs only in several countries worldwide. Generally, according to the Mayo Clinic, the bacteria affects only a few people in U.S. rural areas in Western states.

Recent cases have occurred mainly in Africa, Asia, and Latin America. Countries with frequent plague cases include Madagascar, the Democratic Republic of Congo, and Peru, the clinic says. There were multiple cases of plague reported in Inner Mongolia, China, in recent years, too.

Symptoms

Symptoms of a bubonic plague infection include headache, chills, fever, and weakness. Health officials say it can usually cause a painful swelling of lymph nodes in the groin, armpit, or neck areas. The swelling usually occurs within about two to eight days.

The disease can generally be treated with antibiotics, but it is usually deadly when not treated, the Mayo Clinic website says.

“Plague is considered a potential bioweapon. The U.S. government has plans and treatments in place if the disease is used as a weapon,” the website also says.

According to data from the U.S. Centers for Disease Control and Prevention, the last time that plague deaths were reported in the United States was in 2020 when two people died.

Tyler Durden Wed, 03/13/2024 - 21:40

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I created a ‘cosy game’ – and learned how they can change players’ lives

Cosy, personal games, as I discovered, can change the lives of the people who make them and those who play them.

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Cosy games exploded in popularity during the pandemic. Takoyaki Tech/Shutterstock

The COVID pandemic transformed our lives in ways many of us are still experiencing, four years later. One of these changes was the significant uptake in gaming as a hobby, chief among them being “cosy games” like Animal Crossing: New Horizons (2020).

Players sought comfort in these wholesome virtual worlds, many of which allowed them to socialise from the safety of their homes. Cosy games, with their comforting atmospheres, absence of winning or losing, simple gameplay, and often heartwarming storylines provided a perfect entry point for a new hobby. They also offered predictability and certainty at a time when there wasn’t much to go around.

Cosy games are often made by small, independent developers. “Indie games” have long been evangelised as the purest form of game development – something anyone can do, given enough perseverance. This means they can provide an entry point for creators who hadn’t made games before, but were nevertheless interested in it, enabling a new array of diverse voices and stories to be heard.

In May 2020, near the start of the pandemic, the small poetry game A Solitary Spacecraft, which was about its developer’s experience of their first few months in lockdown, was lauded as particularly poignant. Such games showcase a potential angle for effective cosy game development: a personal one.

Personal themes are often explored through cosy games. For instance, Chicory and Venba (both released in 2023) tackle difficult topics like depression and immigration, despite their gorgeous aesthetics. This showcases the diversity of experiences on display within the medium.

However, as the world emerges from the pandemic’s shadow, the games industry is facing significant challenges. Economic downturns and acquisitions have caused large layoffs across the sector.

Historically, restructurings like these, or discontent with working conditions, have led talented laid-off developers to create their own companies and explore indie development. In the wake of the pandemic and the cosy game boom, these developers may have more personal stories to tell.

Making my own cosy game

I developed my own cosy and personal game during the pandemic and quickly discovered that creating these games in a post-lockdown landscape is no mean feat.

What We Take With Us (2023) merges reality and gameplay across various digital formats: a website, a Discord server that housed an online alternate reality game and a physical escape room. I created the game during the pandemic as a way to reflect on my journey through it, told through the videos of game character Ana Kirlitz.

The trailer for my game, What We Take With Us.

Players would follow in Ana’s footsteps by completing a series of ten tasks in their real-world space, all centred on improving wellbeing – something I and many others desperately needed during the pandemic.

But creating What We Take With Us was far from straightforward. There were pandemic hurdles like creating a physical space for an escape room amid social distancing guidelines. And, of course, the emotional difficulties of wrestling with my pandemic journey through the game’s narrative.

The release fared poorly, and the game only garnered a small player base – a problem emblematic of the modern games industry.

These struggles were starkly contrasted by the feedback I received from players who played the game, however.

This is a crucial lesson for indie developers: the creator’s journey and the player’s experience are often worlds apart. Cosy, personal games, as I discovered, can change the lives of those who play them, no matter how few they reach. They can fundamentally change the way we think about games, allow us to reconnect with old friends, or even inspire us to change careers – all real player stories.

Lessons in cosy game development

I learned so much about how cosy game development can be made more sustainable for creators navigating the precarious post-lockdown landscape. This is my advice for other creators.

First, collaboration is key. Even though many cosy or personal games (like Stardew Valley) are made by solo creators, having a team can help share the often emotional load. Making games can be taxing, so practising self-care and establishing team-wide support protocols is crucial. Share your successes and failures with other developers and players. Fostering a supportive community is key to success in the indie game landscape.

Second, remember that your game, however personal, is a product – not a reflection of you or your team. Making this distinction will help you manage expectations and cope with feedback.

Third, while deeply considering your audience may seem antithetical to personal projects, your game will ultimately be played by others. Understanding them will help you make better games.

The pandemic reignited the interest in cosy games, but subsequent industry-wide troubles may change games, and the way we make them, forever. Understanding how we make game creation more sustainable in a post-lockdown, post-layoff world is critical for developers and players alike.

For developers, it’s a reminder that their stories, no matter how harrowing, can still meaningfully connect with people. For players, it’s an invitation to embrace the potential for games to tell such stories, fostering empathy and understanding in a world that greatly needs it.


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Adam Jerrett does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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KIMM finds solution to medical waste problem, which has become a major national issue

A medical waste treatment system, which is capable of 99.9999 percent sterilization by using high-temperature and high-pressure steam, has been developed…

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A medical waste treatment system, which is capable of 99.9999 percent sterilization by using high-temperature and high-pressure steam, has been developed for the first time in the country.

Credit: Korea Institute of Machinery and Materials (KIMM)

A medical waste treatment system, which is capable of 99.9999 percent sterilization by using high-temperature and high-pressure steam, has been developed for the first time in the country.

The Korea Institute of Machinery and Materials (President Seog-Hyeon Ryu, hereinafter referred to as KIMM), an institute under the jurisdiction of the Ministry of Science and ICT, has succeeded in developing an on-site-disposal type medical waste sterilization system that can help to resolve the problem caused by medical waste, which has become a national and social issue as the volume of medical waste continues to increase every year. This project was launched as a basic business support program of the KIMM and was expanded into a demonstration project of Daejeon Metropolitan City. Then, in collaboration with VITALS Co., Ltd., a technology transfer corporation, the medical waste treatment system was developed as a finished product capable of processing more than 100 kilograms of medical waste per hour, and was demonstrated at the Chungnam National University Hospital.

Moreover, the installation and use of this product have been approved by the Geumgang Basin Environmental Office of the Ministry of Environment. All certification-related work for the installation and operation of this product at the Chungnam National University Hospital has been completed, including the passage of an installation test for efficiency and stability conducted by the Korea Testing Laboratory.

Through collaboration with VITALS Co., Ltd., a corporation specializing in inhalation toxicity systems, the research team led by Principal Researcher Bangwoo Han of the Department of Urban Environment Research of the KIMM’s Eco-Friendly Energy Research Division developed a high-temperature, high-pressure steam sterilization-type medical waste treatment system by using a high-temperature antimicrobial technology capable of processing biologically hazardous substances such as virus and bacteria with high efficiency. After pulverizing medical waste into small pieces so that high-temperature steam can penetrate deep into the interior of the medical waste, steam was then compressed in order to raise the boiling point of the saturated steam to over 100 degrees Celsius, thereby further improving the sterilization effect of the steam.

Meanwhile, in the case of the high-pressure steam sterilization method, it is vitally important to allow the airtight, high-temperature and high-pressure steam to penetrate deep into the medical waste. Therefore, the research team aimed to improve the sterilization effect of medical waste by increasing the contact efficiency between the pulverized medical waste and the aerosolized steam.

By using this technology, the research team succeeded in processing medical waste at a temperature of 138 degrees Celsius for 10 minutes or at 145 degrees Celsius for more than five (5) minutes, which is the world’s highest level. By doing so, the research team achieved a sterilization performance of 99.9999 percent targeting biological indicator bacteria at five (5) different locations within the sterilization chamber. This technology received certification as an NET (New Excellent Technology) in 2023.

Until now, medical waste has been sterilized by heating the exposed moisture using microwaves. However, this method requires caution because workers are likely to be exposed to electromagnetic waves and the entrance of foreign substances such as metals may lead to accidents.

In Korea, medical waste is mostly processed at exclusive medical waste incinerators and must be discharged in strict isolation from general waste. Hence, professional efforts are required to prevent the risk of infection during the transportation and incineration of medical waste, which requires a loss of cost and manpower.

If medical waste is processed directly at hospitals and converted into general waste by applying the newly developed technology, this can help to eliminate the risk of infection during the loading and transportation processes and significantly reduce waste disposal costs. By processing 30 percent of medical waste generated annually, hospitals can save costs worth KRW 71.8 billion. Moreover, it can significantly contribute to the ESG (environmental, social, and governance) management of hospitals by reducing the amount of incinerated waste and shortening the transportation distance of medical waste.

[*Allbaro System (statistical data from 2021): Unit cost of treatment for each type of waste for the calculation of performance guarantee insurance money for abandoned wastes (Ministry of Environment Public Notification No. 2021-259, amended on December 3, 2021). Amount of medical waste generated on an annual basis: 217,915 tons; Medical waste: KRW 1,397 per ton; General waste from business sites subject to incineration: KRW 299 per ton]

As the size and structure of the installation space varies for each hospital, installing a standardized commercial equipment can be a challenge. However, during the demonstration process at the Chungnam National University Hospital, the new system was developed in a way that allows the size and arrangement thereof to be easily adjusted depending on the installation site. Therefore, it can be highly advantageous in terms of on-site applicability.

Principal Researcher Bangwoo Han of the KIMM was quoted as saying, “The high-temperature, high-pressure steam sterilization technology for medical waste involves the eradication of almost all infectious bacteria in a completely sealed environment. Therefore, close cooperation with participating companies that have the capacity to develop airtight chamber technology is very important in materializing this technology.” He added, “We will make all-out efforts to expand this technology to the sterilization treatment of infected animal carcasses in the future.”

 

President Seog-Hyeon Ryu of the KIMM was quoted as saying, “The latest research outcome is significantly meaningful in that it shows the important role played by government-contributed research institutes in resolving national challenges. The latest technology, which has been developed through the KIMM’s business support program, has been expanded to a demonstration project through cooperation among the industry, academia, research institutes, and the government of Daejeon Metropolitan City.” President Ryu added, “We will continue to proactively support these regional projects and strive to develop technologies that contribute to the health and safety of the public.”

 

Meanwhile, this research was conducted with the support of the project for the “development of ultra-high performance infectious waste treatment system capable of eliminating 99.9999 percent of viruses in response to the post-coronavirus era,” one of the basic business support programs of the KIMM, as well as the project for the “demonstration and development of a safety design convergence-type high-pressure steam sterilization system for on-site treatment of medical waste,” part of Daejeon Metropolitan City’s “Daejeon-type New Convergence Industry Creation Special Zone Technology Demonstration Project.”

###

The Korea Institute of Machinery and Materials (KIMM) is a non-profit government-funded research institute under the Ministry of Science and ICT. Since its foundation in 1976, KIMM is contributing to economic growth of the nation by performing R&D on key technologies in machinery and materials, conducting reliability test evaluation, and commercializing the developed products and technologies.

 

This research was conducted with the support of the project for the “development of ultra-high performance infectious waste treatment system capable of eliminating 99.9999 percent of viruses in response to the post-coronavirus era,” one of the basic business support programs of the KIMM, as well as the project for the “demonstration and development of a safety design convergence-type high-pressure steam sterilization system for on-site treatment of medical waste,” part of Daejeon Metropolitan City’s “Daejeon-type New Convergence Industry Creation Special Zone Technology Demonstration Project.”


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