Environmental issues on covid-19 medical waste: review from policy perspective

The Covid-19 pandemic brings two sides to the environment. On one side, it reduces air pollution due to travel and work limitations but on the other hand, medical waste increases. This contradictory situation on the environment has been studied by research all around the world. This study is trying to map the concern of experts on environmental issues during Covid-19. This paper conducts a systematic literature review from prominent databases to portray the environmental issues that emerged during the Covid-19 Pandemic from a policy perspective. Unique keywords that combine environment, covid-19, and policy filtered the literature available in the research database. No less than 152 literature were collected and extracted using PRISMA approach. The result indicates very limited policy issued by the government to protect the environment for the post-covid era.


Introduction
The Covid-19 pandemic has surged the world during the past two years. Life adjustments have changed the world's facets in the last two years. Covid-19 Pandemic is an outbreak that causes severe acute respiratory syndrome [1,2] and systemic disorders [3]. The virus is contagious and transmitted either directly and indirectly [4]. Covid-19 has increased infections and mortality, putting pressure on public health, economic sectors [5], and the environment [6]. The World Health Organization (WHO) has declared several preventive strategies to reduce disease spread and infection rates, including patient isolation, masks, and gloves, social distancing, preserving hygiene behavior and prohibiting a crowd of people. Several countries have established a lockdown policy in response to this problem. Besides that policy, governments worldwide also oblige their citizens to wear masks, clean their hands, and avoid crowds. These policies have been effective in reducing the virus spread. Interestingly the policy had an impact on the environment.
In April 2021, the air quality in China and India has improved due to the decrease of air pollution as one of the side effects of the government's lockdown policy to break the chain of covid-19 infection [7,8]. Prior studies compared the air quality before and after the lockdown policy was considered. The result indicated that the concentrations of air pollution (PM2.5, PM10, SO2, NO2, and CO) were all decreasing significantly [6,8,9]. This reveals a positive air quality impact from the pandemic Covid-19 in China and India, which is the positive side of the impact of Covid-19 on the environment. 3 access criteria. This searching also focused on journal articles with more complete results than any other forms of publications. As policy and politics were more related to social science, the social fields were also used to filter the result. Lastly, the review only focused on the article that is written in English compared to other languages. Based on twelve search iterations with different keywords, 170 literature were collected, and 142 were relevant to the issue. The complete use of keywords, the results, and references are depicted in Table 1.

Data analysis and discussion
PRISMA has four steps: (1) import references and checks the duplicates, (2) screen the studies based on the abstract reading, (3) full text studies, reading the full article to decide whether the study will be included or excluded, and (4) evaluate and classify the full paper. The 170 results from the Scopus database were inserted to Covidence software. Among the 170, 28 of them were duplicates, so they were removed. After reading the abstract 105 studies were deemed to be irrelevant to the topics discussed. In the full paper review, 31 studies were excluded from the next phase due to four reasons: (1) not discussing policy on environmental issues, (2) not discussing the environmental issue, (3) cannot be accessed. Finally,6 studies were evaluated and classified based on the theme discussed in the paper. The complete result of the PRISMA procedure on each step is presented in Figure 1.
The six studies included in the final step discuss the various issues around the policy of the environment. Five studies out of six urge the importance of government policy in protecting the environment based on the lockdown policy during the Covid-19 restriction. In Egypt, the positive impact on lockdown policy, i.e., pollution decrease, will not be sustained without the government's stricter law [6]. The other studies urge the importance of partnership between government, business [24], and NGO [13] to reshape the policy [17] and take further action in handling the Covid-19 pollution and educating people's awareness toward it. From China's experience, future policymakers must balance sustainable urban development and appropriate human activities based on the pandemic handling experience [9]. One study discusses Italy's government policy in developing a permanent bike lane to facilitate its citizens in urban transport during the pandemics [62]. This policy utilizes the covid-19 travel restriction by pushing citizens to use bicycles instead of other means of transportation. By issuing this policy, the government tries to push the lockdown, positive impact to be more sustainable after the pandemic ends by developing green infrastructure.

Conclusion
The Covid-19 pandemic brings many changes to daily life. Based on prior studies, the pandemic also affects the environment both in negative and positive ways. How can government capitalize on the positive impact on the environment and reduce the negative impact? This study capture government policy that has been taken during 2020-2021 to maintain the environmental sustainability. No less than 142 literature were reviewed using the PRISMA approach, and only 6 were related to policy in environmental issues. This result indicates that very limited studies have been conducted focusing on the policy aspects of environmental sustainability in post-pandemic settings. This study suggests further research to explore the policy and practice of government action during the covid-19 pandemic to preserve environmental sustainability.