--- title: Ebola Waste Removal: A Case Study from Nebraska description: Officials at the University of Nebraska, which treated Ebola patients, issues a case study in how to get rid of Ebola waste canonical: https://time.com/3614010/heres-how-to-remove-ebola-waste-from-a-hospital/ author: Alice Park article:opinion: false article:content_tier: free article:published_time: 2014-12-02T18:48:41.000Z article:modified_time: 2026-08-04T08:00:16.819Z article:section: Health og:title: Here’s How to Remove Ebola Waste From a Hospital og:description: Officials at the University of Nebraska, which treated Ebola patients, issues a case study in how to get rid of Ebola waste og:url: https://time.com/3614010/heres-how-to-remove-ebola-waste-from-a-hospital/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/bltde093bcdab65f2d0/6988d9b9bc6cfc69913e2a3c/time-logo.jpg?branch=production og:image:width: 1200 og:image:height: 675 og:image:alt: TIME og:type: article twitter:card: summary_large_image twitter:title: Here’s How to Remove Ebola Waste From a Hospital twitter:description: Officials at the University of Nebraska, which treated Ebola patients, issues a case study in how to get rid of Ebola waste twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/bltde093bcdab65f2d0/6988d9b9bc6cfc69913e2a3c/time-logo.jpg?branch=production --- # Here’s How to Remove Ebola Waste From a Hospital > Sponsored content. 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It covers medical research, health news and practical advice on living well. #### Where can I get reliable health news by email? Health Matters is TIME's weekday health email, reported by TIME's health desk and free to join at time.com/newsletters. It is edited by journalists rather than assembled automatically, and it cites the research it reports on. #### Is Health Matters free? Yes. Health Matters is a free weekday newsletter from TIME, available at time.com/newsletters. #### Who reads TIME's Health Matters newsletter? Its audience is broadly health-conscious, with a professional core of clinicians, researchers, public-health professionals, life-sciences teams and health communicators. ### Sources * TIME Newsletters: [time.com/newsletters](/c/time-nl-health-2026q3/newsletters?i=f6b22c05-e06e-406b-a223-3dff0cce63e4&cr=time-nl-health-2026q3-v1) ## Video: Nigeria is an Ebola Success Story: Here's What The Country Did Right [Watch (HLS stream): Nigeria is an Ebola Success Story: Here's What The Country Did Right](https://cdn.jwplayer.com/manifests/mSo7iFZ3.m3u8) (2:43)  _Published 2014-10-21. The World Health Organization declared Nigeria free of Ebola on Monday, a containment victory in an outbreak that has stymied other countries’ response efforts._  by [Alice Park](https://time.com/author/alice-park/)  ## Alice Park Senior Correspondent Dec 2, 2014 6:48 PM UTC  by [Alice Park](https://time.com/author/alice-park/)  ## Alice Park Senior Correspondent Dec 2, 2014 6:48 PM UTC When treating Ebola patients, hospitals have more than their patients and workers to protect. It’s their responsibility to properly dispose of anything involved in caring for the patients that might be contaminated—and that includes liquid waste, protective equipment, anything used in the lab, linens, towels, pillows, mattresses and even the curtains used in the patient’s room. In the [latest issue of the _American Journal of Infection Control_](http://time.com/wp-content/uploads/2014/12/ymic%5F3269.pdf), John Lowe, associate director of research from the Nebraska Biocontainment Unit at the Nebraska Medical Center, describes how the team there disposed of waste generated while two patients recovered from their infections there. Some of the procedures in place, Lowe says, go beyond the guidelines set by the Centers for Disease Control and Prevention (CDC). The report will undoubtedly be studied by the [35 hospitals that the CDC designated on Dec. 2 as Ebola treatment centers across the nation](http://time.com/3614047/ebola-hospitals-cdc/). “A number of things came up that surprised us and that we felt really needed to be shared with our colleagues,” he says. The first of those was the sheer volume of waste generated by each Ebola patient. The group calculated that each patient treated at the Nebraska facility created about 1,010 pounds of solid waste, most of it in the form of personal protective equipment (PPE) — the hoods, face shields, suits and foot covers that doctors and nurses wear. That equipment, as well as towels and linens used for bedding, created around four to eight large bags of waste a day. Lowe says that the group decided to treat liquid waste generated by the patients even more stringently than required by the CDC. “The lion’s share of calls we took from groups both within our facility and from outside the facility were concerns about exactly what we were doing with all that liquid waste,” he says. CDC guidelines say that normal waste treatment chemicals in toilets are sufficient to kill Ebola. But the unit’s director Philip Smith and Lowe had two concerns. In the event that the toilets backed up, potentially infectious material could flood into the patient rooms and possibly into other pipes in the hospital as well. Public health groups also wanted assurances that the waste would not be contaminating facilities outside of the hospital. So Smith decided to take extra measures by treating the toilets in the patient’s room with hospital-grade disinfectant. Normally it takes four minutes to sterilize the waste, but to be safe, all Ebola patients’ waste was held in this sterilizing solution for 2.5 times the recommended time before it was flushed. Flushing, says Smith, is preferable to storing the waste in a separate container and then autoclaving the contents. “You could end up having containers full of liquid that are difficult and hazardous to work with,” he says. The bags of solid waste, meanwhile, were tied and taped closed, then doused with bleach and handled in very strict ways by workers in full PPE. The Nebraska biocontainment unit is intentionally designed to have its own decontaminating autoclave inside the unit, so soiled waste does not have to be removed from the premises. While Ebola-related waste requires special sterilization and decontamination procedures, it can be turned into normal medical waste that can be disposed of in the hopsital’s normal ways. **MORE:** [12 Answers to Ebola’s Hard Questions](http://time.com/3533565/12-answers-to-ebolas-hard-questions/) To do that, health care workers send the bags into a sterilizing room. Each bag is handled at arm’s length so the workers don’t get contaminated by virus that may be on the bag and so that workers who may have virus on their PPE don’t contaminate the bags further. The bags are then treated with high temperatures and sterilizing chemicals. Once decontaminated, the bags are placed into another bag and into a watertight container and marked as biohazardous material. In this state, the waste can be disposed of as any other hospital waste in the proper medical waste removal sites. So far, those strategies are working. Two Ebola patients, [Ashoka Mukpo](http://time.com/3474617/ebola-ashoka-mukpo/) and [Dr. Richard Sacra](http://time.com/3584846/ebola-doctor-sierra-leone-treatment-nebraska/), were treated there and recovered, and no health care workers were infected with the virus. ## Transcript Africa's most populous country, Nigeria, is free of Ebola after it went 42 straight days with no new cases reported. As the epidemic rages out of control in neighboring Liberia, Guinea, and Sierra Leone, how did Nigeria become an Ebola success story? [ MUSIC ] Declaring an emergency right away. When Nigeria had its first confirmed case of Ebola, the government declared a national public health emergency immediately. That means that strict procedures for treating patients and screening people were quickly put into place. For example, local health workers paid $ 18, 500 face to face visits to take the temperatures of nearly 900 people who had contact with Ebola patients. Training local doctors. The World Health Organization and Doctors Without Borders trained local doctors on how to treat patients effectively. But the country posed a unique challenge as the number of people living in Lagos is around 21 million. That's almost as large as the populations of Guinea, Liberia and Sierra Leone combined. How can the disease be contained under such circumstances? The answer, high quality contact tracing by experienced epidemiologists. With the help of GPS systems and daily mapping, government officials reached 100 % of known contacts in Lagos and placed them in isolation wards. Managing Fear. Nigeria used social media and televised campaigns to reach its 174 million residents. To prevent panic, the country showcased patients who were successfully treated, and produced awareness campaigns on the disease. From national TV appearances by the president, to an online campaign starting Nigerian actors. No effort was spared to reassure the country's vast population. 0800 EBOLA HELP now. Keeping borders open. Nigeria made the decision of keeping it's frontiers open to travelers from Sierra Leone, Liberia, and Guinea. Saying that closing the borders would only hurt commercial activities in the countries whose economies were already struggling due to Ebola. At the same time effective screening procedures checked incoming visitors. The average number of travelers screened each day reached more than 16, 000. Even though the outbreak was contained Nigeria is now slowing down its training and preparation procedures in case there are new cases. 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