US states refuse to take incinerated Ebola waste According to the American Hospital Association, a typical hospital patient produces roughly three pounds of waste a day, much of it not considered hazardous. However, an Ebola patient could generate eight 55-gallon drums of waste, all of it treated as highly infectious. By contrast, there isn't much debate about what to do with ashes of Ebola waste, said Julie Damond, a spokeswoman for Medecins Sans Frontieres in Dakar, Senegal. Such waste is routinely incinerated. We know that the virus doesn't survive heat more than about 60 degrees (Celsius) for several minutes and it is very sensitive to detergents such as chlorine. So we use both to get rid of it," she said. In the US, Ebola waste is categorized as a Class A infectious substance under federal transportation guidelines, meaning it can cause death or permanent disability. But traditional packaging requirements for Class A waste make it hard to transport such large volumes. Class A material, often needles and blood vials, are packaged inside two small water-tight containers and then placed inside a third container for transport. CDC guidelines call for Ebola-related waste to be decontaminated and bagged, then bagged a second time and placed into 55-gallon (208-liter) drums. Of 123 hospitals of various sizes across the country contacted by Associated Press reporters, three said they lacked a plan for Ebola, and several others said their plans were evolving. Eleven said they had on-site incinerators for waste disposal. More than a hundred said they relied on outside contractors. But some companies have said they can't or won't pick up Ebola waste. Clay Jenkins, the Dallas County judge overseeing the Ebola response, said fear, as well as logistics, caused some companies to balk. "Any time we move away from science and into fear and panic, we're making it harder for our first responders to do their jobs," said Mr Jenkins. The idea that you can't take ash, or waste disposal companies that deal with medical waste won't handle Ebola waste - it's just crazy for people to be afraid of ashes. Last week, the Department of Transportation developed a new permit to help solve at least the logistics part of the problem, allowing qualified companies to pick up and transport Ebola-contaminated waste from any location, be it hospital or an apartment, in place of the usual site-specific permits. The new permits were designed to help avoid scenarios that played out in Duncan's apartment and at Atlanta's Emory University Hospital shortly after its first Ebola patients arrived in August, when the company contracted to collect its Class A medical waste refused to take the Ebola waste. "We had some really unexpected adventures in waste management," Dr Aneesh Mehta, the hospital's assistant director of transplant and infectious diseases, told the American Society of Microbiology in September. We had a buildup. We in fact went to Home Depot and bought up every large trash can/sealed canister we could get and kept them in a separate room until we renegotiated our contract with our waste-management company.