The overall objective of this work was to conduct a critical literature review on the application of the circular economy (CE) hierarchy for the management of COVID-19 healthcare waste (HCW). To describe the problem created by COVID-19 HCW, first, the subsystems of the overall management system, including generation, segregation, classification, storage, collection, transport, treatment and disposal, were reviewed and briefly described. Then, the CE hierarchy using the 10R typology was adapted to the management of COVID-19 HCW and included the strategies Refuse, Reduce, Resell/Reuse, Repair, Reprocess, Refurbish, Remanufacture, Repurpose, Recycle and Recover (energy). Disposal was added as a sink of residues from the CE strategies. Using the detailed 10R CE hierarchy for COVID-19 HCW management is the novelty of this review. It was concluded that R-strategy selection depends on its position in the CE hierarchy and medical item criticality and value. Indicative HCW components, which can be managed by each R-strategy, were compiled, but creating value by recovering infectious downgraded materials contaminated with body fluids and tissues is not currently possible. Therefore, after applying the circular solutions, the end of pipe treatment and disposal would be necessary to close material cycles at the end of their life cycles. Addressing the risks, knowledge gaps and policy recommendations of this article may help to combat COVID-19 and future pandemics without creating environmental crises.

中文翻译：

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基于循环经济层次结构的 COVID-19 医疗废物管理：严格审查。

这项工作的总体目标是对循环经济 (CE) 层次结构在管理 COVID-19 医疗废物 (HCW) 中的应用进行重要文献综述。为了描述COVID-19医护人员造成的问题，首先回顾并简要描述了整个管理系统的子系统，包括产生、隔离、分类、储存、收集、运输、处理和处置。然后，使用 10R 类型的 CE 层次结构适应了 COVID-19 HCW 的管理，包括拒绝、减少、转售/再利用、修理、再加工、翻新、再制造、重新利用、回收和恢复（能源）策略。处置被添加为 CE 策略中的残留物汇。使用详细的 10R CE 层次结构进行 COVID-19 HCW 管理是本次审查的新颖之处。结论是，R 策略的选择取决于其在 CE 层次结构中的位置以及医疗项目的重要性和价值。编制了可由每个 R 策略管理的指示性 HCW 组件，但目前不可能通过回收被体液和组织污染的传染性降级材料来创造价值。因此，在应用循环解决方案后，有必要进行管道末端处理和处置，以在其生命周期结束时关闭材料循环。解决本文的风险、知识差距和政策建议可能有助于抗击 COVID-19 和未来的流行病，而不会造成环境危机。