Expired and Unwanted Pharmaceuticals: The Hidden Environmental Legacy of COVID-19

While concerns have been raised on the discharge of sanitary wastes containing antiviral drugs and metabolites, which are often inadequately treated at municipal wastewater treatment plants and pose threats to the receiving aquatic environments, a wider and potentially more far-reaching issue has been overlooked. The enormous quantities of pharmaceuticals dispensed to or purchased by the general public that are left unused or expired throughout the COVID-19 pandemic may have created an unintended yet massive legacy of potent bioactive substances that are destined for the environment. These include expired, unused (e.g., from recovered or deceased owners), and excess pharmaceuticals due to over-prescription, patient incompliance, panic buying, or stockpiling (i.e., hoarding). Without proper management and regulatory oversight, these may culminate an ecological disaster given their enormous quantities and prominent toxicities to aquatic and terrestrial biota.