Background: The rise in facemask waste with the uncertainty of deposition data and all its concomitant pressure on management has resulted in new risks and challenges for achieving sustainable development goals (SDGs). The purpose of this mixed methods study was to estimate facemask waste generation and examine management in Bhutan since the COVID-19 pandemic.

Method: One thousand five hundred and twenty-seventh (1,527) consenting members of the public from Class A Thromdes (self-governing municipalities) were surveyed online from February to April 2022, to estimate mask waste using descriptive statistics. This was supported by the waste characterization conducted in Memelhakha, the biggest open landfill in Thimphu Thromde. In-depth interviews were conducted with environmental officers, later summarized on emerging themes.

Results: The participants discarded on average 3-4 surgical facemasks in a week. Thimphu, Thromde generated 144.5 and 186 surgical and N95 waste (tons/year), while those respective figures were (30.7, 54.2), (47.3,65.7), and (65.8, 91.8) for Samdrup Jongkhar, Gelephu, and Phuentsholing. The pandemic has exposed the fragility of the waste system, with an increase in plastic waste that is largely landfilled. This issue can persist and result in big problems, given Thromde negligence and the country's inefficiencies and inadequacies in social and technical aspects.

Conclusion: The findings can be used as a tool to re-examine Bhutan’s overwhelmed management system to incorporate disaster preparedness and resilience to resist the change and impact beyond the pandemic.