COVID-19 Crisis Creates Opportunity towards Global Monitoring & Surveillance

Abstract

The spectrum of emerging new diseases as well as re-emerging old diseases is broadening as infectious agents evolve, adapt, and spread at enormous speeds in response to changing ecosystems. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a recent phenomenon and may take a while to understand its transmission routes from less traveled territories, ranging from fomite exposure routes to wastewater transmission. The critical challenge is how to negotiate with such catastrophic pandemics in high-income countries (HICs ~20% of the global population) and low-and middle-income countries (LMICs ~ 80% of the global population) with a total global population size of approximately eight billion, where practical mass testing and tracing is only a remote possibility, particularly in low-and middle-income countries (LMICs). Keeping in mind the population distribution disparities of high-income countries (HICs) and LMICs and urbanisation trends over recent years, traditional wastewater-based surveillance such as that used to combat polio may help in addressing this challenge. The COVID-19 era differs from any previous pandemics or global health challenges in the sense that there is a great deal of curiosity within the global community to find out everything about this virus, ranging from diagnostics, potential vaccines/therapeutics, and possible routes of transmission. In this regard, the fact that the gut is the common niche for both poliovirus and SARS-CoV-2, and due to the shedding of the virus through faecal material into sewerage systems, the need for long-term wastewater surveillance and developing early warning systems for better preparedness at local and global levels is increasingly apparent. This paper aims to provide an insight into the ongoing COVID-19 crisis, how it can be managed, and what measures are required to deal with a current global international public health concern. Additionally, it shed light on the importance of using wastewater surveillance strategy as an early warning practical tool suitable for massive passive screening, as well as the urgent need for microfluidic technology as a rapid and cost-effective approach tracking SARS-CoV-2 in wastewater.

Sewage Systems Surveillance for SARS-CoV-2: Identification of Knowledge Gaps, Emerging Threats, and Future Research Needs

“…The joint research center of the European Union (JRC) has shown a correlation between the number of people infected in a sewershed and the viral load in wastewater [ 222 ]. Results also showed that the viral load in the sewage increases before the number of infected persons increases [ 22 , 223 ].…”

“…In the case of a lack of such reliable epidemiological data, wastewater surveillance can still be used in less favored conditions. Nevertheless, wastewater surveillance can be useful in three main categories [ 222 , 223 ]: As an early-warning tool to detect (re-)emergence of the pandemic in a specific sewage catchment area; As a management tool to identify the prevalence and trend of infection, as well as to determine low- or high-risk areas, for example, if surveillance data shows the absence of virus in wastewater, the corresponding community can be considered as of low risk; and As a safety factor in cases where testing of residents shows negative results but the virus is detected in wastewater, then further investigations should be prescribed—it can also be useful to evaluate the safety of tourists’ facilities with a controlled environment, such as cruise ships and other similar facilities.…”

One-Year Update on Salivary Diagnostic of COVID-19

“…The World Health Organization (WHO) indicates the pivotal importance of mass testing in the find–test–trace–isolate–support strategy to contain COVID-19 transmission ( 1 ). The increase in massive testing capacity coupled with artificial intelligence multidisciplinary data should be used to prevent and combat the negative effects of COVID-19 and strengthen global health public systems to improve COVID-19 response ( 2 ). The National Institute of Health supports a rapid scaling up of SARS-CoV-2-detecting tests in the United States ( 3 ); however, the need for better diagnostic tests with high sensitivity has been considered critical to mitigate and suppress the spread of COVID-19 ( 4 ).…”

“…It imposes the development of new strategies for COVID-19 diagnosis; however, despite the colossal demand for novel diagnostic platforms with non-invasive and self-collection samples of COVID-19, the accuracy of salivary SARS-CoV-2 platforms are still not well-elucidated. The pivotal impact on social, health, economic, and educational fields in a global emergency due to COVID-19 makes it more challenging to compare the advantages and limitations in implementing novel potential salivary platforms ( 1 , 2 , 4 ).…”

Integration of RT-LAMP and Microfluidic Technology for Detection of SARS-CoV-2 in Wastewater as an Advanced Point-of-care Platform

“…Although inhalation of aerosol/droplet and person-to-person contact are the major transmission routes of SARS-CoV-2, current evidence points out that the viral RNA is detected in wastewater, urging the need to better understand wastewater as potential source of epidemiological data and human health risks, which can be applied as an early warning system [16][17][18][19]. SARS-CoV-2 may cause asymptomatic or pauci-symptomatic infections [20][21][22], which could add more limitations to determine the actual degree of SARS-CoV-2 circulation in a community.…”