Wastewater-Based Epidemiology (WBE) and Viral Detection in Polluted Surface Water: A Valuable Tool for COVID-19 Surveillance—A Brief Review

Abstract

SARS-CoV-2 is the causative agent of the current COVID-19 pandemic. Disease clinical manifestations range from asymptomatic to severe multiple organ damage. SARS-CoV-2 uses ACE2 as a cellular receptor, which is abundantly expressed in the small intestine, allowing viral replication in the gastrointestinal tract. Viral RNA has been detected in the stool of COVID-19 patients and viable viruses had been isolated in some of these samples. Thus, a putative role of SARS-CoV-2 fecal-oral transmission has been argued. SARS-CoV-2 is shed in human excreta and further disposed in the sewerage or in the environment, in poor basic sanitation settings. Wastewater-based epidemiology (WBE) is a valuable population level approach for monitoring viral pathogens and has been successfully used in different contexts. This review summarizes the current global experience on SARS-CoV-2 WBE in distinct continents and viral detection in polluted surface water. The advantages and concerns of this strategy for SARS-CoV-2 surveillance are discussed. Outcomes suggest that WBE is a valuable early warning alert and a helpful complementary surveillance tool to subside public health response, to tailor containment and mitigation measures and to determine target populations for testing. In poor sanitation settings, contaminated rivers could be alternatively used as a source for environmental surveillance.

Method of Setting Environmental Administrative Fine Amounts

“…Therefore, the wastewater contains dozens of harmful substances such as formaldehyde, acetone, chloride, preservatives, limestone, etc. These substances make the groundwater contain a large number of anions, such as , , , and cations, such as , which make the groundwater acidic or alkaline [ 22 ] and harmful to human health, crop production, animal husbandry, and so on [ 23 ]. Hence, the wastewater should be purified before it is discharged into the outside world.…”

Wastewater-based Epidemiology – Possible Approach for the Prevalence Prediction of SARS-CoV-2 in the Population

“…In communities with low capacity of clinical testing and delays of diagnostics wastewater surveillance can be a temporary solution. Moreover, as it is relatively cost-effective and less invasive, wastewater monitoring can be used in low-income countries 30 . However in communities with working traditional testing, data obtained from wastewater are only additional information in controlling pandemics.…”

COVID-19 mass testing: harnessing the power of wastewater epidemiology

“…The COVID-19 pandemic has necessitated the rapid implementation of surveillance programmes worldwide to track and control the spread of SARS-CoV-2. Initially, such programmes relied on syndromic surveillance, community testing, contact tracing and the monitoring of morbidity and mortality rates (1)(2)(3). Community testing relies on voluntary reporting of clinical signs and is only partially able to capture the pre-symptomatic, asymptomatic and pauci-symptomatic cases of SARS-CoV-2 infection that can contribute significantly to community transmission, and are therefore subject to biases, which can influence estimates of disease burden (1,2).…”

“…Initially, such programmes relied on syndromic surveillance, community testing, contact tracing and the monitoring of morbidity and mortality rates (1)(2)(3). Community testing relies on voluntary reporting of clinical signs and is only partially able to capture the pre-symptomatic, asymptomatic and pauci-symptomatic cases of SARS-CoV-2 infection that can contribute significantly to community transmission, and are therefore subject to biases, which can influence estimates of disease burden (1,2). Syndromic surveillance based on hospital admissions is less biased, but is subject to delays between infection and admission (2), while implementing mass swab-testing on a nationally meaningful scale is not economically feasible for most countries (2).…”

“…(2020) detected SARS-CoV-2 in wastewater early in the pandemic and identified viral RNA in the wastewater of three Dutch cities and a major airport up to six days before the first reported clinical cases (6). WBE studies are now ongoing in over 50 countries (1,7,8).…”