Wastewater surveillance could serve as a pandemic early warning system for COVID‐19 and beyond

Abstract

Wastewater-based surveillance can be used as an early warning system to identify COVID-19 outbreaks because the viral load can be observed in sewage before it is clinically verified. Wastewater surveillance of SARS-CoV-2 can trace the transmission dynamics of infection in communities when using the scale of a wastewater diversion and treatment system. Using this early detection method can help protect human health and mitigate socio-economic losses. It can help quantify the epidemiological data of a given population in real-time and circumvent the need for other epidemiological indicators. There are challenges in using this technique in areas with underdeveloped sewerage infrastructure. It is especially the case in developing nations where uniform protocols for viral detection are lacking, and wastewater is heterogeneous because of environmental and operational conditions. This article explains the need for and importance of wastewater-based surveillance for SARS-CoV-2. It lays out the most recent methodological approaches for detecting SARS-CoV-2 in municipal wastewater and outlines the main challenges associated with wastewater-based epidemiology (WBE). The article includes a case study of surveillance work across India to demonstrate how a developing nation manages research and locational challenges. The socio-economic, ethical, and policy dimensions of WBE for SARS-CoV-2 are also discussed.

Temporal assessment of SARS-CoV-2 detection in wastewater and its epidemiological implications in COVID-19 case dynamics

“…Substantial research has probed into the correlations between SARS-CoV-2 marker genes present in wastewater and the incidence and prevalence of COVID-19 cases in various sewersheds, with the goal of establishing a predictive model for estimating present and future COVID-19 cases. The focus has been on exploring the wastewater surveillance as an early warning system for pandemics, underscoring its capacity to provide diverse lead times before the clinical detection of cases [ [15] , [16] , [17] ]. The lead time is identified as the difference in time between when an increase in viral detection is observed in wastewater and when a corresponding increase in clinical cases is reported [ 18 ].…”

Multiplexed detection, partitioning, and persistence of wild type and vaccine strains of measles, mumps, and rubella viruses in wastewater

“…Numerous use cases for how wastewater monitoring has been used by public health officials for decision-making have been demonstrated, including as an early warning system that can indicate disease trends and hospitalizations before other surveillance data (e.g. clinical testing) [1][2][3][4][5][6][7] , as a source of information on disease trends where there is limited case data 6,[8][9][10][11] , and as a tool for detecting localized outbreaks within communities [12][13][14][15][16][17][18][19][20][21] and facilities [22][23][24][25][26][27][28][29][30][31] . Another important use case for wastewater monitoring is to detect vaccine-preventable diseases and direct immunization resources.…”

Size and velocity correlation for splashing droplets generated by jet impingement

“…The COVID-19 virus, which is about 100 nm in size, is mainly spreading in air through respiratory droplets released by coughing, sneezing or talking (Wang et al 2021). Studies (Gormley et al 2020;Angga et al 2023;Gahlot et al 2023) have suggested that drainage systems are also a potential route of virus transmission. When virus-laden faeces are discharged into drainage systems, large numbers of tiny and virus-laden droplets are produced by the wastewater falling, impacting and splashing.…”