Wastewater-Based Epidemiology: Global Collaborative to Maximize Contributions in the Fight Against COVID-19

“Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel member of the Coronaviridae family, has been identified as the etiologic agent of an ongoing pandemic of severe pneumonia known as COVID-19.(1) To date there have been millions of cases of COVID-19 diagnosed in 184 countries with case fatality rates ranging from 1.8% in Germany to 12.5% in Italy.(2) Limited diagnostic testing capacity and asymptomatic and oligosymptomatic infections result in significant uncertainty in the estimated extent of SARS-CoV-2 infection.(3) Recent reports have documented that infection with SARS-CoV-2 is accompanied by persistent shedding of virus RNA in feces in 27%(4) to 89% of patients at densities from 0.8 to 7.5 log10 gene copies per gram.(5) The presence of SARS-CoV-2 RNA in feces raises the potential to survey sewage for virus RNA to inform epidemiological monitoring of COVID-19, which we refer to as wastewater-based epidemiology (WBE),(6) but is also known as environmental surveillance.(7)
Several studies have reported the detection of SARS-CoV-2 RNA in wastewater in the early stages of local outbreaks, further supporting the technical viability of WBE.(8−10) WBE could be especially informative given that asymptomatic and oligosymptomatic infections are unlikely to be detected during clinical surveillance. In such instances, WBE can be used to determine the burden of undiagnosed infections at the population level, which is critical to refining estimates of case-fatality rates. Additionally, wastewater offers an aggregate sample from an entire community that is more easily accessible than pooled clinical samples.(11) Along with clinical data and other technological approaches, such as contact tracing, WBE could provide critical monitoring of SARS-CoV-2 transmission within a community including the beginning, tapering, or re-emergence of an epidemic (Figure 1). This approach mirrors previous efforts in environmental monitoring, for example poliovirus RNA, to inform mechanistic models of pathogen transmission dynamics.(12)”

(Citation: Bivins, A., North, D., Ahmad, A., et al. – Wastewater-Based Epidemiology: Global Collaborative to Maximize Contributions in the Fight Against COVID-19 – Environmental Science and Technology 54(2020)13. p.7754-7757 – DOI: 10.1021/acs.est.0c02388)

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