Computational analysis of SARS-CoV-2/COVID-19 surveillance by wastewater-based epidemiology locally and globally: Feasibility, economy, opportunities and challenges

Occurrence, fate and removal of SARS-CoV-2 in wastewater: Current knowledge and future perspectives

The coronavirus disease 2019 (COVID-19), a pandemic of global concern, is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Recently, many studies have documented the detection of SARS-CoV-2 in human excreta and wastewater. The presence of SARS-CoV-2 in human excreta and wastewater poses serious implications for wastewater treatment. Thus, this review aims to understand the fate of SARS-CoV-2 in the urban water cycle and its inactivation in different stages of treatment in wastewater treatment plants (WWTPs) for effective control to prevent any recurrence of the outbreak. The viral load of SARS-CoV-2 in feces of individuals tested positive has been reported to be in the range of 104-108 copies/L depending on the infection stages. In the wastewater, dilution of feces results in the decrease of the viral load in the range of 102-106.5 copies/L. Monitoring of SARS-CoV-2 in WWTP samples following the wastewater-based epidemiology (WBE) can complement real epidemiological data from clinical testing to help to monitor disease outbreaks in a community. Though promising, high uncertainty involved with the WBE technique warrants further research for reliable and quantitative information. Inactivation of SARS-CoV-2 in WWTPs depends on the operational parameters and is generally enhanced by the tertiary treatment and disinfection techniques with a higher dosage. However, the risk of SARS-CoV-2 dissemination by the treated effluent intended to be disposed of or reused in the urban water cycle needs to be assessed with respect to the extent of viral infectivity.

Sources and routes of SARS-CoV-2 transmission in water systems in Africa: Are there any sustainable remedies?

Governments across the globe are currently besieged with the novel coronavirus (COVID-19) pandemic caused by SARS-CoV-2. Although some countries have been largely affected by this pandemic, others are only slightly affected. In this regard, every government is taking precautionary measures to mitigate the adverse effects of COVID-19. SARS-CoV-2 has been detected in wastewater raising an alarm for Africa due to the poor water, sanitation, and hygiene (WASH) facilities. Also, most countries in Africa do not have resilient policies governing sanitation and water management systems, which expose them to higher risk levels for the transmission of SARS-CoV-2. Therefore, this study unearthed the likely sources and routes of SARS-CoV-2 transmission in water systems (mainly wastewater) in Africa through a holistic review of published works. This provided the opportunity to propose sustainable remedial measures, which can be extrapolated to most developing countries in the world. The principal sources and routes of potential transmission of SARS-CoV-2 in water systems are hospital sewage, waste from isolation and quarantine centres, faecal-oral transmission, contaminated surface and groundwater sources, and contaminated sewage. The envisioned overwhelming impact of these sources on the transmission of SARS-CoV-2 through water systems in Africa suggests that governments need to put stringent and sustainable measures to curtail the scourge. Hence, it is proposed that governments in Africa must put measures like improved WASH facilities and public awareness campaigns, suburbanization of wastewater treatment facilities, utilizing low-cost point-of-use water treatment systems, legally backed policy interventions, and Community-Led Total Sanitation (CLTS). SARS-CoV-2 in water systems can be inactivated and destroyed by integrating ozonation, chlorination, UV irradiation, and sodium hypochlorite in low-cost point-of-use treatment systems. These proposed sustainable remedial measures can help policymakers in Africa to effectively monitor and manage the untoward impact of SARS-CoV-2 on water systems and consequently, on the health of the general public.

The relevance a technology ecosystem in the Brazilian National Health Service's Covid-19 response: the case of Rio Grande do Norte, Brazil

Technological advances play an undeniable role in strengthening health systems. With regard to digital technologies, information systems and the analysis of health data are playing a growing role in health surveillance and preparing for and responding to disease outbreaks, the theme addressed by this article within the context of the Covid-19 pandemic in the State of Rio Grande do Norte. This study departs from the assumption that digital health interventions can increase Covid-19 response capacity. We developed a technology ecosystem that integrates different information systems to meet the needs outlined in international regulations governing the response to the pandemic. In addition to the main elements of the ecosystem, this article describes the application of this instrument by different institutional actors. The main decision making tool used in the state government's Covid-19 response, the ecosystem is a model for digital health interventions in Brazil's national health service. This experience in Rio Grande do Norte brings together elements that can contribute to studies investigating the resilience of health systems and analyzing health policies in emergency situations.

Exposome-based public health interventions for infectious diseases in urban settings

The COVID-19 pandemic placed public health measures against infectious diseases at the core of global health challenges, especially in cities where more than half of the global population lives. SARS-CoV-2 is an exposure agent recently added to the network of exposures that comprise the human exposome, i.e. the totality of all environmental exposures throughout one's lifetime. At the same time, the application of measures to tackle SARS-CoV-2 transmission leads to changes in the exposome components and in characteristics of urban environments that define the urban exposome, a complementary concept to the human exposome, which focuses on monitoring urban health. This work highlights the use of a comprehensive systems-based approach of the exposome for better capturing the population-wide and individual-level variability in SARS-CoV-2 spread and its associated urban and individual exposures towards improved guidance and response. Population characteristics, the built environment and spatiotemporal features of city infrastructure, as well as individual characteristics/parameters, socioeconomic status, occupation and biological susceptibility need to be simultaneously considered when deploying non-pharmacological public health measures. Integrating individual and population characteristics, as well as urban-specific parameters is the prerequisite in urban exposome studies. Applications of the exposome approach in cities/towns could facilitate assessment of health disparities and better identification of vulnerable populations, as framed by multiple environmental, urban design and planning co-exposures. Exposome-based applications in epidemics control and response include the implementation of exposomic tools that have been quite mature in non-communicable disease research, ranging from biomonitoring and surveillance to sensors and modeling. Therefore, the exposome can be a novel tool in risk assessment and management during epidemics and other major public health events. This is a unique opportunity for the research community to exploit the exposome concept and its tools in upgrading and further developing site-specific public health measures in cities.

Wastewater discharge and surface water contamination pre- and post- COVID 19—global case studies

Global pandemic of SARS-CoV-2 has infected more than 53 million people in more than 190 countries. The major transmission routes of most of the infectious viruses’ including SARS-CoV-2 remain aerosols and droplets. The source of which remains coughing, sneezing, urinary, and intestinal excretions. This book chapter focuses on the latter two sources of water and wastewater contamination with RNA of these contagious viruses. There has been studies regarding the presence of viral RNA of COVID-19 in wastewater in few of the countries like USA, Australia, Netherland, and India. This mainly happens due to the discharge of untreated wastewater from health care facilities and sewage treatment plants. Improper management of the waste has led to the contamination of surface water bodies. Fecal shedding of the virus is common in 50% of the infected individual, and urinal shedding in just around 5%. The former shedding is of the order of 10³–10⁵ copies/mL. The wastewater surveillance for SARS-CoV-2 RNA in wastewater gives the figure of 10²–10⁶ copies/L. The surveillance already known to track down many diseases, drugs in past has been a boon to the countries, where clinical testing is at a slow pace. Therefore, wastewater-based epidemiology is needed to have a better understanding of the water and wastewater surveillances, for prior detection of SARS-CoV-2 and other pathogens, sought to occur in future. The chapter deals with the occurrences, transport pathways, persistence, and removal of most of the reported infectious viruses in water and wastewater, with a special emphasize on SARS-CoV-2. Developing a proper framework and methodology containing environment and human health risk assessments will help the researchers and policyholders to look up for the alternative options. Even after a number of researches detecting the presence of SARS-CoV-2 in wastewater, there has been a limited knowledge in the potential role of water and wastewater in the transmission of these infectious viruses. A well summarized review would surely help in the assessment of the likely fate of most of these contagious human viruses.

SARS-CoV-2 in water services: Presence and impacts

The occurrence of human pathogenic viruses in aquatic ecosystems and, in particular, in internal water bodies (i.e., river, lakes, groundwater, drinking water reservoirs, recreational water utilities, and wastewater), raises concerns regarding the related impacts on environment and human health, especially in relation to the possibility of human exposure and waterborne infections. This paper reviews the current state of knowledge regarding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presence and persistence in human excreta, wastewaters, sewage sludge as well as in natural water bodies, and the possible implications for water services in terms of fecal transmission, public health, and workers' risk. Furthermore, the impacts related to the adopted containment and emergency management measures on household water consumptions are also discussed, together with the potential use of wastewater-based epidemiology (WBE) assessment as a monitoring and early warning tool, to be applied in case of infectious disease outbreaks. The knowledge and tools summarized in this paper provide a basic information reference, supporting decisions makers in the definition of suitable measures able to pursue an efficient water and wastewater management and a reduction of health risks. Furthermore, research questions are provided, in order to direct technical and public health communities towards a sustainable water service management in the event of a SARS-CoV-2 re-emergence, as well as a future deadly outbreak or pandemic.

Systems Dynamics Modeling of Pandemic Influenza for Strategic Policy Development: a Simulation-Based Analysis of the COVID-19 Case

The novel coronavirus disease 2019 (COVID-19) is a truly wicked problem which has remained a stubborn issue plaguing multiple countries worldwide. The continuously increasing number of infections and deaths has driven several countries to implement control and response strategies including community lockdowns, physical distancing, and travel bans with different levels of success. However, a disease outbreak and the corresponding policies can cause disastrous economic consequences due to business closures and risk minimization behaviors. This paper develops a system dynamics framework of a disease outbreak system covering various policies to evaluate their effectiveness in mitigating transmission and the resulting economic burden. The system dynamics modeling approach captures the relationships, feedbacks, and delays in such a system, revealing meaningful insights on the dynamics of several response strategies.

SARS-CoV-2 in wastewater: Challenges for developing countries

The COVID-19 pandemic that has engulfed the world, has affected the human lives in several aspects. The detection of SARS-CoV-2 in faeces and urine of the infected person, even after viral clearance in the respiratory tract, and its presence in untreated wastewater raises the possibility of fecal-oral transmission in future. The situation is likely to be more aggravated in developing and least developed countries struggling with the problem of ineffective waste disposal system, open defecation, poor sanitation, and limited access to clean drinking water. In this review, the available data on wastewater treatment, sanitation status and healthcare infrastructure from middle- and low-income countries is collected and correlated with the risk associated with the fecal-oral transmission of SARS-CoV-2. The review also highlights the limitation of COVID-19 surveillance through sewage monitoring in these countries owing to the absence of proper sewerage system. An inclusive approach of awareness, prevention, and mitigation from global to the local levels is required to overcome this challenging situation in developing countries.

A comprehensive study of COVID-19 in wastewater

The COVID-19 pandemic has had an adverse effect on human health, economy, and diverse environments. Besides the general transmission of the virus through air droplets and human-to-human contact; it is also transmitted while infecting the digestive system, which subsequently is defecated through the feces. Such fecal transmission can cause a major environmental distress, causing community transmission. This chapter attempts to investigate thoroughly the types of aquatic water bodies and addresses their role in the viral dissemination to combat SARS-CoV-2. It further enlightens the need for wastewater-based epidemiology (WBE) studies for surveillance as well as for early warning signal. The study could provide a comprehensive approach for designing effective strategies in the context of COVID-19 to counter the viral transmission and its deactivation. It also serves as a working paper for scholars and strategy regulators for planning and development of a new set-up from the global to the local level.

Multi-Omics Approach in the Identification of Potential Therapeutic Biomolecule for COVID-19

COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has a disastrous effect on mankind due to the contagious and rapid nature of its spread. Although vaccines for SARS-CoV-2 have been successfully developed, the proven, effective, and specific therapeutic molecules are yet to be identified for the treatment. The repurposing of existing drugs and recognition of new medicines are continuously in progress. Efforts are being made to single out plant-based novel therapeutic compounds. As a result, some of these biomolecules are in their testing phase. During these efforts, the whole-genome sequencing of SARS-CoV-2 has given the direction to explore the omics systems and approaches to overcome this unprecedented health challenge globally. Genome, proteome, and metagenome sequence analyses have helped identify virus nature, thereby assisting in understanding the molecular mechanism, structural understanding, and disease propagation. The multi-omics approaches offer various tools and strategies for identifying potential therapeutic biomolecules for COVID-19 and exploring the plants producing biomolecules that can be used as biopharmaceutical products. This review explores the available multi-omics approaches and their scope to investigate the therapeutic promises of plant-based biomolecules in treating SARS-CoV-2 infection.

Wastewater network infrastructure in public health: Applications and learnings from the COVID-19 pandemic

Accurate estimates of COVID-19 burden of infections in communities can inform public health strategy for the current pandemic. Wastewater based epidemiology (WBE) leverages sewer infrastructure to provide insights on rates of infection by measuring viral concentrations in wastewater. By accessing the sewer network at various junctures, important insights regarding COVID-19 disease activity can be gained. The analysis of sewage at the wastewater treatment plant level enables population-level surveillance of disease trends and virus mutations. At the neighborhood level, WBE can be used to describe trends in infection rates in the community thereby facilitating local efforts at targeted disease mitigation. Finally, at the building level, WBE can suggest the presence of infections and prompt individual testing. In this critical review, we describe the types of data that can be obtained through varying levels of WBE analysis, concrete plans for implementation, and public health actions that can be taken based on WBE surveillance data of infectious diseases, using recent and successful applications of WBE during the COVID-19 pandemic for illustration.

Analytical methodologies for the detection of SARS-CoV-2 in wastewater: Protocols and future perspectives

In March 2020 the World Health Organization announced a pandemic outbreak. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative pathogen for the coronavirus disease-19 (COVID-19) pandemic. The authorities worldwide use clinical science to identify infected people, but this approach is not able to track all symptomatic and asymptomatic cases due to limited sampling capacity of the testing laboratories. This drawback is eliminated by the Wastewater-Based Epidemiology (WBE) approach. In this review, we summarized the peer-reviewed published literature (available as of September 28, 2020), in the field of WBE. The commonly used steps (sampling, storage, concentration, isolation, detection) of the analytical protocols were identified. The potential limitations of each stage of the protocols and good practices were discussed. Finally, new methods for the efficient detection of SARS-CoV-2 were proposed.

SARS-CoV-2 viability under different meteorological conditions, surfaces, fluids and transmission between animals

Since the COVID-19 outbreak, researchers have tried to characterise the novel coronavirus SARS-CoV-2 to better understand the pathogenic mechanisms of the virus and prevent further dissemination. As a consequence, there has been a bloom in scientific research papers focused on the behaviour of the virus in different environmental contexts. Nevertheless, despite these efforts and due to its novelty, available information about this coronavirus is limited, as several research studies are still ongoing. This review aims to shed light on this issue. To that end, we have examined the scientific literature to date regarding the viability of SARS-CoV-2 on surfaces and fluids or under different environmental conditions (temperature, precipitation and UV radiation). We have also addressed the role of animals in the transmission of this coronavirus.

Preparing for Emerging Zoonotic Viruses

The risk of emergence and spread of novel human pathogens originating from an animal reservoir has increased in the past decades. However, the unpredictable nature of disease emergence makes surveillance and preparedness challenging. Knowledge of general risk factors for emergence and spread, combined with local level data is needed to develop a risk-based methodology for early detection. This involves the implementation of the One Health approach, integrating human, animal and environmental health sectors, as well as social sciences, bioinformatics and more. Recent technical advances, such as metagenomic sequencing, will aid the rapid detection of novel pathogens on the human-animal interface.

Primary concentration - The critical step in implementing the wastewater based epidemiology for the COVID-19 pandemic: A mini-review

The recent outbreak of a novel coronavirus SARS-CoV-2 has posed a significant global public health threat and caused dramatic social and economic disruptions. A new research direction is attracting a significant amount of attention in the academic community of environmental sciences and engineering, in which rapid community-level monitoring could be achieved by applying the methodology of wastewater based epidemiology (WBE). Given the fact that the development of a mass balance on the total number of viral RNA copies in wastewater samples and the infected stool specimens is the heart of WBE, the result of the quantitative RNA detection in wastewater has to be highly sensitive, accurate, and reliable. Thus, applying effective concentration methods before the subsequent RNA extraction and RT-qPCR detection is a must-have procedure for the WBE. This review provides new insights into the primary concentration methods that have been adopted by the eighteen recently reported COVID-19 wastewater detection studies, along with a brief discussion of the mechanisms of the most commonly used virus concentration methods, including the PEG-based separation, electrostatically charged membrane filtration, and ultrafiltration. In the end, two easy and well-proven concentration strategies are recommended as below, aiming to maximize the practical significance and operational effectiveness of the SARS-CoV-2 virus concentration from wastewater samples.

Assessing the Impact of Lockdown on Atmospheric Ozone Pollution Amid the First Half of 2020 in Shenyang, China

During the eruption of COVID-19, a citywide lockdown was executed from 26 January to 23 March 2020, in Shenyang, in which the ozone pollution has recorded significant variations. This paper mainly anatomized the comprehensive characteristics and evolution trends of ozone pollution based on the lockdown period in the first half of 2020. Using the Hybrid Single Particle Lagrangian Integrated Trajectory (HYSPLIT) model and cluster analysis method to establish backward trajectories and channels, the spatial transport process of ozone in the preset period and the causation of typical ozone pollution events were investigated in depth. The results demonstrated that: The ozone concentration pollution in the first half of 2020 was increased than last year. During the lockdown period, the basic pollutants levels were lower than that in pre-lockdown under different proportions, except O₃ maximum 8-h moving average (MDA8) was increased by 69.7%, accompanied by the delay of daily peak value, increased pollution days and longer pollution cycle. The typical pollution events were highly consistent with the evolution path of fine aerosol compelled by extreme weather. The ozone concentration and the atmospheric oxidation capacity can be stably maintained at a low level when NO₂ concentration remained at 50–70 μg/m³, no matter how much the AQI was. Meanwhile, ozone concentration in the downwind suburban was as low as the central city and soared in few stations amid post-lockdown, simultaneous the correlation between ozone and other pollutants converted from negative to positive. The trajectory indicated that the pollution sources during the lockdown and pre-lockdown were basically Southern Russia, Inner Mongolia, and the three provinces of Northeast China, the pollution from the Bohai Sea provoked ozone pollutants in Shenyang to rebound briskly amid post-lockdown, the pollution of neighboring countries and areas would have a stronger impact on air quality under the effect of lockdown.

Reverse logistics network design for medical waste management in the epidemic outbreak of the novel coronavirus (COVID-19)

The recent pandemic triggered by the outbreak of the novel coronavirus boosted the demand for medical services and protective equipment, causing the generation rate of infectious medical waste (IMW) to increase rapidly. Designing an efficient and reliable IMW reverse logistics network in this situation can help to control the spread of the virus. Studies on this issue are limited, and minimization of costs and the risks associated with the operations of this network consisting of different types of medical waste generation centers (MWGC) are rarely considered. In this research, a linear programming model with three objective functions is developed to minimize the total costs, the risk associated with the transportation and treatment of IMW, and the maximum amount of uncollected waste in MWGCs. Also, multiple functions that calculate the amount of generated waste according to the parameters of the current epidemic outbreak are proposed. Revised Multi-Choice Goal Programming method is employed to solve the multi-objective model, and a real case study from Iran is examined to illustrate the validation of the proposed model. The final results show that the model can create a balance between three considered objectives by determining the flow between centers, deciding to install two new temporary treatment centers, and allowing the network to only have uncollected waste in the first two periods in some MWGCs. Also, managerial insights for health organization authorities extracted from the final results and sensitivity analyses are presented for adequately handling the IMW network.

The role of wastewater treatment plants as tools for SARS-CoV-2 early detection and removal

The world is facing the third coronavirus caused pandemic in less than twenty years. The SARS-CoV-2 virus not only affects the human respiratory system, but also the gastrointestinal tract. The virus has been found in human feces, in sewage and in wastewater treatment plants. It has the potential to become a panzootic disease, as it is now proven that several mammalian species become infected. Since it has been shown that the virus can be detected in sewage even before the onset of symptoms in the local population, Wastewater Based Epidemiology should be developed not only to localize infection clusters of the primary wave but also to detect a potential second, or subsequent, wave. To prevent a panzootic, virus removal techniques from wastewater need to be implemented to prevent the virus dissemination into the environment. In that context, this review presents recent improvements in all the fields of wastewater treatment from treatment ponds to the use of algae or nanomaterials with a particular emphasis on membrane-based techniques.

Effect of lockdown on wastewater characteristics: a comparison of two large urban areas

The effect of the lockdown imposed to limit the spread of SARS-CoV-2 in France between March 14 and May 11, 2020 on the wastewater characteristics of two large urban areas (with between 250,000 and 300,000 inhabitants) was studied. The number of outward and inward daily commuters was extracted from national census databases related to the population and their commuting habits. For urban area A, with the larger number of daily inward commuters (110,000, compared to 53,000 for B), lockdown was observed to have an effect on the monthly load averages of chemical oxygen demand, biochemical oxygen demand, total Kjeldahl nitrogen, total suspended solids and total phosphorus, all of which decreased (confidence level of 95%). This decrease, which varied between 20% and 40% and reached 45% for COD, can be related to the cessation of catering and activities such as hairdressing, which generate large amounts of graywater. The ammonium loads, due to the use of toilets before leaving for work and after returning from work, remained constant. In the case of urban area B, lockdown had no noticeable effect. More data would be necessary in the long term to analyze the effect of changes in the balance between ammonia and carbon sources on the operation of wastewater treatment plants.

Decay of SARS-CoV-2 and surrogate murine hepatitis virus RNA in untreated wastewater to inform application in wastewater-based epidemiology

Wastewater-based epidemiology (WBE) demonstrates potential for COVID-19 community transmission monitoring; however, data on the stability of SARS-CoV-2 RNA in wastewater are needed to interpret WBE results. The decay rates of RNA from SARS-CoV-2 and a potential surrogate, murine hepatitis virus (MHV), were investigated by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) in untreated wastewater, autoclaved wastewater, and dechlorinated tap water stored at 4, 15, 25, and 37 °C. Temperature, followed by matrix type, most greatly influenced SARS-CoV-2 RNA first-order decay rates (k). The average T90 (time required for 1-log10 reduction) of SARS-CoV-2 RNA ranged from 8.04 to 27.8 days in untreated wastewater, 5.71 to 43.2 days in autoclaved wastewater, and 9.40 to 58.6 days in tap water. The average T90 for RNA of MHV at 4 to 37 °C ranged from 7.44 to 56.6 days in untreated wastewater, 5.58-43.1 days in autoclaved wastewater, and 10.9 to 43.9 days in tap water. There was no statistically significant difference between RNA decay of SARS-CoV-2 and MHV; thus, MHV is suggested as a suitable persistence surrogate. Decay rate constants for all temperatures were comparable across all matrices for both viral RNAs, except in untreated wastewater for SARS-CoV-2, which showed less sensitivity to elevated temperatures. Therefore, SARS-CoV-2 RNA is likely to persist long enough in untreated wastewater to permit reliable detection for WBE application.

Applications of GIS and geospatial analyses in COVID-19 research: A systematic review

Background: Geographic information science (GIS) has established itself as a distinct domain and incredibly useful whenever the research is related to geography, space, and other spatio-temporal dimensions. However, the scientific landscape on the integration of GIS in COVID-related studies is largely unknown. In this systematic review, we assessed the current evidence on the implementation of GIS and other geospatial tools in the COVID-19 pandemic. Methods: We systematically retrieved and reviewed 79 research articles that either directly used GIS or other geospatial tools as part of their analysis. We grouped the identified papers under six broader thematic groups based on the objectives and research questions of the study- environmental, socio-economic, and cultural, public health, spatial transmission, computer-aided modeling, and data mining. Results: The interdisciplinary nature of how geographic and spatial analysis was used in COVID-19 research was notable among the reviewed papers. Geospatial techniques, especially WebGIS, have even been widely used to visualize the data on a map and were critical to informing the public regarding the spread of the virus, especially during the early days of the pandemic. This review not only provided an overarching view on how GIS has been used in COVID-19 research so far but also concluded that geospatial analysis and technologies could be used in future public health emergencies along with statistical and other socio-economic modeling techniques. Our review also highlighted how scientific communities and policymakers could leverage GIS to extract useful information to make an informed decision in the future. Conclusions:  Despite the limited applications of GIS in identifying the nature and spatio-temporal pattern of this raging pandemic, there are opportunities to utilize these techniques in handling the pandemic. The use of spatial analysis and GIS could significantly improve how we understand the pandemic as well as address the underserviced demographic groups and communities.

Applications of GIS and geospatial analyses in COVID-19 research: A systematic review

Background: Geographic information science (GIS) has established itself as a distinct domain and incredibly useful whenever the research is related to geography, space, and other spatio-temporal dimensions. However, the scientific landscape on the integration of GIS in COVID-related studies is largely unknown. In this systematic review, we assessed the current evidence on the implementation of GIS and other geospatial tools in the COVID-19 pandemic. Methods: We systematically retrieved and reviewed 79 research articles that either directly used GIS or other geospatial tools as part of their analysis. We grouped the identified papers under six broader thematic groups based on the objectives and research questions of the study- environmental, socio-economic, and cultural, public health, spatial transmission, computer-aided modeling, and data mining. Results: The interdisciplinary nature of how geographic and spatial analysis was used in COVID-19 research was notable among the reviewed papers. Although GIS has substantial potential in planning to slow down the spread, surveillance, contact tracing, and identify the trends and hotspots of breakdowns, it was not employed as much as it could have been. This review not only provided an overarching view on how GIS has been used in COVID-19 research so far but also concluded that this geospatial analysis and technologies could be used in future public health emergencies along with statistical and other socio-economic modeling techniques. Our systematic review also provides how both scientific communities and policymakers could leverage GIS to extract useful information to make an informed decision in the future. Conclusions:  Despite the limited applications of GIS in identifying the nature and spatio-temporal pattern of this raging pandemic, there are opportunities to utilize these techniques in handling the pandemic. The use of spatial analysis and GIS could significantly improve how we understand the pandemic as well as address the underserviced demographic groups and communities.

Municipal solid waste management during the SARS-COV-2 outbreak and lockdown ease: Lessons from Italy

The literature on municipal solid waste in relation to COVID-19 is scarce. Based on the experience of Italy, the present article contributes to the strategies aimed at preventing a second virus outbreak. In fact, the mismanagement of municipal solid waste could undermine the strategies during the ease of the lockdown. During the SARS-COV-2 outbreak in Italy, there was a general decrease in the selective collection rate (-15% in one municipality with a well-developed door-to-door collection system). Delays in the publication of guidelines on waste management impacted on the safety of the operators collecting potentially infected waste. Contrarily to expectations, single-use masks and gloves do not have significant impact on waste management, accounting for <1% of the residual municipal solid waste collected annually. However, the dispersion of abandoned masks and gloves outside indoor environments is creating environmental problems. Recommendations on waste management and the protection of waste operators are discussed. Finally, guidelines on the most appropriate waste treatment are presented and analyzed. The results presented in this article show that the MSW management sector has found useful solutions to tackle COVID-19; however, these solutions are not being shared sufficiently. The case study analyzed in the present work could help define strategies for preventing or controlling similar future epidemics or pandemic episodes.

Presence and infectivity of SARS-CoV-2 virus in wastewaters and rivers

The presence of SARS-CoV-2 in raw wastewaters has been demonstrated in many countries affected by this pandemic. Nevertheless, virus presence and infectivity in treated wastewaters, but also in the receiving water bodies are still poorly investigated. In this study, raw and treated samples from three wastewater treatment plants, and three river samples within the Milano Metropolitan Area, Italy, were surveyed for SARS-CoV-2 RNA detection by means of real time RT-PCR and infectivity test on culture cells. SARS-CoV-2 RNA was detected in raw, but not in treated wastewaters (four and two samples, respectively, sampled in two dates). The isolated virus genome was sequenced, and belonged to the strain most spread in Europe and similar to another found in the same region. RNA presence in raw wastewater samples decreased after eight days, probably following the epidemiological trend estimated for the area. Virus infectivity was always null, indicating the natural decay of viral pathogenicity in time from emission. Samples from receiving rivers (three sites, sampled in the same dates as wastewaters) showed in some cases a positivity to real time RT-PCR, probably due to non-treated, or inefficiently treated discharges, or to the combined sewage overflows. Nevertheless, also for rivers infectivity was null. Risks for public health should be limited, although a precautionary approach to risk assessment is here advocated, giving the preliminary nature of the presented data.

Presence and infectivity of SARS-CoV-2 virus in wastewaters and rivers

The presence of SARS-CoV-2 in raw wastewaters has been demonstrated in many countries affected by this pandemic. Nevertheless, virus presence and infectivity in treated wastewaters, but also in the receiving water bodies are still poorly investigated. In this study, raw and treated samples from three wastewater treatment plants, and three river samples within the Milano Metropolitan Area, Italy, were surveyed for SARS-CoV-2 RNA detection by means of real time RT-PCR and infectivity test on culture cells. SARS-CoV-2 RNA was detected in raw, but not in treated wastewaters (four and two samples, respectively, sampled in two dates). The isolated virus genome was sequenced, and belonged to the strain most spread in Europe and similar to another found in the same region. RNA presence in raw wastewater samples decreased after eight days, probably following the epidemiological trend estimated for the area. Virus infectivity was always null, indicating the natural decay of viral pathogenicity in time from emission. Samples from receiving rivers (three sites, sampled in the same dates as wastewaters) showed in some cases a positivity to real time RT-PCR, probably due to non-treated, or inefficiently treated discharges, or to the combined sewage overflows. Nevertheless, also for rivers infectivity was null. Risks for public health should be limited, although a precautionary approach to risk assessment is here advocated, giving the preliminary nature of the presented data.

When the fourth water and digital revolution encountered COVID-19

The ongoing COVID-19 pandemic is, undeniably, a substantial shock to our civilization which has revealed the value of public services that relate to public health. Ensuring a safe and reliable water supply and maintaining water sanitation has become ever more critical during the pandemic. For this reason, researchers and practitioners have promptly investigated the impact associated with the spread of SARS-CoV-2 on water treatment processes, focusing specifically on water disinfection. However, the COVID-19 pandemic impacts multiple aspects of the urban water sector besides those related to the engineering processes, including sanitary, economic, and social consequences which can have significant effects in the near future. Furthermore, this outbreak appears at a time when the water sector was already experiencing a fourth revolution, transitioning toward the digitalisation of the sector, which redefines the Water-Human-Data Nexus. In this contribution, a product of collaboration between academics and practitioners from water utilities, we delve into the multiple impacts that the pandemic is currently causing and their possible consequences in the future. We show how the digitalisation of the water sector can provide useful approaches and tools to help address the impact of the pandemic. We expect this discussion to contribute not only to current challenges, but also to the conceptualization of new projects and the broader task of ameliorating climate change.

SARS-CoV-2 in the environment: Modes of transmission, early detection and potential role of pollutions

The coronavirus disease 2019 (COVID-19) is spreading globally having a profound effect on lives of millions of people, causing worldwide economic disruption. Curbing the spread of COVID-19 and future pandemics may be accomplished through understanding the environmental context of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and adoption of effective detection tools and mitigation policies. This article aims to examine the latest investigations on SARS-CoV-2 plausible environmental transmission modes, employment of wastewater surveillance for early detection of COVID-19, and elucidating the role of solid waste, water, and atmospheric quality on viral infectivity. Transmission of SARS-CoV-2 via faecal-oral or bio-aerosols lacks robust evidence and remains debatable. However, improper disinfection and defected plumbing systems in indoor environments such as hospitals and high-rise towers may facilitate the transport of virus-laden droplets of wastewater causing infection. Clinical and epidemiological studies are needed to present robust evidence that SARS-CoV-2 is transmissible via aerosols, though quantification of virus-laden aerosols at low concentrations presents a challenge. Wastewater surveillance of SARS-CoV-2 can be an effective tool in early detection of outbreak and determination of COVID-19 prevalence within a population, complementing clinical testing and providing decision makers guidance on restricting or relaxing movement. While poor air quality increases susceptibility to diseases, evidence for air pollution impact on COVID-19 infectivity is not available as infections are dynamically changing worldwide. Solid waste generated by households with infected individuals during the lockdown period may facilitate the spread of COVID-19 via fomite transmission route but has received little attention from the scientific community. Water bodies receiving raw sewage may pose risk of infection but this has not been investigated to date. Overall, our understanding of the environmental perspective of SARS-CoV-2 is imperative to detecting outbreak and predicting pandemic severity, allowing us to be equipped with the right tools to curb any future pandemic.

Wastewater surveillance for Covid-19: An African perspective

The COVID-19 pandemic has once again highlighted the importance of access to sufficient quantities of safe water and sanitation in public health. In the current COVID-19 pandemic, an early warning wastewater system has been proposed as a platform for SARS-CoV-2 surveillance, and a potentially important public health strategy to combat the disease. This short communication on wastewater surveillance in sub-Saharan Africa highlights challenges, opportunities and alternatives taken into account the local context.

Snowballing transmission of COVID-19 (SARS-CoV-2) through wastewater: Any sustainable preventive measures to curtail the scourge in low-income countries?

In this communication, we proposed sustainable preventive measures that may be adopted by the low-income countries to forestall the potential outbreak and transmission of COVID-19 (coronavirus disease 2019) through wastewater. Most low-income countries have poor sanitation and wastewater management policies, which create potential risks of COVID 19 spread. Hence, the proposed measures include decentralization of wastewater treatment facilities, community-wide monitoring and testing of SARS-CoV-2 in wastewater samples, improved sanitation, developing point-of-use devices for wastewater decontamination, and more focused policy interventions. Therefore, this paper adds useful insights into the monitoring and management of ongoing COVID-19 outbreak in low-income countries.

Snowballing transmission of COVID-19 (SARS-CoV-2) through wastewater: Any sustainable preventive measures to curtail the scourge in low-income countries?

In this communication, we proposed sustainable preventive measures that may be adopted by the low-income countries to forestall the potential outbreak and transmission of COVID-19 (coronavirus disease 2019) through wastewater. Most low-income countries have poor sanitation and wastewater management policies, which create potential risks of COVID 19 spread. Hence, the proposed measures include decentralization of wastewater treatment facilities, community-wide monitoring and testing of SARS-CoV-2 in wastewater samples, improved sanitation, developing point-of-use devices for wastewater decontamination, and more focused policy interventions. Therefore, this paper adds useful insights into the monitoring and management of ongoing COVID-19 outbreak in low-income countries.

Lysine 164 is critical for SARS-CoV-2 Nsp1 inhibition of host gene expression

The emerging pathogen severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused social and economic disruption worldwide, infecting over 9.0 million people and killing over 469 000 by 24 June 2020. Unfortunately, no vaccine or antiviral drug that completely eliminates the transmissible disease coronavirus disease 2019 (COVID-19) has been developed to date. Given that coronavirus nonstructural protein 1 (nsp1) is a good target for attenuated vaccines, it is of great significance to explore the detailed characteristics of SARS-CoV-2 nsp1. Here, we first confirmed that SARS-CoV-2 nsp1 had a conserved function similar to that of SARS-CoV nsp1 in inhibiting host-protein synthesis and showed greater inhibition efficiency, as revealed by ribopuromycylation and Renilla luciferase (Rluc) reporter assays. Specifically, bioinformatics and biochemical experiments showed that by interacting with 40S ribosomal subunit, the lysine located at amino acid 164 (K164) was the key residue that enabled SARS-CoV-2 nsp1 to suppress host gene expression. Furthermore, as an inhibitor of host-protein expression, SARS-CoV-2 nsp1 contributed to cell-cycle arrest in G0/G1 phase, which might provide a favourable environment for virus production. Taken together, this research uncovered the detailed mechanism by which SARS-CoV-2 nsp1 K164 inhibited host gene expression, laying the foundation for the development of attenuated vaccines based on nsp1 modification.

High-throughput wastewater analysis for substance use assessment in central New York during the COVID-19 pandemic

Wastewater entering sewer networks represents a unique source of pooled epidemiological information. In this study, we coupled online solid-phase extraction with liquid chromatography-high resolution mass spectrometry to achieve high-throughput analysis of health and lifestyle-related substances in untreated municipal wastewater during the coronavirus disease 2019 (COVID-19) pandemic. Twenty-six substances were identified and quantified in influent samples collected from six wastewater treatment plants during the COVID-19 pandemic in central New York. Over a 12 week sampling period, the mean summed consumption rate of six major substance groups (i.e., antidepressants, antiepileptics, antihistamines, antihypertensives, synthetic opioids, and central nervous system stimulants) correlated with disparities in household income, marital status, and age of the contributing populations as well as the detection frequency of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in wastewater and the COVID-19 test positivity in the studied sewersheds. Nontarget screening revealed the covariation of piperine, a nontarget substance, with SARS-CoV-2 RNA in wastewater collected from one of the sewersheds. Overall, this proof-of-the-concept study demonstrated the utility of high-throughput wastewater analysis for assessing the population-level substance use patterns during a public health crisis such as COVID-19.

SARS-CoV-2 in sewer systems and connected facilities

As for the SARS coronavirus in the 2003 epidemic, the presence of SARS-CoV-2 has been demonstrated in faeces and, in some cases, urine of infected people, as well as in wastewater. This paper proposes a critical review of the state of the art regarding studies on the presence of SARS-CoV-2 in wastewater and sewage sludge, the factors affecting its inactivation and the main proposed treatments. In-vitro tests demonstrated low resistance of SARS-CoV-2 to high temperature, while even significant changes in pH would not seem to determine the disappearance of the virus. In real wastewater and in sewage sludge, to date studies on the influence of the different parameters on the inactivation of SARS-CoV-2 are not available. Therefore, studies involving other HCoVs such as SARS-CoV and HCoV-229E have been also considered, in order to formulate a hypothesis regarding its behaviour in sewage and throughout the steps of biological treatments in WWTPs. Finally, SARS-CoV-2 in wastewater might track the epidemic trends: although being extremely promising, an effective and wide application of this approach requires a deeper knowledge of the amounts of viruses excreted through the faeces and the actual detectability of viral RNA in sewage.

Making waves: Wastewater-based epidemiology for COVID-19 - approaches and challenges for surveillance and prediction

The presence of SARS-CoV-2 in the feces of infected patients and wastewater has drawn attention, not only to the possibility of fecal-oral transmission but also to the use of wastewater as an epidemiological tool. The COVID-19 pandemic has highlighted problems in evaluating the epidemiological scope of the disease using classical surveillance approaches, due to a lack of diagnostic capacity, and their application to only a small proportion of the population. As in previous pandemics, statistics, particularly the proportion of the population infected, are believed to be widely underestimated. Furthermore, analysis of only clinical samples cannot predict outbreaks in a timely manner or easily capture asymptomatic carriers. Threfore, community-scale surveillance, including wastewater-based epidemiology, can bridge the broader community and the clinic, becoming a valuable indirect epidemiological prediction tool for SARS-CoV-2 and other pandemic viruses. This article summarizes current knowledge and discusses the critical factors for implementing wastewater-based epidemiology of COVID-19.

SARS-CoV-2 in wastewater: State of the knowledge and research needs

The ongoing global pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a Public Health Emergency of International Concern, which was officially declared by the World Health Organization. SARS-CoV-2 is a member of the family Coronaviridae that consists of a group of enveloped viruses with single-stranded RNA genome, which cause diseases ranging from common colds to acute respiratory distress syndrome. Although the major transmission routes of SARS-CoV-2 are inhalation of aerosol/droplet and person-to-person contact, currently available evidence indicates that the viral RNA is present in wastewater, suggesting the need to better understand wastewater as potential sources of epidemiological data and human health risks. Here, we review the current knowledge related to the potential of wastewater surveillance to understand the epidemiology of COVID-19, methodologies for the detection and quantification of SARS-CoV-2 in wastewater, and information relevant for human health risk assessment of SARS-CoV-2. There has been growing evidence of gastrointestinal symptoms caused by SARS-CoV-2 infections and the presence of viral RNA not only in feces of infected individuals but also in wastewater. One of the major challenges in SARS-CoV-2 detection/quantification in wastewater samples is the lack of an optimized and standardized protocol. Currently available data are also limited for conducting a quantitative microbial risk assessment (QMRA) for SARS-CoV-2 exposure pathways. However, modeling-based approaches have a potential role to play in reducing the impact of the ongoing COVID-19 outbreak. Furthermore, QMRA parameters obtained from previous studies on relevant respiratory viruses help to inform risk assessments of SARS-CoV-2. Our understanding on the potential role of wastewater in SARS-CoV-2 transmission is largely limited by knowledge gaps in its occurrence, persistence, and removal in wastewater. There is an urgent need for further research to establish methodologies for wastewater surveillance and understand the implications of the presence of SARS-CoV-2 in wastewater.

Les indicateurs d’alerte et de surveillance de la Covid-19

Face à la crise sanitaire provoquée par la pandémie de Covid-19 en France, Santé publique France a mis en place un système de surveillance évolutif fondé sur des définitions de cas possible, probable et confirmé. Le décompte quotidien se limite cependant aux cas confirmés par reverse transcriptase polymerase chain reaction ou sérologie SARS-CoV-2 (actuellement via la plateforme SI-DEP), aux cas hospitalisés (via le Système d’information pour le suivi des victimes d’attentats) et aux décès hospitaliers par Covid-19. Ce suivi de la circulation virale est forcément non exhaustif, et l’estimation de l’incidence est complétée par d’autres indicateurs comme les appels au 15, les recours à SOS Médecins, les passages dans les services d’accueil des urgences, les consultations de médecine de ville via le réseau Sentinelle. Le suivi de la mortalité non hospitalière s’est heurté aux délais de transmission des certificats de décès et au manque de diagnostic fiable. Seule la létalité hospitalière a pu être mesurée de manière fiable. Moyennant un certain nombre de précautions statistiques et d’hypothèses de travail, les modèles ont permis d’anticiper l’évolution de l’épidémie à partir de deux indicateurs essentiels : le ratio de reproduction R et le temps de doublement épidémique. En Île-de-France, l’Assistance publique– Hôpitaux de Paris a complété ce tableau de bord grâce à son entrepôt de données de santé et a ainsi pu modéliser de manière fine le parcours de soins des patients. L’ensemble de ces indicateurs a été essentiel pour assurer une planification de la réponse à la crise.

Sampling manholes to home in on SARS-CoV-2 infections

About 50% of individuals infected with the novel Coronavirus (SARS-CoV-2) suffer from intestinal infection as well as respiratory infection. They shed virus in their stool. Municipal sewage systems carry the virus and its genetic remnants. These viral traces can be detected in the sewage entering a wastewater treatment plant (WTP). Such virus signals indicate community infections but not locations of the infection within the community. In this paper, we frame and formulate the problem in a way that leads to algorithmic procedures homing in on locations and/or neighborhoods within the community that are most likely to have infections. Our data source is wastewater sampled and real-time tested from selected manholes. Our algorithms dynamically and adaptively develop a sequence of manholes to sample and test. The algorithms are often finished after 5 to 10 manhole samples, meaning that-in the field-the procedure can be carried out within one day. The goal is to provide timely information that will support faster more productive human testing for viral infection and thus reduce community disease spread. Leveraging the tree graph structure of the sewage system, we develop two algorithms, the first designed for a community that is certified at a given time to have zero infections and the second for a community known to have many infections. For the first, we assume that wastewater at the WTP has just revealed traces of SARS-CoV-2, indicating existence of a "Patient Zero" in the community. This first algorithm identifies the city block in which the infected person resides. For the second, we home in on a most infected neighborhood of the community, where a neighborhood is usually several city blocks. We present extensive computational results, some applied to a small New England city.

A review on presence, survival, disinfection/removal methods of coronavirus in wastewater and progress of wastewater-based epidemiology

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the global pandemic coronavirus 2019 disease (COVID-19). The outbreak of COVID-19 as Public Health Emergency of International Concern is declared by World Health Organization on January 30, 2020. The known route of transmission is due to direct contact or via respiratory droplets. Recently, several studies reported SARS-CoV-2 ribonucleic acid (RNA) in wastewater treatment plant samples. The presence of SARS-CoV-2 RNA in wastewater may predict COVID-19 occurrence qualitatively and quantitatively. The concept is known as wastewater-based epidemiology (WBE) or sewage epidemiology. The present study reviewed the presence of coronavirus in wastewater and investigations relating to WBE development as a tool to detect COVID-19 community transmission. Few articles reported a correlation of SARS-CoV-2 RNA concentration in wastewater with the number of COVID-19 cases, whereas few reported higher prediction by wastewater surveillance than confirmed cases. The application of WBE is still in a preliminary stage but has the potential to indicate an early sign of transmission. The knowledge of persistence of coronavirus in municipal and hospital wastewater is needed for the application of WBE and to understand the chances of transmission. The studies reported more prolonged survival of coronavirus in low-temperature wastewater. Studies relating to the inactivation of coronavirus by disinfectants and removal of coronavirus are also presented. Research on the performance of the commonly adopted disinfection technologies in inactivating SARS-CoV-2 in municipal and hospital wastewater is required to reduce the risk associated with municipal and hospital wastewater.

First environmental surveillance for the presence of SARS-CoV-2 RNA in wastewater and river water in Japan

Wastewater-based epidemiology is a powerful tool to understand the actual incidence of coronavirus disease 2019 (COVID-19) in a community because severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent of COVID-19, can be shed in the feces of infected individuals regardless of their symptoms. The present study aimed to assess the presence of SARS-CoV-2 RNA in wastewater and river water in Yamanashi Prefecture, Japan, using four quantitative and two nested PCR assays. Influent and secondary-treated (before chlorination) wastewater samples and river water samples were collected five times from a wastewater treatment plant and three times from a river, respectively, between March 17 and May 7, 2020. The wastewater and river water samples (200-5000 mL) were processed by using two different methods: the electronegative membrane-vortex (EMV) method and the membrane adsorption-direct RNA extraction method. Based on the observed concentrations of indigenous pepper mild mottle virus RNA, the EMV method was found superior to the membrane adsorption-direct RNA extraction method. SARS-CoV-2 RNA was successfully detected in one of five secondary-treated wastewater samples with a concentration of 2.4 × 103 copies/L by N_Sarbeco qPCR assay following the EMV method, with sequence confirmation of the qPCR product, whereas all the influent samples were tested negative for SARS-CoV-2 RNA. This result could be attributed to higher limit of detection for influent (4.0 × 103-8.2 × 104 copies/L) with a lower filtration volume (200 mL) compared to that for secondary-treated wastewater (1.4 × 102-2.5 × 103 copies/L) with a higher filtration volume of 5000 mL. None of the river water samples tested positive for SARS-CoV-2 RNA. Comparison with the reported COVID-19 cases in Yamanashi Prefecture showed that SARS-CoV-2 RNA was detected in the secondary-treated wastewater sample when the cases peaked in the community. This is the first study reporting the detection of SARS-CoV-2 RNA in wastewater in Japan.

First environmental surveillance for the presence of SARS-CoV-2 RNA in wastewater and river water in Japan

Wastewater-based epidemiology is a powerful tool to understand the actual incidence of coronavirus disease 2019 (COVID-19) in a community because severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent of COVID-19, can be shed in the feces of infected individuals regardless of their symptoms. The present study aimed to assess the presence of SARS-CoV-2 RNA in wastewater and river water in Yamanashi Prefecture, Japan, using four quantitative and two nested PCR assays. Influent and secondary-treated (before chlorination) wastewater samples and river water samples were collected five times from a wastewater treatment plant and three times from a river, respectively, between March 17 and May 7, 2020. The wastewater and river water samples (200-5000 mL) were processed by using two different methods: the electronegative membrane-vortex (EMV) method and the membrane adsorption-direct RNA extraction method. Based on the observed concentrations of indigenous pepper mild mottle virus RNA, the EMV method was found superior to the membrane adsorption-direct RNA extraction method. SARS-CoV-2 RNA was successfully detected in one of five secondary-treated wastewater samples with a concentration of 2.4 × 10³ copies/L by N_Sarbeco qPCR assay following the EMV method, with sequence confirmation of the qPCR product, whereas all the influent samples were tested negative for SARS-CoV-2 RNA. This result could be attributed to higher limit of detection for influent (4.0 × 10³-8.2 × 10⁴ copies/L) with a lower filtration volume (200 mL) compared to that for secondary-treated wastewater (1.4 × 10²-2.5 × 10³ copies/L) with a higher filtration volume of 5000 mL. None of the river water samples tested positive for SARS-CoV-2 RNA. Comparison with the reported COVID-19 cases in Yamanashi Prefecture showed that SARS-CoV-2 RNA was detected in the secondary-treated wastewater sample when the cases peaked in the community. This is the first study reporting the detection of SARS-CoV-2 RNA in wastewater in Japan.

First environmental surveillance for the presence of SARS-CoV-2 RNA in wastewater and river water in Japan

Wastewater-based epidemiology is a powerful tool to understand the actual incidence of coronavirus disease 2019 (COVID-19) in a community because severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent of COVID-19, can be shed in the feces of infected individuals regardless of their symptoms. The present study aimed to assess the presence of SARS-CoV-2 RNA in wastewater and river water in Yamanashi Prefecture, Japan, using four quantitative and two nested PCR assays. Influent and secondary-treated (before chlorination) wastewater samples and river water samples were collected five times from a wastewater treatment plant and three times from a river, respectively, between March 17 and May 7, 2020. The wastewater and river water samples (200-5000 mL) were processed by using two different methods: the electronegative membrane-vortex (EMV) method and the membrane adsorption-direct RNA extraction method. Based on the observed concentrations of indigenous pepper mild mottle virus RNA, the EMV method was found superior to the membrane adsorption-direct RNA extraction method. SARS-CoV-2 RNA was successfully detected in one of five secondary-treated wastewater samples with a concentration of 2.4 × 10³ copies/L by N_Sarbeco qPCR assay following the EMV method, with sequence confirmation of the qPCR product, whereas all the influent samples were tested negative for SARS-CoV-2 RNA. This result could be attributed to higher limit of detection for influent (4.0 × 10³-8.2 × 10⁴ copies/L) with a lower filtration volume (200 mL) compared to that for secondary-treated wastewater (1.4 × 10²-2.5 × 10³ copies/L) with a higher filtration volume of 5000 mL. None of the river water samples tested positive for SARS-CoV-2 RNA. Comparison with the reported COVID-19 cases in Yamanashi Prefecture showed that SARS-CoV-2 RNA was detected in the secondary-treated wastewater sample when the cases peaked in the community. This is the first study reporting the detection of SARS-CoV-2 RNA in wastewater in Japan.

Novel wastewater surveillance strategy for early detection of coronavirus disease 2019 hotspots

The novel coronavirus disease 2019, a pandemic of global concern, caused by the novel severe acute respiratory syndrome coronavirus 2 has severely revealed the need for public monitoring and efficient screening techniques. Despite the various advancements made in the medical and research field, containment of this virus has proven to be difficult on several levels. As such, it is a necessary requirement to identify possible hotspots in the early stages of any disease. Based on previous studies carried out on coronaviruses, there is a high likelihood that severe acute respiratory syndrome coronavirus 2 may also survive in wastewater. Hence, we propose the use of nanofiber filters as a wastewater pretreatment routine and upgradation of existing wastewater evaluation and treatment systems to serve as a beneficial surveillance tool.

Implementation of environmental surveillance for SARS-CoV-2 virus to support public health decisions: Opportunities and challenges

Analysing wastewater can be used to track infectious disease agents that are shed via stool and urine. Sewage surveillance of SARS-CoV-2 has been suggested as a tool to determine the extent of COVID-19 in cities and serve as an early warning for (re-)emergence of SARS-CoV-2 circulation in communities. The focus of this review is on the strength of evidence, opportunities and challenges for the application of sewage surveillance to inform public health decision making. Considerations for undertaking sampling programs are reviewed including sampling sites, strategies, sample transport, storage and quantification methods; together with the approach and evidence base for quantifying prevalence of infection from measured wastewater concentration. Published SARS-CoV-2 sewage surveillance studies (11 peer reviewed and 10 preprints) were reviewed to demonstrate the current status of implementation to support public health decisions. Although being very promising, a number of areas were identified requiring additional research to further strengthen this approach and take full advantage of its potential. In particular, design of adequate sampling strategies, spatial and temporal resolution of sampling, sample storage, replicate sampling and analysis, controls for the molecular methods used for the quantification of SARS-CoV-2 RNA in wastewater. The use of appropriate prevalence data and methods to correlate or even translate SARS-CoV-2 concentrations in wastewater to prevalence of virus shedders in the population is discussed.

SARS-CoV-2 / COVID-19: Salient Facts and Strategies to Combat Ongoing Pandemic

Severe acute respiratory syndrome coronavirus – 2 (SARS-CoV-2), an emerging novel coronavirus causing coronavirus disease 2019 (COVID-19) pandemic, has now rapidly spread to more than 215 countries and has killed nearly 0.75 million people out of more than 20 million confirmed cases as of 10th August, 2020. Apart from affecting respiratory system, the virus has shown multiple manifestations with neurological affections and damaging kidneys. SARS-CoV-2 transmission mainly occurs through close contact of COVID-19 affected person, however air-borne route is also now considered as dominant route of virus spread. The virus has been implicated to have originated from animals. Apart from bats, pangolins and others being investigates to play role in transmitting SARS-CoV-2 as intermediate hosts, the recent reports of this virus infection in other animals (cats, dogs, tigers, lions, mink) suggest one health approach implementation along with adopting appropriate mitigation strategies. Researchers are pacing to develop effective vaccines and drugs, few reached to clinical trials also, however these may take time to reach the mass population, and so till then adopting appropriate prevention and control is the best option to avoid SARS-CoV-2 infection. This article presents an overview on this pandemic virus and the disease it causes, with few recent concepts and advances.