A review of the presence of SARS-CoV-2 RNA in wastewater and airborne particulates and its use for virus spreading surveillance

Urban Wastewater-Based Surveillance of SARS-CoV-2 Virus: A Two-Year Study Conducted in City of Patras, Greece

Wastewater-based epidemiology, during the COVID-19 pandemic years, has been applied as a complementary approach, worldwide, for tracking SARS-CoV-2 virus into the community and used as an early warning of the prevalence of COVID-19 infection. The present study presents the results of the 2-year surveillance project, in the city of Patras, Greece. The purpose of the study was to monitor SARS-CoV-2 and implement WBE as an early warning method of monitoring Public Health impact. The presence of SARS-CoV-2 was determined and quantified in 310 samples using RT-qPCR assays. For the years 2022 and 2023, 93.5% and 78.7% of samples were found positive, respectively. Comparison of detection methods have been conducted to select the method with the highest recovery of the viral load. A seasonal variation of the virus was recorded, showing a recession in summer months confirming the country's epidemiological data as indicated by positive correlation of wastewater viral load with registered cases of COVID-19 infections during these years (p < 0.05) and moreover sealed with a significant negative correlation observed with Daily Average (p < 0.01) and Daily Maximum Temperature (p < 0.01). More research was carried out to elucidate a possible association of physicochemical characteristics of wastewater with viral load showing positive correlation with Chlorides (p < 0.01) advocating possible increased use of chlorine-based disinfectants and Electrical Conductivity (p < 0.01) indicates that wastewater during periods of increased infections is more heavily loaded with ions from chemical and biological pollutants. No correlation found with rainfall and physicochemical indicators, such as COD, BOD5, Total Phosphorus, Total Nitrogen, and Total Suspended Solids. According to the findings, WBE represents a useful tool in the management of epidemics based on an environmental approach and it can also shed light on the interacting parameters that capture Public Health since any infections that may lead to epidemics lead to a parallel change in the use of pharmaceuticals, antimicrobials, disinfectants, and microbial load in urban wastewater.

Variations in the persistence of 5'-end genomic and subgenomic SARS-CoV-2 RNAs in wastewater from aircraft, airports and wastewater treatment plants

Wastewater sequencing has become a powerful supplement to clinical testing in monitoring SARS-CoV-2 infections in the post-COVID-19 pandemic era. While its applications in measuring the viral burden and main circulating lineages in the community have proved their efficacy, the variations in sequencing quality and coverage across the different regions of the SARS-CoV-2 genome are not well understood. Furthermore, it is unclear how different sample origins, viral extraction and concentration methods and environmental factors impact the reads sequenced from wastewater. Using high-coverage, amplicon-based, paired-end read sequencing of viral RNA extracted from wastewater collected directly from aircraft, pooled from different aircraft and airport buildings or from regular wastewater plants, we assessed the genome coverage across the sample groups with a focus on the 5'-end region covering the leader sequence and investigated whether it was possible to detect subgenomic RNA from viral material recovered from wastewater. We identified distinct patterns in the persistence of the different genomic regions across the different types of wastewaters and the existence of chimeric reads mapping to non-amplified regions. Our findings suggest that preservation of the 5'-end of the genome and the ability to detect subgenomic RNA reads, though highly susceptible to environment and sample processing conditions, may be indicative of the quality and amount of the viral RNA present in wastewater.

Human viral pathogens in the wastewater-source water-drinking water continuum: Evidence, health risks, and lessons for future outbreaks in low-income settings

Human viral pathogens, including SARS-CoV-2 continue to attract public and research attention due to their disruption of society, global health, and the economy. Several earlier reviews have investigated the occurrence and fate of SARS-CoV-2 in wastewater, and the potential to use such data in wastewater-based epidemiology. However, comprehensive reviews tracking SARS-CoV-2 and other viral pathogens in the wastewater-water-drinking water continuum and the associated risk assessment are still lacking. Therefore, to address this gap, the present paper makes the following contributions: (1) critically examines the early empirical results to highlight the occurrence and stability of SARS-CoV-2 in the wastewater-source water-drinking water continuum, (2) discusses the anthropogenic and hydro(geo)logical processes controlling the circulation of SARS-CoV-2 in the wastewater-source water-drinking water continuum, (3) discusses the risky behaviour, drivers and high-risk settings in the wastewater-source water-drinking water continuum, (4) uses the available empirical data on SARS-CoV-2 occurrence in the wastewater-source water-drinking water continuum to discuss human health risks from multiple exposure pathways, gendered aspects of SARS-CoV-2 transmission via shared on-site sanitation systems, and (5) develops and risk mitigation strategy based on the available empirical evidence and quantitative human risk assessment data. Finally, it presents a comprehensive research agenda on SARS-CoV-2/COVID-19 to guide the mitigation of future similar outbreaks in low-income settings.

Spike-Seq: An amplicon-based high-throughput sequencing approach for the sensitive detection and characterization of SARS-CoV-2 genetic variations in environmental samples

Ever since the outbreak of COVID-19 disease in Wuhan, China, different variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been identified. Wastewater-based epidemiology (WBE), an approach that has been successfully applied in numerous case studies worldwide, offers a cost-effective and rapid way for monitoring trends of SARS-Cov-2 in the community level without selection bias. Despite being a gold-standard procedure, WBE is a challenging approach due to the sample instability and the moderate efficiency of SARS-CoV-2 concentration in wastewater. In the present study, we introduce Spike-Seq, a custom amplicon-based approach for the S gene sequencing of SARS-CoV-2 in wastewater samples, which enables not only the accurate identification of the existing Spike-related genetic markers, but also the estimation of their frequency in the investigated samples. The implementation of Spike-Seq involves the combination of nested PCR-based assays that efficiently amplify the entire nucleotide sequence of the S gene and next-generation sequencing, which enables the variant detection and the estimation of their frequency. In the framework of the current work, Spike-Seq was performed to investigate the mutational profile of SARS-CoV-2 in samples from the Wastewater Treatment Plant (WWTP) of Athens, Greece, which originated from multiple timepoints, ranging from March 2021 until July 2022. Our findings demonstrate that Spike-Seq efficiently detected major genetic markers of B.1.1.7 (Alpha), B.1.617.2 (Delta) as well as B.1.1.529 (Omicron) variants in wastewater samples and provided their frequency levels, showing similar variant distributions with the published clinical data from the National Public Health organization. The presented approach can prove to be a useful tool for the detection of SARS-CoV-2 in challenging wastewater samples and the identification of the existing genetic variants of S gene.

Real-Time On-Site Monitoring of Viruses in Wastewater Using Nanotrap® Particles and RICCA Technologies

Wastewater-based epidemiology (WBE) is an effective and efficient tool for the early detection of infectious disease outbreaks in a community. However, currently available methods are laborious, costly, and time-consuming due to the low concentration of viruses and the presence of matrix chemicals in wastewater that may interfere with molecular analyses. In the present study, we designed a highly sensitive "Quick Poop (wastewater with fecal waste) Sensor" (termed, QPsor) using a joint approach of Nanotrap microbiome particles and RICCA (RNA Isothermal Co-Assisted and Coupled Amplification). Using QPsor, the WBE study showed a strong correlation with standard PEG concentrations and the qPCR technique. Using a closed format for a paper-based lateral flow assay, we were able to demonstrate the potential of our assay as a real-time, point-of-care test by detecting the heat-inactivated SARS-CoV-2 virus in wastewater at concentrations of 100 copies/mL and within one hour. As a proof-of-concept demonstration, we analyzed the presence of viral RNA of the SARS-CoV-2 virus and PMMoV in raw wastewater samples from wastewater treatment plants on-site and within 60 min. The results show that the QPsor method can be an effective tool for disease outbreak detection by combining an AI-enabled case detection model with real-time on-site viral RNA extraction and amplification, especially in the absence of intensive clinical laboratory facilities. The lab-free, lab-quality test capabilities of QPsor for viral prevalence and transmission in the community can contribute to the efficient management of pandemic situations.

Changes to Public Health Surveillance Methods Due to the COVID-19 Pandemic: Scoping Review

BACKGROUND

Public health surveillance plays a vital role in informing public health decision-making. The onset of the COVID-19 pandemic in early 2020 caused a widespread shift in public health priorities. Global efforts focused on COVID-19 monitoring and contact tracing. Existing public health programs were interrupted due to physical distancing measures and reallocation of resources. The onset of the COVID-19 pandemic intersected with advancements in technologies that have the potential to support public health surveillance efforts.

OBJECTIVE

This scoping review aims to explore emergent public health surveillance methods during the early COVID-19 pandemic to characterize the impact of the pandemic on surveillance methods.

METHODS

A scoping search was conducted in multiple databases and by scanning key government and public health organization websites from March 2020 to January 2022. Published papers and gray literature that described the application of new or revised approaches to public health surveillance were included. Papers that discussed the implications of novel public health surveillance approaches from ethical, legal, security, and equity perspectives were also included. The surveillance subject, method, location, and setting were extracted from each paper to identify trends in surveillance practices. Two public health epidemiologists were invited to provide their perspectives as peer reviewers.

RESULTS

Of the 14,238 unique papers, a total of 241 papers describing novel surveillance methods and changes to surveillance methods are included. Eighty papers were review papers and 161 were single studies. Overall, the literature heavily featured papers detailing surveillance of COVID-19 transmission (n=187). Surveillance of other infectious diseases was also described, including other pathogens (n=12). Other public health topics included vaccines (n=9), mental health (n=11), substance use (n=4), healthy nutrition (n=1), maternal and child health (n=3), antimicrobial resistance (n=2), and misinformation (n=6). The literature was dominated by applications of digital surveillance, for example, by using big data through mobility tracking and infodemiology (n=163). Wastewater surveillance was also heavily represented (n=48). Other papers described adaptations to programs or methods that existed prior to the COVID-19 pandemic (n=9). The scoping search also found 109 papers that discuss the ethical, legal, security, and equity implications of emerging surveillance methods. The peer reviewer public health epidemiologists noted that additional changes likely exist, beyond what has been reported and available for evidence syntheses.

CONCLUSIONS

The COVID-19 pandemic accelerated advancements in surveillance and the adoption of new technologies, especially for digital and wastewater surveillance methods. Given the investments in these systems, further applications for public health surveillance are likely. The literature for surveillance methods was dominated by surveillance of infectious diseases, particularly COVID-19. A substantial amount of literature on the ethical, legal, security, and equity implications of these emerging surveillance methods also points to a need for cautious consideration of potential harm.

Tracking the effects of the COVID-19 pandemic on viral gastroenteritis through wastewater-based retrospective analyses

The COVID-19 pandemic possibly disrupted the circulation and seasonality of gastroenteritis viruses (e.g., Norovirus (NoV), Sapovirus (SaV), group A rotavirus (ARoV), and Aichivirus (AiV)). Despite the growing application of wastewater-based epidemiology (WBE), there remains a lack of sufficient investigations into the actual impact of the COVID-19 pandemic on the prevalence of gastroenteritis viruses. In this study, we measured NoV GI and GII, SaV, ARoV, and AiV RNA concentrations in 296 influent wastewater samples collected from three wastewater treatment plants (WWTPs) in Sapporo, Japan between October 28, 2018 and January 12, 2023 using the highly sensitive EPISENS™ method. The detection ratios of SaV and ARoV after May 2020 (SaV: 49.8 % (134/269), ARoV: 57.4 % (151/263)) were significantly lower than those before April 2020 (SaV: 93.9 % (31/33), ARoV: 97.0 % (32/33); SaV: p < 3.5×10-7, ARoV: p < 1.5×10-6). Furthermore, despite comparable detection ratios before (88.5 %, 23/26) and during (66.7 %, 80/120) the COVID-19 pandemic (p = 0.032), the concentrations of NoV GII revealed a significant decrease after the onset of the pandemic (p < 1.5×10-7, Cliff's delta = 0.72). NoV GI RNA were sporadically detected (24.7 %, 8/33) before April 2020 and after May 2020 (6.5 %, 17/263), whereas AiV was consistently (100 %, 33/33) detected from wastewater throughout the study period (95.8 %, 252/263). The WBE results demonstrated the significant influence of COVID-19 countermeasures on the circulation of gastroenteritis viruses, with variations observed in the magnitude of their impact across different types of viruses. These epidemiological findings highlight that the hygiene practices implemented to prevent COVID-19 infections may also be effective for controlling the prevalence of gastroenteritis viruses, providing invaluable insights for public health units and the development of effective disease management guidelines.

A review on sterilization methods of environmental decontamination to prevent the coronavirus SARS-CoV-2 (COVID-19 virus): A new challenge towards eco-friendly solutions

In recent years, the COVID-19 pandemic is currently wreaking havoc on the planet. SARS-CoV-2, the Severe Acute Respiratory Syndrome Coronavirus, is the current term for this outbreak. Reports about this novel coronavirus have been presented since the pandemic's breakout, and they have demonstrated that it transmits rapidly from person to person, primarily by droplets in the air. Findings have illustrated that SARS-CoV-2 can survive on surfaces from hours to days. Therefore, it is essential to find practical solutions to reduce the virus's impact on human health and the environment. This work evaluated common sterilization methods that can decontaminate the environment and items. The goal is that healthcare facilities, disease prevention organizations, and local communities can overcome the new challenge of finding eco-friendly solutions. Further, a foundation of information encompassing various sterilization procedures and highlighting their limits to choose the most appropriate method to stop disease-causing viruses in the new context has been presented. The findings of this crucial investigation contribute to gaining insight into the comprehensive sterilization approaches against the coronavirus for human health protection and sustainable environmental development.

Time series modelling for wastewater-based epidemiology of COVID-19: A nationwide study in 40 wastewater treatment plants of Belgium, February 2021 to June 2022

BACKGROUND

Wastewater-based epidemiology (WBE) has been implemented to monitor surges of COVID-19. Yet, multiple factors impede the usefulness of WBE and quantitative adjustment may be required.

AIM

We aimed to model the relationship between WBE data and incident COVID-19 cases, while adjusting for confounders and autocorrelation.

METHODS

This nationwide WBE study includes data from 40 wastewater treatment plants (WWTPs) in Belgium (02/2021-06/2022). We applied ARIMA-based modelling to assess the effect of daily flow rate, pepper mild mottle virus (PMMoV) concentration, a measure of human faeces in wastewater, and variants (alpha, delta, and omicron strains) on SARS-CoV-2 RNA levels in wastewater. Secondly, adjusted WBE metrics at different lag times were used to predict incident COVID-19 cases. Model selection was based on AICc minimization.

RESULTS

In 33/40 WWTPs, RNA levels were best explained by incident cases, flow rate, and PMMoV. Flow rate and PMMoV were associated with -13.0 % (95 % prediction interval: -26.1 to +0.2 %) and +13.0 % (95 % prediction interval: +5.1 to +21.0 %) change in RNA levels per SD increase, respectively. In 38/40 WWTPs, variants did not explain variability in RNA levels independent of cases. Furthermore, our study shows that RNA levels can lead incident cases by at least one week in 15/40 WWTPs. The median population size of leading WWTPs was 85.1 % larger than that of non‑leading WWTPs. In 17/40 WWTPs, however, RNA levels did not lead or explain incident cases in addition to autocorrelation.

CONCLUSION

This study provides quantitative insights into key determinants of WBE, including the effects of wastewater flow rate, PMMoV, and variants. Substantial inter-WWTP variability was observed in terms of explaining incident cases. These findings are of practical importance to WBE practitioners and show that the early-warning potential of WBE is WWTP-specific and needs validation.

Potential transmission of SARS-CoV-2 through microplastics in sewage: A wastewater-based epidemiological review

In light of the current COVID-19 pandemic caused by the virus SARS-CoV-2, there is an urgent need to identify and investigate the various pathways of transmission. In addition to contact and aerosol transmission of the virus, this review investigated the possibility of its transmission via microplastics found in sewage. Wastewater-based epidemiological studies on the virus have confirmed its presence and persistence in both influent sewage as well as treated ones. The hypothesis behind the study is that the huge amount of microplastics, especially Polyvinyl Chloride and Polyethylene particles released into the open waters from sewage can become a good substrate and vector for microbes, especially Polyvinyl Chloride and Polyethylene particles, imparting stability to microbes and aiding the "plastisphere" formation. A bibliometric analysis highlights the negligence of research toward plastispheres and their presence in sewage. The ubiquity of microplastics and their release along with the virus into the open waters increases the risk of viral plastispheres. These plastispheres may be ingested by aquatic organisms facilitating reverse zoonosis and the commercial organisms already reported with accumulating microplastics through the food chain poses a risk to human populations as well. Reliance of high population density areas on open waters served by untreated sewage in economically less developed countries might bring back viral transmission.

An exploration of the relationship between wastewater viral signals and COVID-19 hospitalizations in Ottawa, Canada

Monitoring of viral signal in wastewater is considered a useful tool for monitoring the burden of COVID-19, especially during times of limited availability in testing. Studies have shown that COVID-19 hospitalizations are highly correlated with wastewater viral signals and the increases in wastewater viral signals can provide an early warning for increasing hospital admissions. The association is likely nonlinear and time-varying. This project employs a distributed lag nonlinear model (DLNM) (Gasparrini et al., 2010) to study the nonlinear exposure-response delayed association of the COVID-19 hospitalizations and SARS-CoV-2 wastewater viral signals using relevant data from Ottawa, Canada. We consider up to a 15-day time lag from the average of SARS-CoV N1 and N2 gene concentrations to COVID-19 hospitalizations. The expected reduction in hospitalization is adjusted for vaccination efforts. A correlation analysis of the data verifies that COVID-19 hospitalizations are highly correlated with wastewater viral signals with a time-varying relationship. Our DLNM based analysis yields a reasonable estimate of COVID-19 hospitalizations and enhances our understanding of the association of COVID-19 hospitalizations with wastewater viral signals.

Surveillance of multidrug-resistant tuberculosis in sub-Saharan Africa through wastewater-based epidemiology

The spread of multidrug-resistant tuberculosis (MDR-TB) is a serious public health issue, particularly in developing nations. The current methods of monitoring drug-resistant TB (DR-TB) using clinical diagnoses and hospital records are insufficient due to limited healthcare access and underreporting. This study proposes using Wastewater-Based Epidemiology (WBE) to monitor DR-TB in six African countries (Ghana, Nigeria, Kenya, Uganda, Cameroon, and South Africa) and examines the impact of treated wastewater on the spread of TB drug-resistant genes in the environment. Using droplet-digital polymerase chain reaction (ddPCR), the study evaluated untreated and treated wastewater samples in selected African countries for TB surveillance. There was a statistically significant difference in concentrations of genes conferring resistance to TB drugs in wastewater samples from the selected countries (p-value<0.05); South African samples exhibited the highest concentrations of 4.3(±2,77), 4.8(±2.96), 4.4(±3,10) and 4.7(±3,39) log copies/ml for genes conferring resistance to first-line TB drugs (katG, rpoB, embB and pncA respectively) in untreated wastewater. This may be attributed to the higher prevalence of TB/MDR-TB in SA compared to other African countries. Interestingly, genes conferring resistance to second-line TB drugs such as delamanid (ddn gene) and bedaquiline (atpE gene) were detected in relatively high concentrations (4.8(±3,67 and 3.2(±2,31 log copies/ml for ddn and atpE respectively) in countries, such as Cameroon, where these drugs are not part of the MDR-TB treatment regimens, perhaps due to migration or the unapproved use of these drugs in the country. The gene encoding resistance to streptomycin (rrs gene) was abundant in all countries, perhaps due to the common use of this antibiotic for infections other than TB. These results highlight the need for additional surveillance and monitoring, such as WBE, to gather data at a community level. Combining WBE with the One Health strategy and current TB surveillance systems can help prevent the spread of DR-TB in populations.

The spread of the omicron variant: Identification of knowledge gaps, virus diffusion modelling, and future research needs

The World Health Organization (WHO) recognised variant B.1.1.529 of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) as a variant of concern, termed "Omicron", on November 26, 2021. Its diffusion was attributed to its several mutations, which allow promoting its ability to diffuse worldwide and its capability in immune evasion. As a consequence, some additional serious threats to public health posed the risk to undermine the global efforts made in the last two years to control the pandemic. In the past, several works were devoted to discussing a possible contribution of air pollution to the SARS-CoV-2 spread. However, to the best of the authors' knowledge, there are still no works dealing with the Omicron variant diffusion mechanisms. This work represents a snapshot of what we know right now, in the frame of an analysis of the Omicron variant spread. The paper proposes the use of a single indicator, commercial trade data, to model the virus spread. It is proposed as a surrogate of the interactions occurring between humans (the virus transmission mechanism due to human-to-human contacts) and could be considered for other diseases. It allows also to explain the unexpected increase in infection cases in China, detected at beginning of 2023. The air quality data are also analyzed to evaluate for the first time the role of air particulate matter (PM) as a carrier of the Omicron variant diffusion. Due to emerging concerns associated with other viruses (such as smallpox-like virus diffusion in Europe and America), the proposed approach seems to be promising to model the virus spreading.

Harnessing and bioprospecting botanical-based herbal medicines against potential drug targets for COVID-19: a review coupled molecular docking studies

Since the end of February 2020, the world has come to a standstill due to the virus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). Since then, the global scientific community has explored various remedies and treatments against this virus, including natural products that have always been a choice because of their many benefits. Various known phytochemicals are well documented for their antiviral properties. Research is being carried out to discover new natural plant products or existing ones as a treatment measure for this disease. The three important targets in this regard are-papain like protease (PLpro), spike protein, and 3 chymotrypsin like proteases (3CLpro). Various docking studies are also being elucidated to identify the phytochemicals that modulate crucial proteins of the virus. The paper is simultaneously a comprehensive review that covers recent advances in the domain of the effect of various botanically derived natural products as an alternative treatment approach against Coronavirus Disease 2019 (COVID-19). Furthermore, the docking analyses revealed that rutin (inhibitor of the major protease of SARS-CoV-2), gallocatechin (e.g., interacting with 03 hydrogen bonds with a spike-like protein), lycorine (showing the best binding affinity with amino acids GLN498, THR500 and GLY446 of the spike-like protein), and quercetrin (inhabiting at its residues ASP216, PHE219, and ILE259) are promising inhibitors of SARS‑CoV‑2.Communicated by Ramaswamy H. Sarma.

Peculiar weather patterns effects on air pollution and COVID-19 spread in Tokyo metropolis

As a pandemic hotspot in Japan, between March 1, 2020-October 1, 2022, Tokyo metropolis experienced seven COVID-19 waves. Motivated by the high rate of COVID-19 incidence and mortality during the seventh wave, and environmental/health challenges we conducted a time-series analysis to investigate the long-term interaction of air quality and climate variability with viral pandemic in Tokyo. Through daily time series geospatial and observational air pollution/climate data, and COVID-19 incidence and death cases, this study compared the environmental conditions during COVID-19 multiwaves. In spite of five State of Emergency (SOEs) restrictions associated with COVID-19 pandemic, during (2020-2022) period air quality recorded low improvements relative to (2015-2019) average annual values, namely: Aerosol Optical Depth increased by 9.13% in 2020 year, and declined by 6.64% in 2021, and 12.03% in 2022; particulate matter PM2.5 and PM10 decreased during 2020, 2021, and 2022 years by 10.22%, 62.26%, 0.39%, and respectively by 4.42%, 3.95%, 5.76%. For (2021-2022) period the average ratio of PM2.5/PM10 was (0.319 ± 0.1640), showing a higher contribution to aerosol loading of traffic-related coarse particles in comparison with fine particles. The highest rates of the daily recorded COVID-19 incidence and death cases in Tokyo during the seventh COVID-19 wave (1 July 2022-1 October 2022) may be attributed to accumulation near the ground of high levels of air pollutants and viral pathogens due to: 1) peculiar persistent atmospheric anticyclonic circulation with strong positive anomalies of geopotential height at 500 hPa; 2) lower levels of Planetary Boundary Layer (PBL) heights; 3) high daily maximum air temperature and land surface temperature due to the prolonged heat waves (HWs) in summer 2022; 4) no imposed restrictions. Such findings can guide public decision-makers to design proper strategies to curb pandemics under persistent stable anticyclonic weather conditions and summer HWs in large metropolitan areas.

Monitoring of SARS-CoV-2 RNA in wastewater: A surveillance tool to foresee infection's evolution in the Mexican Caribbean

The study aims to determine SARS-CoV-2 RNA in sewage of Cancun wastewater treatment plants, the main touristic destination of Mexico, and to estimate the infected persons during the sampling period. SARS-CoV-2 RNA traces were detected in the inlet of the five plants during almost all the sampling months. However, there is no presence of SARS-CoV-2 RNA traces in the effluent of the five WWTPs during the study period. ANOVA analysis showed differences in the concentrations of RNA traces of SARS-CoV-2 between the sample dates, but no differences were found from one WWTP to another. Estimated infected individuals by Markov chain Monte Carlo simulation are higher (between 77% and 91%) than the cases reported by the health authority. Wastewater monitoring and the estimation of infected individuals are a helpful tool, because estimation provides early warning signs on how broadly SARS-CoV-2 is circulating in the city, and led to the authorities to take measures wisely. PRACTITIONER POINTS: There is no presence of SARS-CoV-2 RNA traces in the effluent of the facilities, suggesting the effectiveness of treatment. Surveillance of viral RNA concentrations at treatment plants revealed presence in the influent of five plants Estimated infected individuals by MCMC simulation are higher than cases reported by health authority Environmental surveillance approach in wastewater influent is helpful to identify the clusters and to take informed decisions.

Evaluation of pre-treated healthcare wastes during COVID-19 pandemic reveals pathogenic microbiota, antibiotics residues, and antibiotic resistance genes against beta-lactams

The disposal of healthcare waste without prior elimination of pathogens and hazardous contaminants has negative effects on the environment and public health. This study aimed to profile the complete microbial community and correlate it with the antibiotic compounds identified in microwave pre-treated healthcare wastes collected from three different waste operators in Peninsular Malaysia. The bacterial and fungal compositions were determined via amplicon sequencing by targeting the full-length 16S rRNA gene and partial 18S with full-length ITS1-ITS2 regions, respectively. The antibiotic compounds were characterized using high-throughput spectrometry. There was significant variation in bacterial and fungal composition in three groups of samples, with alpha- (p-value = 0.04) and beta-diversity (p-values <0.006 and < 0.002), respectively. FC samples were found to acquire more pathogenic microorganisms than FA and FV samples. Paenibacillus and unclassified Bacilli genera were shared among three groups of samples, meanwhile, antibiotic-resistant bacteria Proteus mirabilis, Enterococcus faecium, and Enterococcus faecalis were found in modest quantities. A total of 19 antibiotic compounds were discovered and linked with the microbial abundance detected in the healthcare waste samples. The principal component analysis demonstrated a positive antibiotic-bacteria correlation for genera Pseudomonas, Aerococcus, Comamonas, and Vagococcus, while the other bacteria were negatively linked with antibiotics. Nevertheless, deep bioinformatic analysis confirmed the presence of bla_TEM-1 and penP which are associated with the production of class A beta-lactamase and beta-lactam resistance pathways. Microorganisms and contaminants, which serve as putative indicators in healthcare waste treatment evaluation revealed the ineffectiveness of microbial inactivation using the microwave sterilization method. Our findings suggested that the occurrence of clinically relevant microorganisms, antibiotic contaminants, and associated antibiotic resistance genes (ARGs) represent environmental and human health hazards when released into landfills via ARGs transmission.

Occurrence and transport of SARS-CoV-2 in wastewater streams and its detection and remediation by chemical-biological methods

This paper explains the transmission of SARS-CoV and influences of several environmental factors in the transmission process. The article highlighted several methods of collection, sampling and monitoring/estimation as well as surveillance tool for detecting SARS-CoV in wastewater streams. In this context, WBE (Wastewater based epidemiology) is found to be the most effective surveillance tool. Several methods of genomic sequencing are discussed in the paper, which are applied in WBE, like qPCR-based wastewater testing, metagenomics-based analysis, next generation sequencing etc. Additionally, several types of biosensors (colorimetric biosensor, mobile phone-based biosensors, and nanomaterials-based biosensors) showed promising results in sensing SARS-CoV in wastewater. Further, this review paper outlined the gaps in assessing the factors responsible for transmission and challenges in detection and monitoring along with the remediation and disinfection methods of this virus in wastewater. Various methods of disinfection of SARS-CoV-2 in wastewater are discussed (primary, secondary, and tertiary phases) and it is found that a suite of disinfection methods can be used for complete disinfection/removal of the virus. Application of ultraviolet light, ozone and chlorine-based disinfectants are also discussed in the context of treatment methods. This study calls for continuous efforts to gather more information about the virus through continuous monitoring and analyses and to address the existing gaps and identification of the most effective tool/ strategy to prevent SARS-CoV-2 transmission. Wastewater surveillance can be very useful in effective surveillance of future pandemics and epidemics caused by viruses, especially after development of new technologies in detecting and disinfecting viral pathogens more effectively.

Environmental challenges of COVID-19 pandemic: resilience and sustainability - A review

The emergence of novel respiratory disease (COVID-19) caused by SARS-CoV-2 has become a public health emergency worldwide and perturbed the global economy and ecosystem services. Many studies have reported the presence of SARS-CoV-2 in different environmental compartments, its transmission via environmental routes, and potential environmental challenges posed by the COVID-19 pandemic. None of these studies have comprehensively reviewed the bidirectional relationship between the COVID-19 pandemic and the environment. For the first time, we explored the relationship between the environment and the SARS-CoV-2 virus/COVID-19 and how they affect each other. Supporting evidence presented here clearly demonstrates the presence of SARS-CoV-2 in soil and water, denoting the role of the environment in the COVID-19 transmission process. However, most studies fail to determine if the viral genomes they have discovered are infectious, which could be affected by the environmental factors in which they are found.The potential environmental impact of the pandemic, including water pollution, chemical contamination, increased generation of non-biodegradable waste, and single-use plastics have received the most attention. For the most part, efficient measures have been used to address the current environmental challenges from COVID-19, including using environmentally friendly disinfection technologies and employing measures to reduce the production of plastic wastes, such as the reuse and recycling of plastics. Developing sustainable solutions to counter the environmental challenges posed by the COVID-19 pandemic should be included in national preparedness strategies. In conclusion, combating the pandemic and accomplishing public health goals should be balanced with environmentally sustainable measures, as the two are closely intertwined.

Microbial strategies for degradation of microplastics generated from COVID-19 healthcare waste

COVID-19 pandemic has led to the generation of massive plastic wastes, comprising of onetime useable gloves, masks, tissues, and other personal protective equipment (PPE). Recommendations for the employ of single-use disposable masks made up of various polymeric materials like polyethylene, polyurethane, polyacrylonitrile, and polypropylene, polystyrene, can have significant aftermath on environmental, human as well as animal health. Improper disposal and handling of healthcare wastes and lack of proper management practices are creating serious health hazards and an extra challenge for the local authorities designated for management of solid waste. Most of the COVID-19 medical wastes generated are now being treated by incineration which generates microplastic particles (MPs), dioxin, furans, and various toxic metals, such as cadmium and lead. Moreover, natural degradation and mechanical abrasion of these wastes can lead to the generation of MPs which cause a serious health risk to living beings. It is a major threat to aquatic lives and gets into foods subsequently jeopardizing global food safety. Moreover, the presence of plastic is also considered a threat owing to the increased carbon emission and poses a profound danger to the global food chain. Degradation of MPs by axenic and mixed culture microorganisms, such as bacteria, fungi, microalgae etc. can be considered an eco-sustainable technique for the mitigation of the microplastic menace. This review primarily deals with the increase in microplastic pollution due to increased use of PPE along with different disinfection methods using chemicals, steam, microwave, autoclave, and incineration which are presently being employed for the treatment of COVID-19 pandemic-related wastes. The biological treatment of the MPs by diverse groups of fungi and bacteria can be an alternative option for the mitigation of microplastic wastes generated from COVID-19 healthcare waste.

Wastewater-based epidemiology: a new frontier for tracking environmental persistence and community transmission of COVID-19

Recent research in many parts of the world has pointed towards evidence of SARS-CoV-2 RNA in both treated and raw municipal wastewater discharged by communities. Therefore, concerns regarding it being a possible enteric virus are abundant. Past history of SARS-CoV-1 outbreaks and viral survival information helps in establishing information regarding possible viral infectivity and survival of SARS-CoV-2. The paper examines the existing strategies and techniques including the efficacy of laboratory-based RT-qPCR technique for tracking environmental persistence and community transmission of COVID-19. Analysis of studies targeting untreated and treated wastewater as source of samples is carried out. The analysis shows that untreated samples were mostly positive for SARS-CoV-2 RNA in the target studies. Infectivity estimation from viral load data was found to be about two orders of magnitude higher than actual case data in one of the studies. Additionally, relevant research on environmental survivability of SARS-CoV-2 and possible gaps are examined. Biosensors and excretion metabolite tracking in viral detection are also examined, which hold tremendous importance for future research. Wastewater-based epidemiology (WBE) shows incredible promise in the near future for tracking environmental persistence and community transmission of highly infectious diseases such as SARS-CoV-2. With limited research available on SARS-CoV-2 with regard to WBE, it is imperative that focus be established on the evidence-based targeted studies.

A safe haven of SARS-CoV-2 in the environment: Prevalence and potential transmission risks in the effluent, sludge, and biosolids

The novel coronavirus, SARS-CoV-2, which has caused millions of death globally is recognized to be unstable and recalcitrant in the environment, especially in the way it has been evolving to form new and highly transmissible variants. Of particular concerns are human-environment interactions and the handling and reusing the environmental materials, such as effluents, sludge, or biosolids laden with the SARS-CoV-2 without adequate treatments, thereby suggesting potential transmission and health risks. This study assesses the prevalence of SARS-CoV-2 RNA in effluents, sludge, and biosolids. Further, we evaluate the environmental, ecological, and health risks of reusing these environmental materials by wastewater/sludge workers and farmers. A systematic review of literature from the Scopus database resulted in a total of 21 articles (11 for effluents, 8 for sludge, and 2 for biosolids) that met the criteria for meta-analysis, which are then subdivided into 30 meta-analyzed studies. The prevalence of SAR-CoV-2 RNA in effluent and sludge based on random-effect models are 27.51 and 10^12.25, respectively, with a 95% CI between 6.14 and 48.89 for the effluent, and 10^4.78 and 10^19.71 for the sludge. However, the prevalence of SARS-CoV-2 RNA in the biosolids based on the fixed-effect model is 30.59, with a 95% CI between 10.10 and 51.08. The prevalence of SARS-CoV-2 RNA in environmental materials indicates the inefficiency in some of the treatment systems currently deployed to inactivate and remove the novel virus, which could be a potential health risk concern to vulnerable wastewater workers in particular, and the environmental and ecological issues for the population at large. This timely review portends the associated risks in handling and reusing environmental materials without proper and adequate treatments.

Use of geospatial tools to predict the risk of contamination by SARS-CoV-2 in urban cemeteries

Urban cemeteries are increasingly surrounded by areas of high residential density as urbanization continues world-wide. With increasing rates of mortality caused by the novel coronavirus, SARS-CoV-2, urban vertical cemeteries are experiencing interments at an unprecedented rate. Corpses interred in the 3rd to 5th layer of vertical urban cemeteries have the potential to contaminate large adjacent regions. The general objective of this manuscript is to analyze the reflectance of altimetry, normalized difference vegetation index (NDVI) and land surface temperature (LST) in the urban cemeteries and neighbouring areas of the City of Passo Fundo, Rio Grande do Sul, Brazil. It is assumed that the population residing in the vicinity of these cemeteries may be exposed to SARS-CoV-2 contamination through the displacement of microparticles carried by the wind as a corpse is placed in the burial niche or during the first several days of subsequent fluid and gas release through the process of decomposition. The reflectance analyses were performed utilizing Landsat 8 satellite images applied to altimetry, NDVI and LST, for hypothetical examination of possible displacement, transport and subsequent deposition of the SARS-CoV-2 virus. The results showed that two cemeteries within the city, cemeteries A and B could potentially transport SARS-CoV-2 of nanometric structure to neighboring residential areas through wind action. These two cemeteries are located at high relative altitudes in more densely populated regions of the city. The NDVI, which has been shown to control the proliferation of contaminants, proved to be insufficient in these areas, contributing to high LST values. Based on the results of this study, the formation and implementation of public policies that monitor urban cemeteries is suggested in areas that utilize vertical urban cemeteries in order to reduce the further spread of the SARS-CoV-2 virus.

Elucidating the role of environmental management of forests, air quality, solid waste and wastewater on the dissemination of SARS-CoV-2

The increasing frequency of zoonotic diseases is amongst several catastrophic repercussions of inadequate environmental management. Emergence, prevalence, and lethality of zoonotic diseases is intrinsically linked to environmental management which are currently at a destructive level globally. The effects of these links are complicated and interdependent, creating an urgent need of elucidating the role of environmental mismanagement to improve our resilience to future pandemics. This review focused on the pertinent role of forests, outdoor air, indoor air, solid waste and wastewater management in COVID-19 dissemination to analyze the opportunities prevailing to control infectious diseases considering relevant data from previous disease outbreaks. Global forest management is currently detrimental and hotspots of forest fragmentation have demonstrated to result in zoonotic disease emergences. Deforestation is reported to increase susceptibility to COVID-19 due to wildfire induced pollution and loss of forest ecosystem services. Detection of SARS-CoV-2 like viruses in multiple animal species also point to the impacts of biodiversity loss and forest fragmentation in relation to COVID-19. Available literature on air quality and COVID-19 have provided insights into the potential of air pollutants acting as plausible virus carrier and aggravating immune responses and expression of ACE2 receptors. SARS-CoV-2 is detected in outdoor air, indoor air, solid waste, wastewater and shown to prevail on solid surfaces and aerosols for prolonged hours. Furthermore, lack of protection measures and safe disposal options in waste management are evoking concerns especially in underdeveloped countries due to high infectivity of SARS-CoV-2. Inadequate legal framework and non-adherence to environmental regulations were observed to aggravate the postulated risks and vulnerability to future waves of pandemics. Our understanding underlines the urgent need to reinforce the fragile status of global environmental management systems through the development of strict legislative frameworks and enforcement by providing institutional, financial and technical supports.

SARS-CoV-2 in Atmospheric Particulate Matter: An Experimental Survey in the Province of Venice in Northern Italy

Analysis of atmospheric particulate matter (PM) has been proposed for the environmental surveillance of SARS-CoV-2. The aim of this study was to increase the current knowledge about the occurrence of SARS-CoV-2 in atmospheric PM, introduce a dedicated sampling method, and perform a simultaneous assessment of human seasonal coronavirus 229E. Thirty-two PM samples were collected on quartz fiber filters and six on Teflon using a low- and high-volumetric rate sampler, respectively, adopting a novel procedure for optimized virus detection. Sampling was performed at different sites in the Venice area (Italy) between 21 February and 8 March 2020 (n = 16) and between 27 October and 25 November 2020 (n = 22). A total of 14 samples were positive for Coronavirus 229E, 11 of which were collected in October–November 2020 (11/22; positivity rate 50%) and 3 in February–March 2020 (3/16 samples, 19%). A total of 24 samples (63%) were positive for SARS-CoV-2. Most of the positive filters were collected in October–November 2020 (19/22; positivity rate, 86%), whereas the remaining five were collected in February–March 2020 at two distinct sites (5/16, 31%). These findings suggest that outdoor PM analysis could be a promising tool for environmental surveillance. The results report a low concentration of SARS-CoV-2 in outdoor air, supporting a scarce contribution to the spread of infection.

Factors Modulating COVID-19: A Mechanistic Understanding Based on the Adverse Outcome Pathway Framework

Addressing factors modulating COVID-19 is crucial since abundant clinical evidence shows that outcomes are markedly heterogeneous between patients. This requires identifying the factors and understanding how they mechanistically influence COVID-19. Here, we describe how eleven selected factors (age, sex, genetic factors, lipid disorders, heart failure, gut dysbiosis, diet, vitamin D deficiency, air pollution and exposure to chemicals) influence COVID-19 by applying the Adverse Outcome Pathway (AOP), which is well-established in regulatory toxicology. This framework aims to model the sequence of events leading to an adverse health outcome. Several linear AOPs depicting pathways from the binding of the virus to ACE2 up to clinical outcomes observed in COVID-19 have been developed and integrated into a network offering a unique overview of the mechanisms underlying the disease. As SARS-CoV-2 infectibility and ACE2 activity are the major starting points and inflammatory response is central in the development of COVID-19, we evaluated how those eleven intrinsic and extrinsic factors modulate those processes impacting clinical outcomes. Applying this AOP-aligned approach enables the identification of current knowledge gaps orientating for further research and allows to propose biomarkers to identify of high-risk patients. This approach also facilitates expertise synergy from different disciplines to address public health issues.

Antimicrobial Resistance in the COVID-19 Landscape: Is There an Opportunity for Anti-Infective Antibodies and Antimicrobial Peptides?

Although COVID-19 has captured most of the public health attention, antimicrobial resistance (AMR) has not disappeared. To prevent the escape of resistant microorganisms in animals or environmental reservoirs a "one health approach" is desirable. In this context of COVID-19, AMR has probably been affected by the inappropriate or over-use of antibiotics. The increased use of antimicrobials and biocides for disinfection may have enhanced the prevalence of AMR. Antibiotics have been used empirically in patients with COVID-19 to avoid or prevent bacterial coinfection or superinfections. On the other hand, the measures to prevent the transmission of COVID-19 could have reduced the risk of the emergence of multidrug-resistant microorganisms. Since we do not currently have a sterilizing vaccine against SARS-CoV-2, the virus may still multiply in the organism and new mutations may occur. As a consequence, there is a risk of the appearance of new variants. Nature-derived anti-infective agents, such as antibodies and antimicrobial peptides (AMPs), are very promising in the fight against infectious diseases, because they are less likely to develop resistance, even though further investigation is still required.

SARS-CoV-2 and other airborne respiratory viruses in outdoor aerosols in three Swiss cities before and during the first wave of the COVID-19 pandemic

Caused by the SARS-CoV-2 virus, Coronavirus disease 2019 (COVID-19) has been affecting the world since the end of 2019. While virus-laden particles have been commonly detected and studied in the aerosol samples from indoor healthcare settings, studies are scarce on air surveillance of the virus in outdoor non-healthcare environments, including the correlations between SARS-CoV-2 and other respiratory viruses, between viruses and environmental factors, and between viruses and human behavior changes due to the public health measures against COVID-19. Therefore, in this study, we collected airborne particulate matter (PM) samples from November 2019 to April 2020 in Bern, Lugano, and Zurich. Among 14 detected viruses, influenza A, HCoV-NL63, HCoV-HKU1, and HCoV-229E were abundant in air. SARS-CoV-2 and enterovirus were moderately common, while the remaining viruses occurred only in low concentrations. SARS-CoV-2 was detected in PM₁₀ (PM below 10 µm) samples of Bern and Zurich, and PM_2.5 (PM below 2.5 µm) samples of Bern which exhibited a concentration positively correlated with the local COVID-19 case number. The concentration was also correlated with the concentration of enterovirus which raised the concern of coinfection. The estimated COVID-19 infection risks of an hour exposure at these two sites were generally low but still cannot be neglected. Our study demonstrated the potential functionality of outdoor air surveillance of airborne respiratory viruses, especially at transportation hubs and traffic arteries.

Longitudinal monitoring of SARS-CoV-2 in wastewater using viral genetic markers and the estimation of unconfirmed COVID-19 cases

In this study, wastewater-based surveillance was carried out to establish the correlation between SARS-CoV-2 viral RNA concentrations in wastewater and the incidence of corona virus disease 2019 (COVID-19) from clinical testing. The influent wastewater of three major water reclamation facilities (WRFs) in Northern Nevada, serving a population of 390,750, was monitored for SARS-CoV-2 viral RNA gene markers, N1 and N2, from June 2020 through September 2021. A total of 614 samples were collected and analyzed. The SARS-CoV-2 concentrations in wastewater were observed to peak twice during the study period. A moderate correlation trend between coronavirus disease 2019 (COVID-19) incidence data from clinical testing and SARS-CoV-2 viral RNA concentrations in wastewater was observed (Spearman r = 0.533). This correlation improved when using weekly average SARS-CoV-2 marker concentrations of wastewater and clinical case data (Spearman r = 0.790), presumably by mitigating the inherent variability of the environmental dataset and the effects of clinical testing artifacts (e.g., reporting lags). The research also demonstrated the value of wastewater-based surveillance as an early warning signal for early detection of trends in COVID-19 incidence. This was accomplished by identifying that the reported clinical cases had a stronger correlation to SARS-CoV-2 wastewater monitoring data when they were estimated to lag 7-days behind the wastewater data. The results aided local decision makers in developing strategies to manage COVID-19 in the region and provide a framework for how wastewater-based surveillance can be applied across localities to enhance the public health monitoring of the ongoing pandemic.

"SARS-CoV-2 is transmitted by particulate air pollution": Misinterpretations of statistical data, skewed citation practices, and misuse of specific terminology spreading the misconception

In epidemiology, there are still outdated myths associated with the spread of respiratory infections. Recently, we have witnessed the origination of a new misconception, to the effect that SARS-CoV-2 is transmitted in the open air by way of particulate air pollution (atmospheric particulate matter (PM)). There is no evidence to support the idea behind this misconception. Nevertheless, more and more people are involved in animated debate and the number of studies concerning atmospheric PM as a carrier of SARS-CoV-2 is growing rapidly. In this work, the origin of the misconception was investigated, and the published papers which have contributed to the spread of this myth were analyzed. The results show that the following factors lie behind the origin and spread of the misconception: a) The specific terminology is not always clearly defined or consistently used by scientists. In particular, the terms 'particulate matter', 'atmospheric aerosol particles', 'air pollutants', and 'atmospheric aerosols' need to be clarified, and besides they are often equated to 'infectious aerosols', 'virus-bearing aerosols', 'bio-aerosols', 'virus-laden particles', 'respiratory aerosol/droplets', and 'droplet nuclei'. b) Authors misinterpret statistical data and information from other sources. Interpretation of the correlation between PM levels and the increasing incidence and severity of COVID-19 infection, is often changed from "PM may reflect the indirect action of certain atmospheric conditions that maintain infectious nuclei suspended for prolonged periods, parameters that also act on atmospheric pollutants" to "PM could cause an increase in infectious droplets/aerosols containing SARS-CoV-2." This is a dramatic change to the meaning. Moreover, it is often not taken into account that PM may reflect activities in areas with high population density and this population density at the same time contributes to the spread COVID-19. c) Skewed citation practices. Many authors cite a hypothetical conclusion from an original study, then other authors cite the papers of these authors as primary sources. This practice leads to the effect that there are many witnesses to a 'phenomenon' that did not ever occur. Thus, the terminology used in interdisciplinary communications should be more nuanced and defined precisely. Authors should be more careful when citing unconfirmed data (and hypotheses) as well as in interpreting statistical data so as to avoid confusion and spreading false information. This is especially important now in the era of the COVID-19 pandemic.

A review on measurements of SARS-CoV-2 genetic material in air in outdoor and indoor environments: Implication for airborne transmission

Airborne transmission of SARS-CoV-2 has been object of debate in the scientific community since the beginning of COVID-19 pandemic. This mechanism of transmission could arise from virus-laden aerosol released by infected individuals and it is influenced by several factors. Among these, the concentration and size distribution of virus-laden particles play an important role. The knowledge regarding aerosol transmission increases as new evidence is collected in different studies, even if it is not yet available a standard protocol regarding air sampling and analysis, which can create difficulties in the interpretation and application of results. This work reports a systematic review of current knowledge gained by 73 published papers on experimental determination of SARS-CoV-2 RNA in air comparing different environments: outdoors, indoor hospitals and healthcare settings, and public community indoors. Selected papers furnished 77 datasets: outdoor studies (9/77, 11.7%) and indoor studies (68/77. 88.3%). The indoor datasets in hospitals were the vast majority (58/68, 85.3%), and the remaining (10/68, 14.7%) were classified as community indoors. The fraction of studies having positive samples, as well as positivity rates (i.e. ratios between positive and total samples) are significantly larger in hospitals compared to the other typologies of sites. Contamination of surfaces was more frequent (in indoor datasets) compared to contamination of air samples; however, the average positivity rate was lower compared to that of air. Concentrations of SARS-CoV-2 RNA in air were highly variables and, on average, lower in outdoors compared to indoors. Among indoors, concentrations in community indoors appear to be lower than those in hospitals and healthcare settings.

Wastewater, waste, and water-based epidemiology (WWW-BE): A novel hypothesis and decision-support tool to unravel COVID-19 in low-income settings?

Traditional wastewater-based epidemiology (W-BE) relying on SARS-CoV-2 RNA detection in wastewater is attractive for understanding COVID-19. Yet traditional W-BE based on centralized wastewaters excludes putative SARS-CoV-2 reservoirs such as: (i) wastewaters from shared on-site sanitation facilities, (ii) solid waste including faecal sludge from non-flushing on-site sanitation systems, and COVID-19 personal protective equipment (PPE), (iii) raw/untreated water, and (iv) drinking water supply systems in low-income countries (LICs). A novel hypothesis and decision-support tool based on Wastewater (on-site sanitation, municipal sewer systems), solid Waste, and raw/untreated and drinking Water-based epidemiology (WWW-BE) is proposed for understanding COVID-19 in LICs. The WWW-BE conceptual framework, including components and principles is presented. Evidence on the presence of SARS-CoV-2 and its proxies in wastewaters, solid materials/waste (papers, metals, fabric, plastics), and raw/untreated surface water, groundwater and drinking water is discussed. Taken together, wastewaters from municipal sewer and on-site sanitation systems, solid waste such as faecal sludge and COVID-19 PPE, raw/untreated surface water and groundwater, and drinking water systems in LICs act as potential reservoirs that receive and harbour SARS-CoV-2, and then transmit it to humans. Hence, WWW-BE could serve a dual function in estimating the prevalence and potential transmission of COVID-19. Several applications of WWW-BE as a hypothesis and decision support tool in LICs are discussed. WWW-BE aggregates data from various infected persons in a spatial unit, hence, putatively requires less resources (analytical kits, personnel) than individual diagnostic testing, making it an ideal decision-support tool for LICs. The novelty, and a critique of WWW-BE versus traditional W-BE are presented. Potential challenges of WWW-BE include: (i) biohazards and biosafety risks, (ii) lack of expertise, analytical equipment, and accredited laboratories, and (iii) high uncertainties in estimates of COVID-19 cases. Future perspectives and research directions including key knowledge gaps and the application of novel and emerging technologies in WWW-BE are discussed.

SARS-CoV-2 wastewater surveillance data can predict hospitalizations and ICU admissions

We measured SARS-CoV-2 RNA load in raw wastewater in Attica, Greece, by RT-qPCR for the environmental surveillance of COVID-19 for 6 months. The lag between RNA load and pandemic indicators (COVID-19 hospital and intensive care unit (ICU) admissions) was calculated using a grid search. Our results showed that RNA load in raw wastewater is a leading indicator of positive COVID-19 cases, new hospitalization and admission into ICUs by 5, 8 and 9 days, respectively. Modelling techniques based on distributed/fixed lag modelling, linear regression and artificial neural networks were utilized to build relationships between SARS-CoV-2 RNA load in wastewater and pandemic health indicators. SARS-CoV-2 mutation analysis in wastewater during the third pandemic wave revealed that the alpha-variant was dominant. Our results demonstrate that clinical and environmental surveillance data can be combined to create robust models to study the on-going COVID-19 infection dynamics and provide an early warning for increased hospital admissions.

SARS-CoV-2 and other pathogens in municipal wastewater, landfill leachate, and solid waste: A review about virus surveillance, infectivity, and inactivation

This review discusses the techniques available for detecting and inactivating of pathogens in municipal wastewater, landfill leachate, and solid waste. In view of the current COVID-19 pandemic, SARS-CoV-2 is being given special attention, with a thorough examination of all possible transmission pathways linked to the selected waste matrices. Despite the lack of works focused on landfill leachate, a systematic review method, based on cluster analysis, allows to analyze the available papers devoted to sewage sludge and wastewater, allowing to focalize the work on technologies able to detect and treat pathogens. In this work, great attention is also devoted to infectivity and transmission mechanisms of SARS-CoV-2. Moreover, the literature analysis shows that sewage sludge and landfill leachate seem to have a remote chance to act as a virus transmission route (pollution-to-human transmission) due to improper collection and treatment of municipal wastewater and solid waste. However due to the incertitude about virus infectivity, these possibilities cannot be excluded and need further investigation. As a conclusion, this paper shows that additional research is required not only on the coronavirus-specific disinfection, but also the regular surveillance or monitoring of viral loads in sewage sludge, wastewater, and landfill leachate. The disinfection strategies need to be optimized in terms of dosage and potential adverse impacts like antimicrobial resistance, among many other factors. Finally, the presence of SARS-CoV-2 and other pathogenic microorganisms in sewage sludge, wastewater, and landfill leachate can hamper the possibility to ensure safe water and public health in economically marginalized countries and hinder the realization of the United Nations' sustainable development goals (SDGs).

Occurrence, transformation, bioaccumulation, risk and analysis of pharmaceutical and personal care products from wastewater: a review

Almost all aspects of society from food security to disease control and prevention have benefited from pharmaceutical and personal care products, yet these products are a major source of contamination that ends up in wastewater and ecosystems. This issue has been sharply accentuated during the coronavirus disease pandemic 2019 (COVID-19) due to the higher use of disinfectants and other products. Here we review pharmaceutical and personal care products with focus on their occurrence in the environment, detection, risk, and removal.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10311-022-01498-7.

Dioscin: A review on pharmacological properties and therapeutic values

Dioscin has gained immense popularity as a natural, bioactive steroid saponin, which offers numerous medical benefits. The growing global incidence of disease-associated morbidity and mortality continues to compromise human health, facilitating an increasingly urgent need for nontoxic, noninvasive, and efficient treatment alternatives. Natural compounds can contribute vastly to this field. Over recent years, studies have demonstrated the remarkable protective actions of dioscin against a variety of human malignancies, metabolic disorders, organ injuries, and viral/fungal infections. The successful usage of this phytocompound has been widely seen in medical treatment procedures under traditional Chinese medicine, and it is becoming progressively prevalent worldwide. This review provides an insight into the wide spectrum of pharmacological activities of dioscin, as reported and compiled in recent literature. The various novel approaches and applications of dioscin also verify the advantages exhibited by plant extracts against commercially available drugs, highlighting the potential of phytochemical agents like dioscin to be further incorporated into clinical practice.

Exploring the effects of PM2.5 and temperature on COVID-19 transmission in Seoul, South Korea

With a recent surge of the new severe acute respiratory syndrome-coronavirus 2 (SARS-Cov-2, COVID-19) in South Korea, this study attempts to investigate the effects of environmental conditions such as air pollutants (PM_2.5) and meteorological covariate (Temperature) on COVID-19 transmission in Seoul. To account for unobserved heterogeneity in the daily confirmed cases of COVID-19 across 25 contiguous districts within Seoul, we adopt a full Bayesian hierarchical approach for the generalized linear mixed models. A formal statistical analysis suggests that there exists a positive correlation between a 7-day lagged effect of PM_2.5 concentration and the number of confirmed COVID-19 cases, which implies an elevated risk of the infectious disease. Conversely, temperature has shown a negative correlation with the number of COVID-19 cases, leading to reduction in relative risks. In addition, we clarify that the random fluctuation in the relative risks of COVID-19 mainly originates from temporal aspects, whereas no significant evidence of variability in relative risks is observed in terms of spatial alignment of the 25 districts. Nevertheless, this study provides empirical evidence using model-based formal assessments regarding COVID-19 infection risks in 25 districts of Seoul from a different perspective.

A nationwide indicator to smooth and normalize heterogeneous SARS-CoV-2 RNA data in wastewater

Since many infected people experience no or few symptoms, the SARS-CoV-2 epidemic is frequently monitored through massive virus testing of the population, an approach that may be biased and may be difficult to sustain in low-income countries. Since SARS-CoV-2 RNA can be detected in stool samples, quantifying SARS-CoV-2 genome by RT-qPCR in wastewater treatment plants (WWTPs) has been carried out as a complementary tool to monitor virus circulation among human populations. However, measuring SARS-CoV-2 viral load in WWTPs can be affected by many experimental and environmental factors. To circumvent these limits, we propose here a novel indicator, the wastewater indicator (WWI), that partly reduces and corrects the noise associated with the SARS-CoV-2 genome quantification in wastewater (average noise reduction of 19%). All data processing results in an average correlation gain of 18% with the incidence rate. The WWI can take into account the censorship linked to the limit of quantification (LOQ), allows the automatic detection of outliers to be integrated into the smoothing algorithm, estimates the average measurement error committed on the samples and proposes a solution for inter-laboratory normalization in the absence of inter-laboratory assays (ILA). This method has been successfully applied in the context of Obépine, a French national network that has been quantifying SARS-CoV-2 genome in a representative sample of French WWTPs since March 5th 2020. By August 26th, 2021, 168 WWTPs were monitored in the French metropolitan and overseas territories of France. We detail the process of elaboration of this indicator, show that it is strongly correlated to the incidence rate and that the optimal time lag between these two signals is only a few days, making our indicator an efficient complement to the incidence rate. This alternative approach may be especially important to evaluate SARS-CoV-2 dynamics in human populations when the testing rate is low.

On the Critical Role of Human Feces and Public Toilets in the Transmission of COVID-19: Evidence from China

The surprising spread speed of the COVID-19 pandemic creates an urgent need for investigating the transmission chain or transmission pattern of COVID-19 beyond the traditional respiratory channels. This study therefore examines whether human feces and public toilets play a critical role in the transmission of COVID-19. First, it develops a theoretical model that simulates the transmission chain of COVID-19 through public restrooms. Second, it uses stabilized epidemic data from China to empirically examine this theory, conducting an empirical estimation using a two-stage least squares (2SLS) model with appropriate instrumental variables (IVs). This study confirms that the wastewater directly promotes the transmission of COVID-19 within a city. However, the role of garbage in this transmission chain is more indirect in the sense that garbage has a complex relationship with public toilets, and it promotes the transmission of COVID-19 within a city through interaction with public toilets and, hence, human feces. These findings have very strong policy implications in the sense that if we can somehow use the ratio of public toilets as a policy instrument, then we can find a way to minimize the total number of infections in a region. As shown in this study, pushing the ratio of public toilets (against open defecation) to the local population in a city to its optimal level would help to reduce the total infection in a region.

Impact of COVID-19 on Urban Energy Consumption of Commercial Tourism City

In 2020, the COVID-19 pandemic has spread worldwide. To alleviate this spread, various blockade policies have been implemented in many areas. This has led to a sluggish demand in the world's major economies, sharp drop in the trade index, and negative growth in energy consumption. To formulate a better epidemic prevention policy for urban energy consumption of commercial tourism cities, this study summarizes the major statistics of energy supply and demand before and during the epidemic period based on actual data. The characteristics of energy consumption in different sectors, including hotels, transportation, tourism culture, and public utilities, are then analyzed in detail. Finally, the energy consumption features of commercial tourism cities represented by Macao are compared to those of other typical countries (e.g., Italy, United States, Japan, and Brazil). These analyses demonstrate the impact of COVID-19 on the energy consumption in commercial tourism cities, which provides insights for the government or energy providers to formulate policies to adapt to this pandemic.

A potential risk assessment tool to monitor pathogens circulation in coastal waters

The present study reports data on a 20 months campaign monitoring enteric viruses (hepatitis A, norovirus, rotavirus, astrovirus, sapovirus, and aichivirus) and bacteria (Salmonella spp.) in seawater. The aim of this work was to assess the potential correlation among the presence of viruses/bacteria and different environmental factors like seasonality, water discharge sources (treated and untreated wastewater, mixed waters and raw water) as well as influence of the Italian lockdown measure against COVID-19 pandemic. Results showed different prevalence of the investigated viruses with values equal to 16 % for norovirus GI, 15.1 % for norovirus GII, followed by 13.8 % for astrovirus, and 13.3 % for sapovirus. Rotavirus was detected in the 8.4 % of samples and aichivirus was detected with the lowest prevalence of 3.5 %. Hepatitis A virus was never identified in the monitoring campaign. Salmonella spp. was detected with a prevalence of 36.6 %. Statistical analysis displayed a high correlation for the two noroviruses simultaneous detection (NGI and NGII) while a lower correlation was found for co-presence of noroviruses with astrovirus, sapovirus or Salmonella spp. A significant decrease of enteric pathogens in seawater was observed during the restrictions period. Results on seasonality highlighted a higher viral prevalence correlated to the wet season for all the pathogens but rotavirus and aichivirus, which instead showed an opposite trend and a higher incidence in the dry season. With respect to discharge typology, some viruses displayed a higher prevalence in treated waters (astrovirus, rotavirus, sapovirus and aichivirus) while the other investigated pathogens (noroviruses and Salmonella spp.) showed a higher prevalence in mixed waters. The main observations of this work were used to define a potential monitoring strategy that could be useful for sanitary Authorities to implement surveillance plans aimed at preventing possible sanitary outbreaks and/or environmental quality deterioration.

Monitoring the presence and persistence of SARS-CoV-2 in water-food-environmental compartments: State of the knowledge and research needs

The recent spread of severe acute respiratory syndrome coronavirus (SAR-CoV-2) and the accompanied coronavirus disease 2019 (COVID-19) has continued ceaselessly despite the implementations of popular measures, which include social distancing and outdoor face masking as recommended by the World Health Organization. Due to the unstable nature of the virus, leading to the emergence of new variants that are claimed to be more and rapidly transmissible, there is a need for further consideration of the alternative potential pathways of the virus transmissions to provide the needed and effective control measures. This review aims to address this important issue by examining the transmission pathways of SARS-CoV-2 via indirect contacts such as fomites and aerosols, extending to water, food, and other environmental compartments. This is essentially required to shed more light regarding the speculation of the virus spread through these media as the available information regarding this is fragmented in the literature. The existing state of the information on the presence and persistence of SARS-CoV-2 in water-food-environmental compartments is essential for cause-and-effect relationships of human interactions and environmental samples to safeguard the possible transmission and associated risks through these media. Furthermore, the integration of effective remedial measures previously used to tackle the viral outbreaks and pandemics, and the development of new sustainable measures targeting at monitoring and curbing the spread of SARS-CoV-2 were emphasized. This study concluded that alternative transmission pathways via human interactions with environmental samples should not be ignored due to the evolving of more infectious and transmissible SARS-CoV-2 variants.

Evaluating the presence of SARS-CoV-2 RNA in the particulate matters during the peak of COVID-19 in Padua, northern Italy

The airborne transmission of SARS-CoV-2, the etiologic agent of the current COVID-19 pandemic, has been hypothesized as one of the primary routes of transmission. Current data suggest a low probability of airborne transmission of the virus in open environments and a higher probability in closed ones, particularly in hospitals or quarantine facilities. However, the potential diffusion of the virus in open environments, especially using particulate matter (PM) as a transport carrier, generated concern in the exposed populations. Several authors found a correlation between the exceeding of the PM10 concentration limits in some Italian cities and the prevalence of Covid-19 cases detected in those areas. This study investigated the potential presence of SARS-COV-2 RNA on a representative series of PM samples collected in the province of Padua in Northeastern Italy during the first wave of COVID pandemic. Forty-four samples of PM2.5 and PM10 were collected between February 24 and March 9, 2020 and analyzed with RT-qPCR for SARS-CoV-2 RNA. The experimental results did not indicate the presence of SARS-CoV-2 RNA in the outdoor PMs, thus confirming the low probability of virus airborne transmission through PM.

Molecular Epidemiology of SARS-CoV-2 in Diverse Environmental Samples Globally

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has swamped the global environment greatly in the current pandemic. Wastewater-based epidemiology (WBE) effectively forecasts the surge of COVID-19 cases in humans in a particular region. To understand the genomic characteristics/footprints and diversity of SARS-CoV-2 in the environment, we analyzed 807 SARS-CoV-2 sequences from 20 countries deposited in GISAID till 22 May 2021. The highest number of sequences (n = 638) were reported in Austria, followed by the Netherlands, China, and Bangladesh. Wastewater samples were highest (40.0%) to successfully yield the virus genome followed by a 24 h composite wastewater sample (32.6%) and sewage (18.5%). Phylogenetic analysis revealed that SARS-CoV-2 environmental strains are a close congener with the strains mostly circulating in the human population from the same region. Clade GRY (32.7%), G (29.2%), GR (25.3%), O (7.2%), GH (3.4%), GV (1.4%), S (0.5%), and L (0.4%) were found in environmental samples. Various lineages were identified in environmental samples; nevertheless, the highest percentages (49.4%) of the alpha variant (B.1.1.7) were detected in Austria, Liechtenstein, Slovenia, Czech Republic, Switzerland, Germany, and Italy. Other prevalent lineages were B.1 (18.2%), B.1.1 (9.2%), and B.1.160 (3.9%). Furthermore, a significant number of amino acid substitutions were found in environmental strains where the D614G was found in 83.8% of the sequences. However, the key mutations-N501Y (44.6%), S982A (44.4%), A570D (43.3%), T716I (40.4%), and P681H (40.1%) were also recorded in spike protein. The identification of the environmental belvedere of SARS-CoV-2 and its genetic signature is crucial to detect outbreaks, forecast pandemic harshness, and prepare with the appropriate tools to control any impending pandemic. We recommend genomic environmental surveillance to trace the emerging variants and diversity of SARS-CoV-2 viruses circulating in the community. Additionally, proper disposal and treatment of wastewater, sewage, and medical wastes are important to prevent environmental contamination.

Insights into hazardous solid waste generation during COVID-19 pandemic and sustainable management approaches for developing countries

The recent emergence of the COVID-19 pandemic has contributed to the drastic production and use of healthcare and personal protective equipment, leading to the release of a huge quantity of hazardous medical and solid wastes in the environment. Meanwhile, these solid wastes may contribute to the spread of the SARS-CoV-2 viral particles when disposed of without proper treatment and care. Since SARS-CoV-2 could persist on different material surfaces including plastic, steel, paper, cardboard, cloth, and wood, proper management of these hazardous solid wastes has become a challenging task during the COVID-19 pandemic. In this paper, an overview of the consumption of COVID-19-related healthcare and personal protective equipment along with the production of hazardous solid waste is presented. The efficient management of these wastes is necessary to prevent the entering of SARS-CoV-2 in various environmental compartments. Therefore, some preventive measures including the use of biodegradable materials for manufacturing personal protective equipment, minimizing the use of non-biodegradable materials, efficient pre- and-post planning, careful segregation, and disposal are, therefore, proposed for their sustainable management. The findings reported in this paper contribute to tackling the problems associated with hazardous solid waste management, particularly for low- and middle-income countries.

Role of atmospheric particulate matter exposure in COVID-19 and other health risks in human: A review

Due to intense industrialization and urbanization, air pollution has become a serious global concern as a hazard to human health. Epidemiological studies found that exposure to atmospheric particulate matter (PM) causes severe health problems in human and significant damage to the physiological systems. In recent days, PM exposure could be related as a carrier for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus transmission and Coronavirus disease 2019 (COVID-19) infection. Hence, it is important to understand the adverse effects of PM in human health. This review aims to provide insights on the detrimental effects of PM in various human health problems including respiratory, circulatory, nervous, and immune system along with their possible toxicity mechanisms. Overall, this review highlights the potential relationship of PM with several life-limiting human diseases and their significance for better management strategies.

SARS-CoV-2 and other viruses in soil: An environmental outlook

In the present review, the authors shed light on the SARS-CoV-2 impact, persistence, and monitoring in the soil environment. With this purpose, several aspects have been deepened: i) viruses in soil ecosystems; ii) direct and indirect impact on the soil before and after the pandemic, and iii) methods for quantification of viruses and SARS-CoV-2 monitoring in soil. Viruses are present in soil (i.e. up to 417 × 10⁷ viruses per g TS^-1 in wetlands) and can affect the behavior and ecology of other life forms (e.g. bacteria), which are remarkably important for maintaining environmental equilibrium. Also, SARS-CoV-2 can be found in soil (i.e. up to 550 copies·g^-1). Considering that the SARS-CoV-2 is very recent, poor knowledge is available in the literature on persistence in the soil and reference has been made to coronaviruses and other families of viruses. For instance, the survival of enveloped viruses (e.g. SARS-CoV) can reach 90 days in soils with 10% of moisture content at ambient. In such a context, the possible spread of the SARS-CoV-2 in the soil was evaluated by analyzing the possible contamination routes.

Potential Therapeutic Targets and Vaccine Development for SARS-CoV-2/COVID-19 Pandemic Management: A Review on the Recent Update

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a highly pathogenic novel virus that has caused a massive pandemic called coronavirus disease 2019 (COVID-19) worldwide. Wuhan, a city in China became the epicenter of the outbreak of COVID-19 in December 2019. The disease was declared a pandemic globally by the World Health Organization (WHO) on 11 March 2020. SARS-CoV-2 is a beta CoV of the Coronaviridae family which usually causes respiratory symptoms that resemble common cold. Multiple countries have experienced multiple waves of the disease and scientific experts are consistently working to find answers to several unresolved questions, with the aim to find the most suitable ways to contain the virus. Furthermore, potential therapeutic strategies and vaccine development for COVID-19 management are also considered. Currently, substantial efforts have been made to develop successful and safe treatments and SARS-CoV-2 vaccines. Some vaccines, such as inactivated vaccines, nucleic acid-based, and vector-based vaccines, have entered phase 3 clinical trials. Additionally, diverse small molecule drugs, peptides and antibodies are being developed to treat COVID-19. We present here an overview of the virus interaction with the host and environment and anti-CoV therapeutic strategies; including vaccines and other methodologies, designed for prophylaxis and treatment of SARS-CoV-2 infection with the hope that this integrative analysis could help develop novel therapeutic approaches against COVID-19.

Novel coronavirus disease 2019 (COVID-19) pandemic: From transmission to control with an interdisciplinary vision

There a lot of review papers addressing specific COVID-19 research sectors, then devoted to specialists. This review provides an in-depth summary of the available information about SARS-CoV-2 and the corresponding disease (also known as COVID-19), with a multi-disciplinary approach. After the paper introduction, the first section treats the virological characteristics of SARS-CoV-2, the medical implications of the infection, and the human susceptivity. Great attention is devoted to the factor affecting the infection routes, distinguishing among the possible human-to-human, environmental-to-human, and pollution-to-human transmission mechanisms. The second section is devoted to reporting the impact of SARS-CoV-2 not only on the healthcare systems but also on the economy and society. The third section is devoted to non-pharmaceutical behaviours against COVID-19. In this context, this review section presents an analysis of the European second wave allowing not only to focalize the importance of some restrictions, but also the relevance of social acceptance of some measures. The data reassumed in this work are very useful for interdisciplinary researchers that work in a team to find the basic available information about all the aspects connected with this pandemic (from virus diffusion mechanism to health information, from economic and social impacts to measures to reduce the pandemic spread), with great attention to social acceptance of restriction measures and of vaccines (that currently results to be insufficient to achieve community immunity). Then, this review paper highlights the fundamental role of the trans-multi-disciplinary research that is devoted not only to understand the basics of the pandemic to propose solutions but has also the commitment to find strategies to increase population resilience. For this aim, the authors strongly suggest the establishment of an international health-care trans-multi-disciplinary workforce devoted to investigate, mitigate, and control also future viral events.