Wastewater Surveillance for COVID-19

Wastewater-based epidemiology can be used to monitor viral RNA in wastewater to assess disease prevalence and spread in defined populations.

There is an urgent need to quickly determine the status and trends of COVID-19 within and across communities nationwide. Rapid monitoring is critical for the further development of containment and mitigation strategies (1). Over the past 15 years, wastewater-based epidemiology (WBE) has evolved to monitor virus particles and can be designed to detect SARS-CoV-2, thus significantly improving a nation’s ability to control the spread of the virus (1). Instead of relying on diagnostic testing, scientists are turning toward wastewater epidemiology as a potential method for assessing and managing the COVID-19 pandemic (2).
Wastewater-based epidemiology can be used to monitor viral RNA in wastewater to assess disease prevalence and spread in defined populations (3). Various studies continue to show this method of detection to be feasible and cheaper than clinical screenings (2). The results further support that for resource-poor regions and nations, WBE may be the most practical method of efficient surveillance by testing large segments of the population at a fraction of the cost and a fraction of the time (4). By reducing the demand for diagnostic testing, WBE can avoid supply-chain shortages caused by insufficient manufacturing capacity (5). WBE could also provide early warnings for community-wide emergence, resurgence, and status/trends, of COVID-19. Since WBE can detect COVID-19 before random diagnostic testing of asymptomatic individuals, it could save critical days in facilitating a head-start for contact tracing (5).
An accurate quantitative assessment of a community SARS-CoV-2 infection could be challenging due to several factors, such as the unknown persistence of viral RNA in wastewater and variable flow conditions in sewer systems (3). Since the U.S. has less experience with the implementation of WBE, international research collaboration must be encouraged (1). More extensive partnerships between a broader range of science disciples will be required to expand the usefulness of WBE to infectious diseases and biomolecules (5).