Establishing a national COVID 19 wastewater and non-sewer based water quality survaillance programme

Surveillance of wastewater treatment plants offers an opportunity for near–real-time outbreak data and as an early warning for resurgence of the outbreak. To date, the wastewater-based epidemiology approach has been successfully piloted in developed countries where there is wide coverage of waterborne sanitation, such as the Netherlands, France, United States of America, etc. However, given the varied water and sanitation services delivery mechanisms in South Africa (and lack of), the country, through the Water Research Commission, is in a unique position to pioneer the development and piloting of an all-encompassing water and sanitation-focused approach for the surveillance of COVID-19 spread in less developed communities.

In view of the above, the Water Research Commission in association with SALGA launched a special programme on surveillance of COVID 19 in wastewater, sanitation and health. The main aim of this programme is to share knowledge, stimulate research and innovations on water quality, sanitation and health in support of government’s initiatives aimed at curbing the spread of COVID -19. The programme consists of planned, inter-related activities aimed at achieving the defined objectives, by producing specified outputs. The aims and objectives of the programme will be achieved through the following initiatives:
• Pilot and full-scale implementation of wastewater surveillance as a non-invasive approach for monitoring the spread of COVID-19 in communities -based epidemiological surveillance of COVID-19 spread in communities.
• Research work and capacity building on COVID-19 in relation to water and sanitation and health
• Knowledge dissemination through webinars, workshops

To date, a few countries have been able to demonstrate the presence of SARS-CoV-2 nucleic acids in the faeces of infected people and the potential use of the WBE approach for monitoring wastewater for COVID-19 infections. The number of cases in these countries is 5-10 times more the reported cases in South Africa, thus it remains to be seen if the same approach can be successfully applied. For this reason, implementation of the wastewater surveillance initiative will follow a three phased approach .

• Phase one – proof of concept - A proof of concept study, aimed at optimizing sample design, testing and fine-tuning sampling protocol, preliminary sampling and analysis of wastewater samples from selected metropolitan cities.

• Phase two – pilot scale monitoring - Partnerships for pilot-scale monitoring will be sought through a special call collaborators, funders and partners (research and laboratory service providers, water utilities, government and private sector). This phase will see the commissioning of a collaborative monitoring initiative in provincial hotspots (Gauteng, KZN & Western Cape) using the sampling and testing protocols developed in phase one.

Phase three – national wastewater surveillance - Once partnerships with capable and compliant laboratories have been formalized, the Water Research Commission and partners will coordinate the implementation of the national programme.

The expected outputs of the programme are as follows:
• Novel water and sanitation-based approach for the surveillance of COVID-19 spread in less developed communities
• Real time tracking of COVID-19 spread and resurgence in communities
• Understanding the fate of the virus in the water, sanitation and wastewater environment.

In order for wastewater surveillance to be successful and sustainable, there is need to develop best practice and considerations for wastewater sample design, collection and storage. Such best practice will ensure that all the challenges associated with credibility of data are addressed and safeguard the integrity of the surveillance outcome. Rapid action is vital to outpace COVID-19. Wastewater and water quality surveillance of COVID 19 offers this opportunity and can contribute to the second wave and longer term management of this virus.