WASTEWATER-BASED EPIDEMIOLOGY FOR COVID-19 DETECTION IN WASTEWATER

With the economic and practical limits of medical screening for SARS-CoV-2/COVID-19 coming sharply into focus worldwide, scientists are turning now to wastewater-based epidemiology (WBE) as a potential tool for assessing and managing the pandemic. This approach is built on the knowledge that some infected persons shed viral particles/RNA in their stool as a result of gastrointestinal infections (GI) and other excreta. Early reports from Wuhan, China, showed that abdominal pain (an indication of GI infections) was reported more frequently in patients admitted into intensive care, than individuals not requiring intensive care (Yang et al., 2020; Wang et al., 2020; Chen et al., 2020). The proportion of patients with diarrhoea varied between regions, in China about 10% of the patients had diarrhoea, 1-2 days before the development of fever and respiratory symptoms (Wang et al., 2020). The proportion of patients with diarrhoea varied between regions, in China about 10% of the patients had diarrhoea, 1-2 days before the development of fever and respiratory symptoms (Wang et al., 2020). Studies have reported 2-35% of the patients having gastrointestinal (GI) symptoms, such as diarrhoea, abdominal pain, and vomiting, although it is less frequent compared to respiratory symptoms (Yeo et al., 2020; Wang et al., 2020). It is estimated that infected individuals with Coronavirus will shed about 106gc/g of faeces and 101 gc/mL of urine (Woelfel et al., 2020; Hung et al., 2004). The relative infection level for a population could, therefore, be estimated using the information on RNA copies shed per gram of faeces and litre of urine and viral titer in wastewater per day (Ahmed et al., 2020). These findings support the potential of stool, urine and wastewater analysis as an early warning system, since viral RNA can be detected in feces, and subsequently wastewater, weeks before the onset of illness. A number of publications have proven the applicability of this concept in estimating viral infection connected populations. For instance WBE was able to detect infections almost a week to actual clinal reports, this has been demonstrated in several countries like the Netherlands (Medema et al (2020), Spain (Randazzo et al., 2020), Australia (Ahmed et al., 2020) and the USA (Peccia et al., 2020). This early detection of infection though WBE could therefore provide the means for the development of an early warning system. The use of this approach has also shown some correlation with clinical infection numbers, provings it potential use to determine infection levels within communities (Ahmed et al., 2020; Wurtzer et al., 2020; Peccia et al., 2020). Therefore, WBE could also be optimized for the estimation or determination of infection levels/hotspots within communities. Therefore, we aim is to use wastewater-based epidemiology to determine COVID-19 infection hotspots and develop an early warning system to detect changes in infection levels within the community.