"Sewage Epidemiology Can Critically Strengthen, Save Lives"

NEW DELHI || A new and expanding UK-India sewage-surveillance research partnership is working to demonstrate that amidst public-health crises such as COVID-19, sewage epidemiology can critically strengthen global responses and save lives.

A recent webinar by India’s International Academy of Sanitation and Public Health (IAESPH) New Delhi, UK’s NVH Global Ltd and UK’s University of Surrey called for urgent global technology and investment in embedding and improving early-warning sewage-surveillance systems.

University of Surrey’s Dr Devendra P Saroj Head of the Centre for Environmental Health & Engineering said: “We provide multidisciplinary research support globally through international agencies such as the WHO, Pan American Health Organisation and UNICEF. Our scoping studies over the last two years have identified Delhi as a city for further work. We are now seeking funding to help roll out a pilot project in select municipalities in Delhi where sewage samples can be collected periodically and analysed for SARS-Cov-2 RNA to better inform public health responses even when communities within municipalities are asymptomatic and there is insufficient or delayed clinical data. If successful the Government of India and state governments can consider scaling up such interventions across the country.”

UK’s Professor Davey L Jones said, ‘Wastewater never lies; wastewater epidemiology can significantly improve the prediction and management of virus outbreaks.’ His Soil and Environment Science team in UK’s University of Bangor is leading risk-assessment monitoring of the SARS-Cov-2 RNA in communities and wastewater treatment plants. Jones said that secondary and tertiary treatment can reduce the presence of viruses in treated wastewater by a 1000-fold.

Dr Arunabha Majumder former Director-Professor All India Institute of Hygiene & Public Health said that in the absence of adequate clinical surveillance and given the high proportion of asymptomatic and undiagnosed cases in outbreaks such as COVID-19, early warning systems can help more swiftly and effectively manage pandemics.

Netherlands’ Professor Gertjan Medema at KWR Water Research Institute said that a study of six cities across the Netherlands showed a correlation between surge in COVID positive cases and subsequently discovered concentrations of SARS-Cov-2 RNA in wastewater. His team found that virus detection in wastewater preceded detection in communities by at least a few days. Frequent sampling of wastewater treatment plants can provide trends to inform decisions on testing, personal protection and social distancing, including by reducing bias in COVID-19 testing.

Dr Manish Kumar, Assistant Professor at the Indian Institute of Technology (IIT), Gandhinagar said that sewage-surveillance can complement, not replace, human testing but early-warnings can help better target public health responses toward communities at greater risk.

ADB’s Chief of Water Sector Group Thomas Panella said that of ADB’s $16 billion in emergency and co-financing in 41 countries much of it was for fiscal stimulus and health response but that the Bank had a strong interest in efforts to improve early warning detection of viruses in water and wastewater.

He said investment and technology in such sewage surveillance could save millions of lives, especially those of children at risk from water-borne diseases and untreated or unmonitored wastewater. He called for greater public and private partnership globally, ‘the challenge is to get technology and investment right since public resources are scarce; it costs $1-2 million to establish testing protocols in a city of 3-5 million.’