The Water Research Commission (WRC) has launched a National Programme on Monitoring Covid-19 Spread in Communities to track the prevalence of the virus in communities through wastewater surveillance and monitoring.

The WRC aims to work with local and international partners to research and measure the scope of the Covid-19 outbreak, independent from patient testing, across South Africa, by testing wastewater samples in communities for the genetic fingerprint of the virus.

“Developing countries may not be able to afford or implement mass screening programmes to uncover new infections, however, there is an opportunity of tracing Covid-19 spread, in sewered wastewater treatment systems and non-sewered sanitation systems that promises to provide us with information that could track and trace and signal hotspots of community transmissions,” says WRC research and development group executive Dr Stanley Liphadzi.

The SARS-CoV-2 genomic was detected in faeces within the wastewater and sanitation environment, with studies showing it may survive in stools for three to four days.

No infective strain has been confirmed as yet.

There is an opportunity to launch a wastewater surveillance project at a much lower cost and investment and larger reach to provide community level indicators of where South Africa is with regards to Covid-19 using a water and sanitation-based approach, added WRC CEO Dhesigen Naidoo.

WRC aims to complement the government’s Covid-19 initiatives by using the much broader environmental health surveillance initiative, with intentions of establishing a South African – and then African – chapter of the various programmes initiated worldwide.

Currently, countries such as Canada, Australia and the US, as well as many across Europe, are surveilling sewer systems to detect the virus’s fingerprint and provide indications of when the virus arrived, or serve as an early detection signal for communities that have already experienced an outbreak and are concerned about a resurgence.

While the developed world’s focus is that of safety of water services personnel and using this virus as a marker to determine the prevalence and health of their residents, for a developing country like South Africa, understanding the fate of the virus in water is of significance as many communities in rural, dense and informal settlements are highly vulnerable, the WRC indicated.

“The programme allows us a toolbox to monitor exactly how we engage our interventions around this pandemic, monitor the course of the pandemic and engage the issue of the efficacy of our interventions over this time,” he said.

Liphadzi pointed out that the programme can enable South Africa to measure the scope of the outbreak, determine the hotspots and determine if the wastewater – sewered and non-sewered – systems are potential infection points owing to occupational exposure.

“There is a lot we do not know on the Covid-19 virus, and several research initiatives are being undertaken internationally to answer the same concern we all have regarding how long the virus can survive in the wastewater and sanitation environment and under what conditions. If the virus does survive in wastewater and sanitation samples, understanding the level of risk posed to communities and implementing key strategies that involve an early warning alert of potential communal spread will be critical.”

It will also provide decision-making support and determine the timing and severity of public health interventions to mitigate the spread of the virus and better anticipate the likely impact and inform hospital readiness and the necessity of public health interventions.

Further, the project will assist in tracking the effectiveness of interventions and provide an early warning system for potential re-emergence.

WRC drinking water quality and treatment research manager Dr Nonhlanhla Kalebaila says the project will kick off with a proof of concept phase, followed by pilot-scale monitoring and then nationwide surveillance.

The proof of concept, over the next three to four months, will cover sample design, testing sampling protocol and preliminary characterisation and the risk of infection in wastewater treatment plants.

The second phase will include the pilot-scale monitoring of provincial hotspots and the preliminary pilot surveillance monitoring data within six months, while the third phase over the next one to three years will comprise national wastewater surveillance and includes a full-scale national sewershed surveillance, data analysis, integration, communication and research with sector and government support.

The programme can also form part of a larger initiative integrating water quality and sanitation health, as well as security of supply, Naidoo concluded.