The present day pandemic and wastewater.

 In a previous post, I mentioned COVID-19 is thought to have spread in Sudan after the breakdown of sanitation caused by recent floods. When reading around the subject this week, I came across an article on the wastewater management, or in this case, the lack there of, which was also thought to be contributing to the transmission of the virus. 

The paper by Liu, Thompson, Carducci and Bi (2020), suggests the potential for a secondary transmission of COVID-19, via wastewater should be considered. They combine papers written around the world to make a strong argument for this which I don't think has been given enough attention in the media. As we are all aware, the primary process of transmission is through respiratory droplets and direct or indirect contact. However, COVID-19 (scientific name SARS-CoV-2) and its sequence have been identified in human faecal samples in Australia, China, France, Japan, Italy, Spain, the Netherlands, USA and Turkey (Liu et al., 2020). For example, in Guangzhou, China, a case found multiple people from different households were infected from a wastewater leak of a broken sewer from a known COVID-19 patient, despite having no contact with the person (Guangzhou Center for Disease Control and Prevention 2020). However, the WHO has not directly acknowledged the link but has recommended the safe management of water and sanitation services to prevent infection (WHO and UNICEF 2020).

Figure 1, source FDA

The paper doesn't note an example of findings in Africa, however this is possibly due to a lack of  data reporting (Sandefur and Glassman 2014). For example, findings by Schoder and Amukele (2014) suggest that in Kampula, Uganda less than 1% of labs meet international standards which is also problematic in determining other water and sanitation issues.  

A solution?

Liu et al., 2020 suggest mobile treatment facilities with disinfection devices and rural solar toilets could be appropriate to help remove pathogens. An alternate option could be disposing in sanitary landfills where faecal material is treated with cheap and effective disinfectants such as sodium hypochlorite and is covered with soil (Zamorano et al., 2007). However, this requires anti-seepage education. 

Better analytical methods to identify coronavirus in surface waters, tap water or sewage sludge could help refine estimates of the spread and provide early warnings (Medema et al., 2020), however this would require large efforts in cities such as Kampala. 

Summary

Therefore, this paper demonstrates a possible link of Covid-19 transmission in the faecal-oral route. I found this paper really interesting as it reminds us to stay broad and explore information for ourselves rather than relying on media sound-bites. Future research could pay more attention to aquatic environments and food chains to mitigate further spread. I think this is an opportune time to reflect on sources of knowledge. Consider, what do we know about the pandemic and how to avoid being infected. This information is based on quantitative and qualitative data analysis. Now consider living where this is not as widely available and the data presented is potentially unknown...