Waste Water Surveillance: COVID-19

Since the emergence of the COVID-19 pandemic, waste water has been investigated as a means to identify the presence of the SARS-CoV-2 virus (this is the virus that causes the COVID-19 disease) in the community. The surveillance of waste water is a tool to track the presence of pathogens in waste water. Waste water surveillance for the RNA of the SARS-CoV-2 virus is being used as a relatively cheap and reliable tool to support the tracking of the presence of the virus, both within the EU and internationally. Waste water surveillance for the SARS-CoV-2 virus should be carried out in conjunction with the collection of information on the prevalence of the virus from health based sources, such as swab testing, blood testing, tracing apps.

In light of the progression of the pandemic, tracking the presence of the virus in waste water is highly recommended, as a relatively cheap and reliable way of gathering essential information. It should be used in conjunction with other public health indicators and can be very useful to establish and adjust public health management strategies. The tool also appears useful in providing targeted ad-hoc support in less favoured countries where epidemiological data are not available.

In summary:

Information gathered so far show acorrelation between the quantities of the SARS-CoV-2 virus found in waste waters and the number of persons infectedin the corresponding area.
Waste water surveillance can be effectively used as:

preventive or early warning tool – as soon as the virus is detected, this should be taken as a signal of a possible (re)emergence of the pandemic;
management tool – absence of the virus in waste water could indicate that the corresponding zone can be considered of a lower risk;
safety net – if the virus is detected in waste water but the testing of the resident population is negative, investigations of undetected infection sources should be undertaken.

Data from wastewater surveillance should always be used as a complement to epidemiological data. Where no such epidemiological data are available, information on the presence of the virus in waste water can help in designing the most effective assistance strategies to the benefit of less-favoured countries and social categories.
Tracking wastewater is a cost-effective preparedness and resilience tool: securing effective surveillance of 1 treatment plant requires ca. 25 000 €/year.^[1]
Tracking pathogen’ presence at regular interval in waste water can also be usefulto anticipate possible new epidemics and pandemics ^[2], as well as further waves of the COVID-19 pandemic.

DG ENV with the support of JRC has elaborated the attached memo. The purpose of the memo is to (1) synthetize the main results obtained so far; and (2) draw first conclusions and recommendations. Most of the results included in this memo are extracted from the JRC/ENV project on the feasibility assessment for an EU-wide Wastewater Monitoring System for SARS-CoV-2 Surveillance. More information available here.

Recommendation on monitoring COVID-19 and its variants in wastewaters in the EU

In March 2021, the Commission adopted a Recommendation on monitoring COVID-19 and its variants in wastewaters in the EU. This Recommendation is part of a set of COVID-19 measures adopted by the Commission as announced in the European preparedness plan entitled the ‘HERA Incubator’. The aim is to provide new independent information on the presence of SARS-CoV-2 and its variant in waste water. This will be an important source of additional and complementary information for public health decision-making. The Recommendation asks the Member States to put in place wastewater surveillance systems by October 2021, ensuring that relevant data is promptly provided to the competent health authorities. Common methods for sampling, measurement and data analysis, supported by a European exchange platform should be made available and used in practice to ensure that the collected data is reliable and comparable. Financial support is being provided to with €20 million of the Emergency Support Instrument have been allocated to the EU Member States, interested to rollout wastewater-based surveillance... Neighbouring countries are also being supported to set up this monitoring system or to expand it to variants analysis. The EU Commission will also put in place an exchange IT platform, the European Exchange Platform (DEEP), to connect national, regional and local wastewater surveillance programmes.

View the Recommendation.

[1] Average cost based on two analysis per week – valuable for large waste water treatments (up to 1M inhabitants). For comparison: the development of the CORONA warn app in Germany costed 22.7 Mio € plus an estimated of 2.5 – 3.5 Mio € of monthly running costs

[2] This risk was recently highlighted in a IPBES publication – see: https://ipbes.net/pandemics