This computational modeling study and cost analysis served to identify WBE as a rapid, inexpensive and potentially robust tool for tracking SARS-CoV-2/COVID-19. Effective use of this emerging surveillance tool will require the consideration of temperature effects in order to obtain robust, informative data. Whereas WBE cannot replace clinical testing, it can serve to alert emergency response teams to the presence of infected individuals in towns, cities and specific drainage areas (sub-sewersheds) of large metropolitan areas down to the neighborhood and building complex level. The feasibility of performing longitudinal monitoring of wastewater at the city-area/neighborhood level already has been demonstrated in the city that served as the use case of this study, Tempe, AZ, where SARS-CoV-2 recently was added to a spectrum of public health indicator that have been tracked continuously since May 2018. To accelerate the global economic recovery, it is desirable to implement restrictions to people's mobility and livelihoods only in locales where these are needed. WBE is well positioned to inform this local decision-making process. WBE also appears to constitute the only viable means of enabling large-scale population-wide testing globally, particularly in resource poor regions. Since effective use of large-scale WBE requires access to wastewater that is centrally collected, composited and treated, the global use of WBE relying on sampling of wastewater treatment plants currently is restricted to about 2.1 billion people or 27% of the global population. Billions of additional people could benefit from human waste analysis by integrating sampling of latrines into global health surveillance. However, he required effort would be disproportionately larger and the number of people reflected in each sample relatively low. Yet, if only 1% of the resources currently allocated for clinical testing were diverted to WBE, significant cost savings could be realized, vulnerable populations could be protected more effectively, and economic recovery could be balanced locally more selectively with the need for containing community spread of the new coronavirus. list the conclusions

Several studies have demonstrated the advantages of environmental surveillance through the monitoring of sewage for the assessment of viruses circulating in a given community (wastewater-based epidemiology, WBE). During the COVID-19 public health emergency, many reports have described the presence of SARS-CoV-2 RNA in stools from COVID-19 patients, and a few studies reported the occurrence of SARS-CoV-2 in wastewaters worldwide. Italy is among the world's worst-affected countries in the COVID-19 pandemic, but so far there are no studies assessing the presence of SARS-CoV-2 in Italian wastewaters. To this aim, twelve influent sewage samples, collected between February and April 2020 from Wastewater Treatment Plants in Milan and Rome, were tested adapting, for concentration, the standard WHO procedure for Poliovirus surveillance. Molecular analysis was undertaken with three nested protocols, including a newly designed SARS-CoV-2 specific primer set. SARS-CoV-2 RNA detection was accomplished in volumes of 250 ml of wastewaters collected in areas of high (Milan) and low (Rome) epidemic circulation, according to clinical data. Overall, 6 out of 12 samples were positive. One of the positive results was obtained in a Milan wastewater sample collected a few days after the first notified Italian case of autochthonous SARS-CoV-2. The study confirms that WBE has the potential to be applied to SARS-CoV-2 as a sensitive tool to study spatial and temporal trends of virus circulation in the population list the conclusions

, we review the current knowledge related to the potential of wastewater surveillance to understand the epidemiology of COVID-19, methodologies for the detection and quantification of SARS-CoV-2 in wastewater, and information relevant for human health risk assessment of SARS-CoV-2. There has been growing evidence of gastrointestinal symptoms caused by SARS-CoV-2 infections and the presence of viral RNA not only in feces of infected individuals but also in wastewater. One of the major challenges in SARS-CoV-2 detection/quantification in wastewater samples is the lack of an optimized and standardized protocol. Currently available data are also limited for conducting a quantitative microbial risk assessment (QMRA) for SARS-CoV-2 exposure pathways. However, modeling-based approaches have a potential role to play in reducing the impact of the ongoing COVID-19 outbreak. Furthermore, QMRA parameters obtained from previous studies on relevant respiratory viruses help to inform risk assessments of SARS-CoV-2. Our understanding on the potential role of wastewater in SARS-CoV-2 transmission is largely limited by knowledge gaps in its occurrence, persistence, and removal in wastewater. There is an urgent need for further research to establish methodologies for wastewater surveillance and understand the implications of the presence of SARS-CoV-2 in wastewater. list the conclusions

In summary, the paper-based device has the potential to beused as a small, portable device to detect SARS-CoV-2 inwastewater on site and to track virus carriers in the community.Such an approach could provide near real-time and continuousdata and serve as an early warning sensing system to help localgovernments and agencies make effective interventions toisolate potential virus carriers and prevent the spread ofepidemics. We believe that in the case of asymptomaticinfections in the community or people are not sure whetherthey are infected or not, rapid and real-time community sewagedetection through paper analytical devices can determinewhether there are SARS-CoV-2 carriers in the area in a timelymanner to enable rapid screening, quarantine, and prevention.The potentially infected patient will also benefit from paperanalytical device tracing SARS-CoV-2 sources with WBE,providing information for the correct and timely treatment ofCOVID-19 list the conclusions

SARS-CoV-2 is the etiological agent of COVID-19. Most of SARS-CoV-2 carriers are assumed to exhibit no or mild non-specific symptoms. Thus, they may contribute to the rapid and mostly silent circulation of the virus among humans. Since SARS-CoV-2 can be detected in stool samples it has recently been proposed to monitor SARS-CoV-2 in wastewaters (WW) as a complementary tool to investigate virus circulation in human populations. In the present work we assumed that the quantification of SARS-CoV-2 genomes in wastewaters should correlate with the number of symptomatic or non-symptomatic carriers. To test this hypothesis, we performed a time-course quantitative analysis of SARS-CoV-2 by RT-qPCR in raw wastewater samples collected from several major wastewater treatment plant (WWTP) of the Parisian area. The study was conducted from 5 March to 23 April 2020, therefore including the lockdown period in France (since 17 March 2020). We confirmed that the increase of genome units in raw wastewaters accurately followed the increase of human COVID-19 cases observed at the regional level. Of note, the viral genomes could be detected before the beginning of the exponential growth of the epidemic. As importantly, a marked decrease in the quantities of genomes units was observed concomitantly with the reduction in the number of new COVID-19 cases which was an expected consequence of the lockdown. A s a conclusion, this work suggests that a quantitative monitoring of SARS-CoV-2 genomes in wastewaters should bring important and additional information for an improved survey of SARS-CoV-2 circulation at the local or regional scale.list the conclusions

Concerns about possible secondary transmission of the novel SARS-CoV-2 via water are growing with the evidence of its fecal elimination. Moreover, the results of in vitro experiments of prolonged virus survival with declining temperatures suggest that coronavirus excreted in feces could reach wastewater treatment plants in an infective state, especially in cool climates. However, current knowledge is very scarce and fragmentary. Prior to COVID19, interest in this topic was very low owing to the common belief that enveloped viruses cannot survive for extended periods in water. However, the assumption that SARS-CoV-2 is not involved in environmental circulation cannot be accepted without better knowledge, as highlighted by the detection of SARS-CoV-2 RNA in wastewater by six different global research groups. The ongoing SARS-CoV-2 emergency and its rapid spread demands new attention on its detection in water. The scarcity of information on the presence and persistence of coronavirus in the environment merits urgent research. In the meantime, we should respond to the ongoing pandemic by taking precautions and assume that there is a potential for secondary transmission. In particular, we believe that research should address the following:Set up efficient methods to concentrate and detect enveloped viruses (and coronavirus in particular) from water matrices;  Evaluate the survival of these viruses in natural conditions, at different temperatures and in different types of water;  Assess the efficiency of water treatments and disinfection to avoid contamination from urban and hospital wastewater;  Evaluate the implications for water reuse for agriculture including the possibility of food (raw vegetables) contamination;  Establish a surveillance system through sewage monitoring of the potential virus circulation. list the conclusions