Abstract

The ongoing COVID-19 pandemic is caused by SARs-CoV-2. The virus is transmitted from person to person through droplet infections i.e. when infected person is in close contact with another person. In January 2020, first report of detection of SARS-CoV-2 in faeces, has made it clear that human wastewater might contain this virus. This may illustrate the probability of environmentally facilitated transmission, mainly the sewage, however, environmental conditions that could facilitate faecal oral transmission is not yet clear. We used existing Pakistan polio environment surveillance network to investigate presence of SARs-CoV-2 using three commercially available kits and E-Gene detection published assay for surety and confirmatory of positivity. A Two-phase separation method is used for sample clarification and concentration. An additional high-speed centrifugation (14000Xg for 30 min) step was introduced, prior RNA extraction, to increase viral RNA yield resulting a decrease in Cq value. A total of 78 wastewater samples collected from 38 districts across Pakistan, 74 wastewater samples from existing polio environment surveillance sites, 3 from drains of COVID-19 infected areas and 1 from COVID 19 quarantine center drainage, were tested for presence of SARs-CoV-2. 21 wastewater samples (27%) from 13 districts turned to be positive on RT-qPCR. SARs-COV-2 RNA positive samples from areas with COVID 19 patients and quarantine center strengthen the findings and use of wastewater surveillance in future. Furthermore, sequence data of partial ORF 1a generated from COVID 19 patient quarantine center drainage sample also reinforce our findings that SARs-CoV-2 can be detected in wastewater. This study finding indicates that SARs-CoV-2 detection through wastewater surveillance has an epidemiologic potential that can be used as supplementary system to monitor viral tracking and circulation in cities with lower COVID-19 testing capacity or heavily populated areas where door-to-door tracing may not be possible. However, attention is needed on virus concentration and detection assay to increase the sensitivity. Development of highly sensitive assay will be an indicator for virus monitoring and to provide early warning signs.

Highlights

  • Novel coronavirus pneumonia (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection has become a global emergency through its widespread infection with 43,504,448 confirmed cases resulting 1,159,533 deaths in 213 countries as of 26th October, 2020 [1]

  • A total of 76 wastewater samples were collected between 12 to 18 epidemiological weeks from 38 districts across country and were tested for SARs-CoV-2 RNA (Fig 1). 21 wastewater samples (27%) from 13 districts were positive on RT-qPCR (Table 2)

  • 20 wastewater samples were collected during March 20, 2020 to April 09, 2020 from districts of Pakistan; samples from different polio environmental sites (ES) distributed across 16 districts and 02 samples in areas with recent history of SARS-CoV2 cases from capital city Islamabad

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Summary

Introduction

Novel coronavirus pneumonia (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection has become a global emergency through its widespread infection with 43,504,448 confirmed cases resulting 1,159,533 deaths in 213 countries as of 26th October, 2020 [1]. The primary routes of viral transmission (SARS-CoV-2) was considered to be through droplet infections and person to person close contact, but later it is evident from various published studies that there is increasing possibility of fecal-oral transmission, environmental conditions that could facilitate faecal oral transmission is not yet clear [9, 10]. This shows the probability of environmentally mediated transmission. Since the early days of pandemic, we got interested in understanding and utilizing the role of environmental sampling mainly the sewage

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