Study of the correlation between Covid-19 cases and deaths and basic sanitation in Brazil: Is this a possible secondary route of virus transmission?

Abstract

People with COVID-19 may excrete viable SARS-CoV-2 virus through urine and faeces, which has raised concerns about the possibility of transmission of COVID-19 via water contaminated or sewage. These concerns are especially exacerbated in underdeveloped countries like Brazil, where untreated sewage is usually discharged to surface water or soil. Because of that, a hypothesis emerged that was addressed in this study, which seeks to understand whether access to basic sanitation services can influence the proliferation of the virus. A correlation study was carried out between the cases of COVID-19 and the indicators of basic sanitation from all regions of Brazil. The results showed that there was a correlation only with the water supply indicator. A hypothesis that would explain the presented correlation would be the inefficiency of the water treatment systems in Brazil, not totally inactivating the virus, or possible contamination of the water distribution networks by sanitary sewage. In general, the data presented reinforce the need to expand and monitor basic sanitation services, especially to ensure the effective and efficient disinfection of drinking water. This monitoring could be useful for early warning surveillance of the spread of the virus.