The Water Research Commission (WRC) has led the South African initiative towards developing web-based epidemiology (WBE) platform that reports on the presence of the SARS-CoV-2 virus in collected samples of wastewater.
Launched together with the South African Local Government Association (SALGA) in May 2020 and backed by SACCESS (Supporting the EU access to South Africa’s research and innovation programmes), the WBE platform has shown that SARS-CoV-2 was detected in 98% of collected wastewater samples. To date, the wastewater-based epidemiology approach has been successfully scaled up as a national intervention in many developed countries where there is wide coverage of waterborne sanitation, such as the Netherlands, Turkey and the United States of America. “However, South Africa has varied water and sanitation service delivery mechanisms (and lack of). Therefore, we needed to develop and pilot our own water and sanitation-focused approach for the surveillance of Covid-19 spread in serviced and in less serviced communities,” explains Jay Bhagwan, the executive manager: water use and waste management at the WRC. Discovery by Durban University of Technology
An important breakthrough has been made from the Durban University of Technology (DUT) WBE Covid-19 programme that is supported by the WRC, in partnership with Ethekweni Municipality and Umgeni Water. The DUT has been monitoring treatment plants in the Durban area since July 2020, with a focus on a central wastewater treatment plant that services a large area.
Detection and quantification of the N2 gene within the SARS-CoV-2 genome has been ongoing at the head of works at Central Wastewater Treatment Plant (CWWTP) since July 2020Number of active clinical cases in KZN and eThekwini Municipality has been increasing steadily since 20 April 2021The wastewater surveillance revealed an increase in (SARS-CoV-2) copy numbers as early as 30 March 2021- three weeks before reported clinical cases shown in Figure 2The number of active clinical cases in April/May 2021 is significantly lower when compared to February 2021, despite the viral loads in wastewater being almost the same. This suggests that there may be a greater number of infected individuals within the population than what is being reported currently for eThekwini.There has been a significant increase in SARS-CoV-2 copy numbers in wastewater (Table 1 and Figure 3) observed over the last 4 weeks (28 April 2021 – 18 May 2021). This indicates that a spike in clinical cases in the coming weeks is imminent – and requires urgent attention from the relevant authorities. WBE surveillance is a cost-effective means of providing an early warning of the spread and increase in infections. An increase in Covid-19 was shown in samples of collected wastewater – three weeks before reported increase in clinical cases. The increase in the viral loads of the collected wastewater offers a very effective signal on the increases in infections, as it is able to capture the asymptomatic cases as well which form a pathway for the spread of infections. This progress has demonstrated the importance and effectiveness of WBE surveillance and why it needs to be escalated at a national level in the fight of this pandemic, but can also in the future be used to determine the impact of the large rollout of vaccinations in the country.
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