• R Johnson, C J F Muller, S Ghoor, J Louw, E Archer, S Surujlal-Naicker, N Berkowitz, M Volschenk, L H L Bröcker, G Wolfaardt, M Van der Walt, A M Mutshembele, S Malema, H C Gelderblom, M Muhdluli, G Gray, A Mathee, and R Street.
• Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town, South Africa; Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa. renee.street@mrc.ac.za.
• S. Afr. Med. J. 2021 Jan 28; 111 (3): 198-202.

AbstractRecent studies have shown that the detection of SARS-CoV-2 genetic material in wastewater may provide the basis for a surveillance system to track the environmental dissemination of this virus in communities. An effective wastewater-based epidemiology (WBE) system may prove critical in South Africa (SA), where health systems infrastructure, testing capacity, personal protective equipment and human resource capacity are constrained. In this proof-of-concept study, we investigated the potential of SARS-CoV-2 RNA surveillance in untreated wastewater as the basis for a system to monitor COVID-19 prevalence in the population, an early warning system for increased transmission, and a monitoring system to assess the effectiveness of interventions. The laboratory confirmed the presence (qualitative analysis) and determined the RNA copy number of SARS-CoV-2 viral RNA by reverse transcription polymerase chain reaction (quantitative) analysis from 24-hour composite samples collected on 18 June 2020 from five wastewater treatment plants in Western Cape Province, SA. The study has shown that a WBE system for monitoring the status and trends of COVID-19 mass infection in SA is viable, and its development and implementation may facilitate the rapid identification of hotspots for evidence-informed interventions.

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