A pilot project has found Covid-19 RNA signals in wastewater plants in Gauteng hotspots. Now it needs to be scaled up nationally as it could be a vital and cost-effective early warning system, and could help track the waves of the transmission as the pandemic unfolds.

With the growing escalation in Covid-19 infections in the country and the challenges associated with individual testing, the importance of introducing a nationwide wastewater surveillance programme becomes more immediate and relevant to complement national interventions. This could offer a cost-effective method of understanding the pandemic trends, provide an early warning system, identify hotspots and track the waves of the transmission as the pandemic unfolds.

To date, the wastewater-based epidemiology approach has been successfully piloted in developed countries where there is wide coverage of waterborne sanitation, such as the Netherlands and the US. However, given the varied water and sanitation services delivery mechanisms in South Africa (and lack thereof), we are in a unique position to pioneer the development and piloting of an all-encompassing water and sanitation-focused approach for the surveillance of Covid-19 spread in less developed communities.

Risk hotspot mapping has proven to be an effective preparedness strategy in previous complex and dynamic extreme...