Novel Coronavirus may spread through contaminated water

The modes of transmission for Novel Coronavirus include droplets from coughs/sneezes, touching contaminated objects and rarely airborne spread. The other less common way of spread of infection include fecal-oral route (not washing hands after using bathroom). Holshue et al demonstrated that Novel Coronavirus can be isolated from feces and urine.

There is plenty of evidence that SARS coronavirus, a close cousin of Novel Coronavirus, can spread through sewage. It was proven that inadequate plumbing systems could transmit SARS coronavirus. A study published in the journal Water Research concluded that “Coronaviruses can remain infectious for long periods in water and pasteurized settled sewage, suggesting contaminated water is a potential vehicle for human exposure if aerosols are generated.” Centers for Disease Control and Prevention (CDC) also stated, “SARS, a similar coronavirus, has been detected in untreated sewage for up to 2 to 14 days. In the 2003 SARS outbreak, there was documented transmission associated with sewage aerosols.”

According to a recent study published in the journal Environmental Science and Technology, wastewater in a community can be tested for COVID-19 to detect the presence of infection in that community. Novel Coronavirus can be detected in feces and urine of the infected people. Water contaminated with these body fluids can spread the infection to healthy people.

As of now, there are no documented cases where COVID-19 spread through contaminated water. However, as Novel Coronavirus is isolated in feces and urine, there is a risk of transmission of COVID-19 through sewage and contaminated water, just like SARS coronavirus. We may have to take necessary precautions to avoid water contamination with biowaste. As per CDC, chlorination and other recommended sewage water treatments are sufficient enough to prevent the spread of infection from sewage and contaminated water. Required Personal Protective Equipment (PPE) should be used by all the personnel dealing with sewage. Face masks are also recommended for this personnel as there is a risk of spread through aerosols.

References:

1. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. Van Doremalen et al. N Engl J Med. https://doi.org/10.1056/NEJMc2004973
2. Karako K et al. Biosci Trends. 2020 Mar 19. doi: 10.5582/bst.2020.01482. Analysis of COVID-19 infection spread in Japan based on stochastic transition model.
3. Holshue, M. L. et al. First Case of 2019 Novel Coronavirus in theUnited States.N. Engl. J. Med.2020,382(10), 929-936.
4. Inadequate plumbing systems probably contributed to SARS transmission. Wkly Epidemiol Rec. 2003 Oct 17;78(42):371-2.
5. Casanova et al. Survival of surrogate coronaviruses in water. Water Res. 2009 Apr;43(7):1893-8. doi: 10.1016/j.watres.2009.02.002. Epub 2009 Feb 10.
6. Wang XW et al. Concentration and detection of SARS coronavirus in sewage from Xiao Tang Shan Hospital and the 309th Hospital. J Virol Methods. 2005 Sep;128(1-2):156-61.
7. Mao K et al. Can a Paper-Based Device Trace COVID-19 Sources with Wastewater-Based Epidemiology? Environ Sci Technol. 2020 Mar 23. doi: 10.1021/acs.est.0c01174. Can a Paper-Based Device Trace COVID-19 Sources with Wastewater-Based Epidemiology?