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Kerala yet to take a call on sewage surveillance for Covid-19

- June 17, 2022

Dileep V Kumar, Thiruvananthapuram, June 17

Despite an increase in fresh coronavirus infections, the state government is yet to take a call on implementing new surveillance strategies. It turns out that the state is yet to devise a strategy for rolling out the wastewater/ sewage surveillance for SARS-CoV-2. The strategy, it’s said, can provide an early warning of COVID-19’s spread in communities. However, government sources said that they are waiting for directions from the Indian Sars-CoV-2 Genomic Consortium (INSACOG), which is monitoring the sewage surveillance in the country.

“As of now, no such decision has been taken by the health department. The call for sewage/wastewater surveillance will have to come from the government,” said a source from the health department.

At the same time, state health principal secretary Rajan Khobragade was unavailable for comment on the same.

As per the revised surveillance strategy for Covid-19, released by the health ministry on June 9, sewage/wastewater surveillance forms an integral part as ‘several studies have demonstrated that increases in SARS-CoV-2 RNA can be detected in environmental samples several days before detection of Covid-19 through clinical surveillance.’

It also added that such surveillance will help in understanding an estimate of the virus load in local circulation and to detect circulating mutations/variants. The major highlight of such surveillance is it might provide early warning on the impending local surge of Covid-19.

Meanwhile, citing the same strategy document, a health official said, the surveillance strategy is on a pilot basis. Also, the network of sites for sewage/wastewater samples would be finalized by INSACOG. ‘So let them decide.’

According to United States’ Centers for Disease Control and Prevention, people infected with SARS-CoV-2 can shed the virus in their feces, even if they don’t have symptoms. The virus can then be detected in wastewater, enabling wastewater surveillance to capture the presence of SARS-CoV-2 shed by people with and without symptoms. This allows wastewater surveillance to serve as an early warning that Covid-19 is spreading in a community.

At the same time, an epidemiologist with the health department said that wastewater-based epidemiology is an emerging field and it has its challenges.

“It might work in places that have a centralized sewer system. But here we have fragmented ones. Thus sample collection is difficult. Also given our understaffed health workforce it is sure to backpedal,” said the epidemiologist.

But health officials also point out that the system can be adapted to antimicrobial resistance (AMR) monitoring activities in the future.

“It might give a shot in the arm for the state’s activities in fighting AMR as Kerala is the first state in the country to come out with an action plan in dealing with AMR, which is an emerging threat,” said an official.