Shedding of SARS-CoV-2 in feces and urine and its potential role in person-to-person transmission and the environment-based spread of COVID-19

Occupational safety of janitors in Ethiopian University during COVID-19 pandemic: Results from observational study

Introduction

Janitors are at high risk of COVID-19 infection, as they are among the frontline workers for the prevention and control of COVID-19. Poor occupational safety practices could contribute to loss of lives of janitors and the general public. However, there are no detailed investigations on occupational safety practices of janitors involved in different settings, such as universities where there are crowds of people. In addition, although observation is recognized as a better tool to investigate occupational safety practices, previous studies mainly employed self-administered questionnaires and/or face-to-face interviews as data collection mechanisms. Therefore, this study aimed to assess occupational safety practices to prevent COVID-19 transmission and associated factors among Ethiopian University janitors using an observation tool and a self-administered questionnaire.

Methods

An institutional-based cross-sectional study was conducted among 410 janitors of Bule Hora University (Ethiopia) from November to December, 2021. A multivariable logistic regression model was used to identify the independent factors associated with occupational safety practices.

Results

Occupational safety practices for COVID-19 were good only among 53.9% of the janitors. Training on COVID-19 prevention measures (AOR = 2.62; 95% CI: 1.57–4.37), availability of policy and protocol in the work place (AOR = 5.46; 95% CI: 3.57–8.36), and availability of soap/bleach (AOR = 2.71; 95% CI: 1.64–4.46) were found to significantly increase the likelihood of occupational safety of the janitors.

Conclusion

A significant proportion of the janitors had poor occupational safety practices. Therefore, an adequate supply of PPE and regular training and awareness creation on COVID-19 should be strengthened. Close follow-up and regular supervision of safety procedures should also be conducted as controlling strategies.

Monitoring of SARS-CoV-2 in wastewater: what normalisation for improved understanding of epidemic trends?

SARS-CoV-2 RNA quantification in wastewater has emerged as a relevant additional means to monitor the COVID-19 pandemic. However, the concentration can be affected by black water dilution factors or movements of the sewer shed population, leading to misinterpretation of measurement results. The aim of this study was to evaluate the performance of different indicators to accurately interpret SARS-CoV-2 in wastewater. Weekly/bi-weekly measurements from three cities in France were analysed from February to September 2021. The concentrations of SARS-CoV-2 gene copies were normalised to the faecal-contributing population using simple sewage component indicators. To reduce the measurement error, a composite index was created to combine simultaneously the information carried by the simple indicators. The results showed that the regularity (mean absolute difference between observation and the smoothed curve) of the simple indicators substantially varied across sampling points. The composite index consistently showed better regularity compared to the other indicators and was associated to the lowest variation in correlation coefficient across sampling points. These findings suggest the recommendation for the use of a composite index in wastewater-based epidemiology to compensate for variability in measurement results.

A comparison of four commercially available RNA extraction kits for wastewater surveillance of SARS-CoV-2 in a college population

Localized wastewater surveillance has allowed for public health officials to gain a broader understanding of SARS-CoV-2 viral prevalence in the community allowing public health officials time to prepare for impending outbreaks. Given variable levels of virus in the population through public health interventions, proper concentration and extraction of viral RNA is a key step in ensuring accurate detections. With many commercial RNA extraction kits and methodologies available, the performance of 4 different kits were evaluated for SARS-CoV-2 RNA detection in wastewater, specifically focusing on their applicability to lower population densities such as those at university campus dorms. Raw wastewater samples were collected at 4 sites on a college campus over a 24 hour period as a composite sample. Included in these sites was an isolation site that housed students that tested positive for Covid-19 via nasopharyngeal swabs. These samples were analyzed using the following kits: Qiagen All Prep PowerViral DNA/RNA kit, New England BioLabs Monarch RNA MiniPrep Kit, and Zymo Quick RNA-Viral Kit, and the Zymo Quick-RNA Fecal/Soil Microbe MicroPrep Kit. All four sites were processed according to the manufacturer's guidelines. Extractions were then quantified with RT-qPCR one-step reactions using an N2 primer and a linearized plasmid standard. While the Zymo Quick-RNA Fecal/Soil Microbe MicroPrep Kit (also known as the Zymo Environ Water RNA Kit) only recovered approximately 73% (±38%) SARS-CoV-2 RNA compared to the Zymo Quick-RNA Viral kit, it was the most time efficient kit to yield comparable results. This extraction kit had a cumulative processing time of approximately 5 h compared, while the other three kits had processing times between approximately 9 and 9.5 h. Based on the current research, the most effective kits for smaller population densities are pellet based and include a homogenization, inhibitor removal, and RNA preservation step.

Implementation of environmental surveillance for SARS-CoV-2 virus to support public health decisions: Opportunities and challenges

Analysing wastewater can be used to track infectious disease agents that are shed via stool and urine. Sewage surveillance of SARS-CoV-2 has been suggested as a tool to determine the extent of COVID-19 in cities and serve as an early warning for (re-)emergence of SARS-CoV-2 circulation in communities. The focus of this review is on the strength of evidence, opportunities and challenges for the application of sewage surveillance to inform public health decision making. Considerations for undertaking sampling programs are reviewed including sampling sites, strategies, sample transport, storage and quantification methods; together with the approach and evidence base for quantifying prevalence of infection from measured wastewater concentration. Published SARS-CoV-2 sewage surveillance studies (11 peer reviewed and 10 preprints) were reviewed to demonstrate the current status of implementation to support public health decisions. Although being very promising, a number of areas were identified requiring additional research to further strengthen this approach and take full advantage of its potential. In particular, design of adequate sampling strategies, spatial and temporal resolution of sampling, sample storage, replicate sampling and analysis, controls for the molecular methods used for the quantification of SARS-CoV-2 RNA in wastewater. The use of appropriate prevalence data and methods to correlate or even translate SARS-CoV-2 concentrations in wastewater to prevalence of virus shedders in the population is discussed.