Cost advantage

 

Virus Forensic Services: Covid-19 Sewerage Surveillance

 

Cost advantage

Cost advantages to institutions

One lesson we are learning from the COVID-19 pandemic is that governments all over the world are forced to deal with the unexpected. From the global trends it is safe to assume that the virus is here to stay, and its presence will be felt in multiple ways not yet fully understood. For this reason, it is likely that the development of science will constantly lag behind the manifestation of the crisis in the real world. Therefore, the cost to both society and government will be high. The social cost will manifest as a debilitating loss of livelihoods, likely to fuel growing social unrest. The cost to the government will be an erosion of authority, growing inability to close the fiscal gap, and the rapid onset of the ravages of the fiscal cliff. This opens the debate about cost and benefit. At present a noble effort is underway by both the NICD and WRC. These are aimed at improving the science of wastewater surveillance. However, they do not focus in any significant way on the logistical complexity of bulk sampling of the 824 WWTWs that ultimately need to be incorporated if a viable national surveillance strategy is to be presented

Growing public anger at the misappropriation of government funds is a reality that will have increasing implications on the state. The efficiency of personal testing is debatable, and will increasingly feed into the growing public anger. Wastewater surveillance increases the defendability of personal testing and is in no way a challenge to that approach. Through wastewater surveillance, known hotspots can be more effectively targeted for personal testing and other mitigation measures deemed appropriate by the Command Council. The funds also already deployed into the NICD and WRC initiative will be enhanced by a comprehensive national wastewater surveillance program, because the impact of their work will be amplified through an efficient rollout of the logistical network needed to sustain a national program.

 

Department of Water and Sanitation (DWS)

The A-4-A offering represents a one-stop solution from installation of sampling and flow measuring equipment through to the lab testing and generation of results. The appointment of separate contractors to handle each stage of the process is not required. Instead, our offering is inclusive of other role players as the project scales up. We aim to incorporate existing piecemeal activities into one coherent national-level initiative designed to restore the economy to a healthy status and create the jobs needed for social cohesion.

We have access to systems that allow us to accurately identify the correct sampling and measuring points based on defined requirements, such as population density upstream, presence of key facilities within the catchment (hospitals, clinics etc) and / or the level of infiltration within the network. This process ensures the results obtained are meaningful, objective and forms part of a well thought out process that can stand up to scrutiny and questioning.

By implementing this project now, DWS not only gains to benefit from the critical data obtained in the short-term, but is also in a position to use this process and equipment to monitor for other pathogens, reinstate the Blue and Green Drop process in parallel, and be ready for the next wave of infections and / or mutations of the virus, and new viruses that are likely to follow. In addition to this, testing for narcotics can easily be incorporated, using the infrastructure created by this proposal.

Multiple pathogens can be sampled and tested with the same equipment proposed, so there is no need to procure additional equipment to test for (example) e-coli, polio, cholera and so on.

Another value-add is the high-level overview of existing WWTW functionality and maintenance costs required without the need for costly additional studies, as well as being able to quickly identify the value of leaks and night flows in the WWTW systems being measured.

Waste-water Based Epidemiology (WBE) is the emerging global standard and DWS is perfectly positioned to adopt our methodology, for the benefit of all. This also enables DWS and the Department of Health to align their efforts by using WBE as a key resource in our countries’ fight against this pandemic.

To the Municipalities within the catchment(s)

The one-stop offering will enable municipalities to strategically allocate stretched resources to the areas requiring intervention, as opposed to the current blanket approach that has had to be applied. By knowing what areas are feeding the WWTW and / or other sampling points, we are able to determine the level of infection in that specific area, as well as determine if it is increasing, decreasing, stabilising or not present at all.

This in turn can be used to determine where the hot-spots and safe-zones are, and react accordingly, isolating areas requiring attention and letting safe-zones open up again and resume economic activity.

We are also able to move further upstream from the WWTW and further define the catchment and areas of focus at a much lower cost compared to mass individual screening and testing.

Using the same equipment, other important pathogens can be tested as well as the presence of narcotics within the catchment.

An additional benefit is determining the state of municipal infrastructure within the municipal catchment as well as being able to quantify minimum night flows and / or leaks in the network within the same project.

To the Department of Health (DoH)

The data and results generated via our WBE approach with DWS will enable the DoH to achieve much greater coverage at a fraction of the cost of individual testing, relative to the catchment area being sampled and tested.

The results are accurate and in-line with international best practices and standards, and are completely indicative of viral loads within the sampled catchment. The quantification process possible with our offering can also help estimate infection numbers within that catchment.

The continuous tracking of sampled data and results will confirm whether or not the DoH interventions are working, if more or less resources are required, where areas can be defined as ‘safe-zones’ and so on.

Further pathogens can be tested utilising the same equipment and such equipment can support other DoH processes such as polio testing.

Utilising the systems at our disposal, we can further zoom in on sites of critical importance to the DoH such as hospitals, clinics, field hospitals, quarantine facilities etc to give a correct and quantification as to the level of infection at these sites.

As a standard practice going forwards and once rolled out nationally, the DoH in conjunction with the DWS will be at Day Zero the next time around, and resources can be deployed more strategically, at a much lower cost to our economy.

Government and South Africa as a whole

The implementation of this project has the potential to support other key departments and their respective management of the current situation:

  • Department of Education (Basic + Higher)

    • enable strategic and continuous monitoring of schools, ECD’s and institutes for higher education (ECD = Ministry of Social Development)

    • confirm when these sites require attention and / or closing to contain a situation

    • confirm safe-zone status and the continued learning of it’s learners

    • help ensure our learners do not fall further behind and provide comfort of being able to learn in a safe-zone

  • Department of Public Works

    • monitoring and evaluation of important government buildings and facilities, such as the Union Buildings, Parliament, Presidential Houses + Guest Houses as well as Ministerial Houses

    • Monitoring of all Department of Public Works main Client Departments namely:

      • Department of Correctional Services

      • South African Police Services

      • South African National Defence Force

    • monitoring and evaluation of the above to determine and / or contain potential hot-spots and outbreaks

  • Police and Ministry

    • monitor and evaluate infection levels at a police station level if required

    • monitor and determine presence of narcotics in a defined catchment – prisons, towns, suburbs and larger network

  • Department of Home Affairs

    • monitor and evaluate safe-zones for the Department of Home Affairs offices

    • protection and monitoring of border posts and other key transit points in and out of the country

  • Ministry of Defence + Military Veterans

    • monitor and evaluate army bases, temporary bases, military hospitals and other areas of importance

    • safeguard and protect our nation’s defence force

  • Ministry of State Security

    • All of the data collected for the various institutions above as well as DWS and DoH is of strategic national importance for State Security and Intelligence.

Wastewater-based Epidemiology (WBE) is a relatively new field brought to the fore during the COVID-19 pandemic worldwide.

There are a handful of countries around the world implementing WBE methods to determine infection levels, but none as yet have implemented a nation-wide surveillance program, nor do any of these countries have the one-stop offering proposed here. The work completed thus far has been documented as a first for Africa and a Proudly South African first for the world.

Having this approach implemented now will help better manage the current situation as well as probable ‘second waves’, mutations and other pandemics still to come. The cost of full implementation is insignificant in comparison to the economic losses already suffered, and will help shorten the time for recovery by being able to document and prove when our borders are safe to open again.

The sophisticated methodology proposed can provide results for the country as a whole compared to the impossible task of complete nation-wide screening and individual testing.

South Africa will also be in a position to help its neighbouring SADC and African Union countries in dealing with their pandemics via knowledge transfer and implementation of these initiatives.

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