Possibilities of waterborne and faeco-oral transmission of COVID-19 in India

Possibilities of waterborne and faeco-oral transmission of COVID-19 in India
गर्मी के मौसम में अशुद्ध पीने के पानी से भारत में COVID-19 फ़ैलने की संभावनाएं.

The safest way to get rid of fear is: Drink boiled water

बचने का सीधा उपाय: पानी उबाल कर पियें 

It is a well-known fact that Coronaviruses not only spread through sneezes, spitting and contacts (direct contact or through fomites), they get faecal excretion too (https://www.thelancet.com/journals/langas/article/PIIS2468-1253(20)30048-0/fulltext). The SARS virus, a similar Coronavirus as SARS-CoV-2 (causing COVID-19), has been detected in untreated sewage for up to 2 to 14 days. Diarrhoea occurred in about 10-20% of patients afflicted with severe acute respiratory syndrome about 17 years ago and was the source of an explosive SARS outbreak (https://www.livemint.com/news/world/coronavirus-lurking-in-feces-may-reveal-hidden-risk-of-spread-11580556507678.html). Contamination of drinking water or fruits and vegetables through sewage water is not a remote possibility if sewage is not treated properly before release into natural water bodies. We all know that all drinking water utilities disinfect the water we drink before it is pumped to pipeline reaching your home tap. We also know that all wastewater utilities disinfect the water before its release back to the environment. The disinfection of drinking water and wastewater are two crucial determinants which protect us from waterborne Coronavirus infections but what if your drinking water is not decontaminated or disinfected (https://www.medscape.com/viewarticle/926390). Therefore,

1.    Wastewater treatment plant operations should ensure that workers follow routine practices to prevent their exposure to raw (untreated) wastewater. These include using engineering and administrative controls, safe work practices, and personal protective equipment (PPE) normally required for work tasks when handling untreated wastewater.

2.    All wastewaters and sewage must be treated before its release environment to stop the spread of COVID-19 and other viral and bacterial infections.

3.    Fruits and vegetables must not be allowed to get contaminated through washing/ irrigations with untreated waste and sewage water.

4.    Proper and daily monitoring of the efficacy of the disinfection of drinking water and its freedom from contamination (through the broken sewer and drinking water pipelines or some intentional activity) at consumer points must be ensured to stop the community spread of COID-19 and other communicable diseases.

5.    Public water points (Piaus) must be monitored closely for their freedom from contamination (including the people serving the water) in light of fast-approaching summer.

6.    All food plazas may be the potential source of spread of the disease due to cross-contamination from contaminated wastewater or drinking water either by the customer or by the waiter or cleaner.

Before rubbishing the idea of faeco-oral transmission of COVID-19 through the water we must remember some basic facts and the status of disinfection of drinking water and treatment of wastewater and sewage in India.

1.    Only two Indian cities have continuous water supply and according to an estimate from 2018, about 8% of Indians still lack access to improved sanitation facilities (Sridhar, Kala Seetharam; Reddy, A. Venugopal (24 July 2018). State of Urban Services in India's Cities: Spending and Financing. Public Affairs Centre. ISBN 9780198065388).

2.    In India in 2017, 59.5% have access to "at least basic sanitation". Between 2014 and 2019, the NDA Government in India built around 110 million toilets all across India, due to which the basic sanitation coverage went up from 38.7% in October 2014 to 93.3% in 2019 (https://data.unicef.org/resources/data_explorer/unicef_f/?ag=UNICEF&df=GLOBAL_DATAFLOW&ver=1.0&dq=.WS_PPL_S-ALB..&startPeriod=2014&endPeriod=2019).

3.    It is estimated that the annual impact of waterborne disease in India affects 37.7 million persons annually including the loss of 73 million working days and the death of 1.5 million children from diarrhoea alone (https://www.waterworld.com/international/desalination/article/16202105/filtering-through-indias-drinking-water-challenges).

4.    In India, approximately 85% of the rural population, comprised of more than 700 million people, is dependent on groundwater (https://www.waterworld.com/international/desalination/article/16202105/filtering-through-indias-drinking-water-challenges). 

5.    More than 26.6% of Indians drink water from untreated drinking water supply (http://censusmp.nic.in/censusmp/All-PDF/5.%20Chapter-3%20%20Drinking%20water%20sources%20and%20availability.pdf).

6.    The highest number of people in the world, almost 76 million Indians, don’t have safe drinking water to stand at 120th place among 122 nations for its water quality (https://swachhindia.ndtv.com/76-million-dont-have-safe-drinking-water-indias-looming-water-crisis-5606/; https://www.kent.co.in/blog/3-facts-about-drinking-water-in-india-why-a-water-purifier-is-a-must/).

7.    Forget safe drinking water, India does not have enough water to drink (https://www.indiatoday.in/india/story/why-india-does-not-have-enough-water-to-drink-1557669-2019-06-28).

8.    India can treat approximately 37% of its wastewater, or 22,963 million litres per day (MLD), against a daily sewage generation of approximately 61,754 MLD according to the report of the Central Pollution Control Board (https://www.thethirdpole.net/en/2017/05/15/rethinking-wastewater-management-in-india/). India generates a staggering 1.7 million tonnes of faecal waste a day. Official figures show that 78% of the sewage generated remains untreated and is disposed of in rivers, groundwater or lakes (https://www.drishtiias.com/daily-updates/daily-news-editorials/wastewater-management-in-india).