Water-sanitation-health nexus in the Indus-Ganga-Brahmaputra River Basin: need for wastewater surveillance of SARS-CoV-2 for preparedness during the future waves of pandemic

The Indus-Ganga-Brahmaputra River Basin (IGBRB) is a trans-boundary river basin flowing through four major countries in South Asia viz., India, Pakistan, Bangladesh, and Nepal. Contamination of surface water by untreated or inadequately treated wastewater has been a huge problem for pathogenic microorganisms in economies in transition. Recent studies have reported that sewage surveillance can provide prior information of the outbreak data, because faeces can contain the novel coronavirus (SARS-CoV-2) shed by infected humans. Hence, in this study we geo-spatially mapped the COVID-19 hotspots during the peak time in the first and second wave of pandemic to demonstrate the need and usefulness of wastewater surveillance strategy in IGBRB during ongoing pandemic. Further we discussed the status of sanitation, health and hand-hygiene in the IGBRB along with characterization of the challenges posed by the pandemic in achieving the United Nations Sustainable Development Goals (UN-SDGs). Monthly Geographical Information System (GIS) mapping of COVID-19 hotspots in the IGBRB showed an increase in the spread along the direct sewage discharge points. The social inequalities expose the vulnerabilities of the urban poor in terms of the burden, risks and access to Water, Sanitation, and Hygiene (WASH) needs. Such an evidence-based image of the actual SARS-CoV-2 viral load in the community along the IGBRB can provide valuable insights and recommendations to deal with the future waves of COVID-19 pandemic in this region that can go a long way in achieving the UN-SDGs.