Environmental monitoring of SARS-COV-2 to complement public health surveillance – Interim guidance, 14 April 2022 – Global


1. Introduction

Managing the COVID-19 pandemic continues to prove challenging in the face of an evolving virus and uncertainties in designing proportionate and evidence-based public health interventions. The main source of evidence on the incidence of SARS-CoV-2 infection is PCR and rapid antigen diagnostic tests of upper respiratory tract specimens.

In a growing number of settings around the world, routine COVID-19 surveillance programs have augmented diagnostic testing with community-wide COVID-19 environmental (ES) surveillance of SARS-CoV-2 in specimens of waste water. Similarly, ES have been performed for other diseases and risks such as poliomyelitis, typhoid and antimicrobial resistance (AMR).

The purpose of SE is to provide early warning and additional evidence regarding the virus circulating in the population, including its presence or absence, trends in concentrations, and variants of concern or interest. ES can help inform decisions about interventions and measure their effect.


The purpose of this guide is to provide globally applicable guidance on the following issues:

  • Why, or in what situations, does EM add value to public health decision-making at different stages of the pandemic, and in different settings? (section 3)

  • What are the minimum requirements to plan and coordinate an effective SARS-COV-2 SE program in different resource settings? (Section 4)

  • How to proceed with the collection, analysis, interpretation and communication of the results? (section 5)

Target audience

This guidance is for public health officials and COVID-19 incident management team members who want to understand and integrate complementary ES into their national, subnational, or local COVID-19 response strategy. COVID-19. The guide also provides general information on coordination, capacity and methods for laboratory scientists and water and sanitation service providers. This document is intended for:

  • help public health professionals make informed, evidence-based decisions about the value of EM in their context to decide whether or not to implement such a program;

  • show how entities would implement a successful ES program;

  • support public communication of SARS-COV-2 ES results;

  • promote sharing and harmonization of SARS-COV-2 ES methods and approaches across localities, countries and regions;

  • guide the use of SARS-COV-2 ES results as well as other COVID-19 surveillance modalities in public health decision-making; and

  • support the sharing of lessons and case studies from implementation experiences for more effective application of ES globally.


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