Evaluating the theoretical performance of aircraft wastewater monitoring as a tool for SARS-CoV-2 surveillance

• DOI: 10.1371/journal.pgph.0001975
• Publication Date: 2023-06-22T19:45:08Z
• Authors: Joseph W. Shingleton; Chris J. Lilley; Matthew J. Wade
• Keywords: Pandemic

Air travel plays an important role in the cross-border spread of infectious diseases. During SARS-CoV-2 pandemic many countries introduced strict border testing protocols to monitor incursion virus. However, high implementation costs and significant inconvenience passengers have led public health authorities consider alternative methods disease surveillance at borders. Aircraft wastewater monitoring has been proposed as one such alternative. In this paper we assess theoretical limits aircraft compare its performance post-arrival screening approaches. Using model, simulate unmitigated epidemic originating a seed country spreading United Kingdom (UK) through daily flights. We use probabilistic approach estimate time first detection UK respiratory swab screening. Across broad range model parameters, our analysis indicates that median between would be approximately 17 days (IQR: 7-28 days), resulting 25 cumulative cases 6-84 cases) point detection. Comparisons suggest is effective random 20% border, using test with 95% sensitivity. For regimes sensitivity 85% or less, required coverage outperform increases 30%. Analysis other parameters suggests most when used on long-haul flights where probability defecation above 30%, target pathogen faecal shedding rates reasonable detectability wastewater. These results demonstrate potential utility wider system surveillance.