Pathology

Business

Disease

Wastewater reuse

Coronavirus disease 2019 (COVID-19)

Infectious disease (medical specialty)

Biology

Pandemic

Environmental planning

Risk assessment

Risk analysis (engineering)

Outbreak

Engineering

Virology

Reuse

Waterborne diseases

2019-20 coronavirus outbreak

Computer science

Wastewater

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

Computer security

Environmental science

Waste management

Medicine

Environmental engineering

Environmental health

Nature Sustainability

The COVID-19 pandemic has severely impacted public health and the worldwide economy. Converging evidence from the current pandemic, previous outbreaks and controlled experiments indicates that SARS-CoVs are present in wastewater for several days, leading to potential health risks via waterborne and aerosolized wastewater pathways. Conventional wastewater treatment provides only partial removal of SARS-CoVs, thus safe disposal or reuse will depend on the efficacy of final disinfection. This underscores the need for a risk assessment and management framework tailored to SARS-CoV-2 transmission via wastewater, including new tools for environmental surveillance, ensuring adequate disinfection as a component of overall COVID-19 pandemic containment. Converging evidence indicates that SARS-CoVs are present in wastewater for several days with potential health risks. This Review analyses knowledge about such risks as well as the potential spread of SARS-CoVs in waterborne, waterborne–aerosolized and waterborne–foodborne pathways during a pandemic.

Rethinking wastewater risks and monitoring in light of the COVID-19 pandemic