The COVID-19 pandemic has revealed a significant number of cracks in the current vigilance techniques that stand to minimise outbreaks of SARS-CoV-2. There is a serious inadequacy of the testing capacity of healthcare systems worldwide, which can be attributed to the lack of appropriate testing and monitoring methods for a disease such as COVID-19. The current tools in use for COVID-19 surveillance are either expensive, not applicable to large populations or yield results after the outbreak has already occurred. The immense contagiousness in combination with a wealth of asymptomatic carriers means that RT-PCR testing is not feasible on a mass scale. It is evident that new methods are required for the monitoring of COVID-19 and a range of new epidemiological tools must be implemented if public health systems worldwide want to make relevant predictions on the patterns of disease spread and increase the efficacy of their decisions. In addition to this, the pandemic has highlighted the necessity for redirecting biomedical research towards early diagnosis and rational therapy of respiratory viruses in particular, as well as prevention of their spread by conventional means. An efficient early detection system would save lives and allow countries to return to pre-pandemic standards of living. At the forefront of this lies wastewater-based epidemiology, which carries immense potential as a means of pre-symptomatic diagnosis and population-based surveillance.

Institute of Hygiene and Epidemiology 1st Faculty of Medicine Charles University and General University Hospital Prague Prague Czech Republic

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