The presence of SARS-CoV-2 in the feces of infected patients and wastewater has drawn attention, not only to the possibility of fecal-oral transmission but also to the use of wastewater as an epidemiological tool. The COVID-19 pandemic has highlighted problems in evaluating the epidemiological scope of the disease using classical surveillance approaches, due to a lack of diagnostic capacity, and their application to only a small proportion of the population. As in previous pandemics, statistics, particularly the proportion of the population infected, are believed to be widely underestimated. Furthermore, analysis of only clinical samples cannot predict outbreaks in a timely manner or easily capture asymptomatic carriers. Threfore, community-scale surveillance, including wastewater-based epidemiology, can bridge the broader community and the clinic, becoming a valuable indirect epidemiological prediction tool for SARS-CoV-2 and other pandemic viruses. This article summarizes current knowledge and discusses the critical factors for implementing wastewater-based epidemiology of COVID-19.

在感染患者的粪便和废水中存在SARS-CoV-2不仅引起了粪口传播的可能性，而且也引起了人们对废水作为一种流行病学手段的关注。由于缺乏诊断能力，COVID-19大流行病突出表明了使用经典的监测方法评估该病的流行病学范围时遇到的问题，并且该方法仅适用于一小部分人群。与以前的大流行一样，人们普遍低估了统计数据，尤其是受感染人口的比例。此外，仅对临床样本进行分析无法及时预测疾病爆发或轻易捕获无症状携带者。因此，社区规模的监测（包括基于废水的流行病学）可以在更广泛的社区和诊所之间架起桥梁，成为SARS-CoV-2和其他大流行病毒的有价值的间接流行病学预测工具。本文总结了当前的知识，并讨论了实施基于废水的COVID-19流行病学的关键因素。