Sewage-based epidemiology and covid-19 in Brazil: a necessary discussion

The study aimed to gather evidence about the occurrence of SARS-CoV-2 in feces and sanitary sewage, in addition to discussing the potential ities of sewage-based epidemiology in the face of the current pandemic. A literature review was carried out in the first week of May 2020 at the Web of Science, SciELO, Scopus, CAPES Publications Portal. Few studies have reported the presence of genetic traits of SARS-CoV-2 in feces and sewers so far. However, the analyses direct the epidemiology of sewage to be considered in the discussions for surveillance of COVID-19, given the expansion of cases. Sewage-based epidemiology has been successfully used to track and provide early warnings of virus outbreaks. In Brazil, considering the increase in infected and deaths, the restrictions of mass tests and the fragile sanitation conditions, strengthening the monitoring of sewage may add to the actions of the Sistema Único de Saúde for assistance to the population and in the proposals of preventive measures in areas with greater presence and circulation of the virus through sewage. Even with the difficulties related to sanitation in Brazil, sewage-based epidemiology can be an important tool for collective diagnosis of COVID-19 in the country.