Understanding COVID-19 Situation in Nepal and Implications for SARS-CoV-2 Transmission and Management

Abstract

Emerging infectious diseases (EIDs) present one of the greatest challenges to public health in the 21st century. An emerging virus, depending on its potential to spread among humans, may cause individual or sporadic cases, culminating in a localized outbreak requiring public health intervention, or, in the worst-case scenario, a widespread epidemic, or worldwide pandemic.1 The novel Coronavirus Disease 2019 (COVID-19) is a new respiratory disease caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) that is causing worldwide public health and economic challenges and has been recognized as a pandemic by the World Health Organization.2 The virus was first reported in Wuhan, Hubei Province, China, in December 2019.2,3 SARS-CoV-2 is an enveloped and positive single-stranded RNA virus belonging to the ß-coronavirus genus.2-4 SARS-CoV-2 holds high homology with SARS-CoV and targets angiotensin-converting enzyme receptor-2 (ACE2) for the viral attachment.4 A schematic depicting SARS-CoV-2 structure and pathogenesis is presented in Figure 1.5 There are very few studies on the transmission of SARS-CoV-2 through treated or untreated wastewater from advanced countries; however, COVID-19 surveillance of wastewater in developing countries has not been reported adequately.6 There is thus a need to study the presence of SARS-CoV-2 in wastewater in the developing countries like Nepal.