Very few city and state Governments are willing to undertake these studies. This is due to two reasons: (1) No directive from central government or other regulatory bodies (2) lack of trust on scientific community and media regarding how the results are communicated such that citizens do not panic.

State Government of Telangana has taken the bold step to institute a study. We are their partners and we would greatly appreciate any collaborative effort that comes our way. 

best
Malini   

Dear Sir,

Scientific studies conducted globally are yet to establish infectivity of the covid-19 strains detected in wastewater. Studies in India are sparce and yet to conclusively determine presence of the virus, leave alone infectivity. As the evidence develops it will get suitably referenced and cited in academic circles. We are all conscious academics and reserachers.

This topic of discussion here however is about the challenges of communicating with citizens at large who may not be as discerning about news items as you and members in this forum maybe. 

There is a growing interest in media to report about presence of covid-19 in wastewater and this could potentially lead to an unecessary panic. Would greately appreciate if you could share your views on this to benefit this discussion.

thanks and regards D

Dear Malini,

I'll attempt to answer two questions here:

1.  What communication challenges can the potential COVID-wastewater connection create/aggravate?

A lot official and informal communication about COVID has used terms like 'deadly' and 'highly infectious'. This has painted a picture of an unseen 'enemy' that must be defeated at all costs. The warlike hysteria this has whipped up has led to stimatisation of COVID+ people, attacks on health workers, extreme lockdown measures and uninformed decision-making.

A reality check on how the virus is transmitted, chances of contracting an infection, the chances of falling seriously ill or dying need to be clearly stated in communication material. Further, as we are concerned here with transmission from sewage, it needs to be stated clearly that on date, there is no evidence to suggest a person can get COVID-19 from sewage.

1. What are the SOPs for establishing a robust communication infrastructure that delivers
   coordinated and consistent  communication across multiple channels?

Thankfully, many channels exist now. Each lends itself to a certain type of message and audience.
WhatsApp: One of the most popular, used for spreading messages. It is powerful and multilingual. The district health officer can be provided readymade messages in the local language to transmit every day. They can be forwarded onto citizens through the health workers' network. However, it needs compatible phones and some literacy.
TikTok: Another hugely popular medium, this can run on lower-end phones and needs no literacy. Content can be produced and sent out in local languages.
Facebook: This has gained appeal during the lockdown and there is a lot of local language content. Can be used as a more static medium to put out messages by officialsConventional media: Regular advertorials with detailed information can be placed in local papers and TV
Community radio: Can carry the audio content from TikTok to a local audience
A schedule to send out content will need to be established. The district swachhata preraks had developed an IEC strategy for districts with the messages, timings, media and person(s) responsible. This can be adapted for COVID-19.

Regards
Nitya

Good Day Paresh
There are 2 or 3 methods to arrive at a collective guidance.
1. Create Narratives or Scenarios and address them -- Empirical method 
2. Establish a Theoretical basis for the approach
and 
3. Trial-and-Error method. Start with some approach, and refine as one progresses

I have an actual case scene from where I am now locked-in. Since I drafted it, 4 more active Covid-19 positives have emerged and 6 are unwell (Arogya Setu). {Attached}

Q1- What is the communication that the District Collector can/should do?
Q2- How should he/she be doing it?

Once Q1 is clear, Q2 is a choice of tool.  WhatsApp, Hoardings, Personal-Pamphlets, Posters, Newspaper announcements, +++  are more local in nature and have to change from place to place (urban, semi-urban, rural etc).

We need to work on -
i) how we create our guidance; {I am aware of 3 methods identified above for it, more can be added}
ii) how evidence/support to any view is collected and reviewed; and {This is my request to Dr. Malini to subject all ideas to systematic review and evidence}
iii) how variations are collated.  {Nitya Jacob has taken this role. Some previous work at Susana may be available as good guidance}

Hope we give some carefully thought and implementable direction from our efforts.

Thanks

Dear Srikanth,
No denying there is no evidence of faeco-oral transmission of COVID-19. However, there is evidence that Wastewater Based Epidemiology (WBE) can provide early warning.

The questions Malini is posing pertains to a situation where once it is identified that a particular area has infected person/s, how would the local government communicate with people residing in that particular area and  especially 'at risk' population. 

I hope this clarifies.

Regards
paresh

Dear All,
I think this is a very interesting topic and we (UNHabitat) would like to support the group to develop this further. Maybe we can contribute to the protocol development and in particularly how we determine the contributing population. We can also help to shape this tool so it can be readily applied in local settings, where local authorities and water and sanitation utilities hold ultimate responsibility.

Kind regards
Graham Alabaster 

Dear Dr. Malini

There is no evidence of "infective virus" prevailing in waste-water (sewage). Presence of RNA strands points to faecal excretion of Covid-19. Direct faecal sample analysis to establish "infectivity" is a precursor to further work on WBE. 

While we continue to pursue ideas to use emerging research on sparse (highly non-correlated, and not infective) Covid-19 traces in Waste-Water, Please consider the following:

1. Request to quote the original science publication or organizational report
   
2. Refrain from using news-paper science articles as the onus of reading entire paper is shifted to unknown reporter
   
3. Where possible, highlight the constraints or limitations the original authors have raised (so, we know the boundaries)

Some of us may have expertise in Endemics or Epidemics, yet they may be facing life's first Pandemic. Many are from disciplines outside epidemiology (like myself) and need to read original science reports to grasp the tip of complexity.
 
Kindly encourage formal positioning of all suggestions and opinions. Clear referencing, pointers to case-studies and logical positioning are needed to make the effort a reasonable science. 
 
Mr. Nitya Jacob is considering taking these viewpoints and making a recommendation report to the recipient agency. This necessitates every position taken in this forum to be responsible and carefully reviewed.
 
Thanks!


 

Thank you Malini for initiating the discussion.

I don't think we are in a situation where local governments are communicating at all; they are simply following the orders of the state government which is also following guidelines issued by the Union. This mechanism can be very useful if the messaging from the top is scientific and right.  Unfortunately that has not been the case. The lockdown for example was sold as a solution rather than a mechanism to buy time to prepare for the peak. We have now been shut for more than 2 months with no exit strategy. Now that Covid-19 is reaching villages with migrant labours, the only option panchayats know of is shutting down. 

On the communication front, I think local WhatsApp groups are playing an important role. However, they are also used to spread fake news and rumours which can spread panic.  Kerala's strategy of communication, that is a daily press conference at a fixed hour, which has been applauded all around could be easily remodelled. Local leadership can use Facebook live (Media may not always be available) to update about the situation and spread the message. Local TV channels can also be used if available. 

Regards
paresh


 

The COVID-19 pandemic has once again exposed India’s inadequate waste management abilities. While the guidelines and standard operating practices for handling solid waste (municipal, bio-medical, COVID contaminated domestic waste) are developed by the Central Pollution Control Board and Health Ministry and operationalized at the state and municipal level, liquid waste and the associated problems during this period of pandemic are hardly being addressed.

The potential spread of COVID 19 in India via wastewater simply cannot be ignored. In line with the global trends, media coverage highlighting the need for conducting studies on the presence of the virus in wastewater has been increasing. Sampling protocols suitable for the complex non-sewered contexts in India are under development and pilot studies are being undertaken. Results of initial studies undertaken by scientific community in collaboration with city water boards are also being reported. A potential fallout of this increasing reporting on the presence of COVID-19 in wastewater could be unnecessary public panic and the undesirable reactions towards pandemic response activities by the local governments.

Communication during the time of pandemic and emergency response is therefore a major challenge particularly in todays times of information overload and conflicting recommendations. The principles of good risk communication require it to be quick, transparent, credible and consistent. Balancing this in the context of changing information and high chances of misunderstanding of research findings is difficult.Further, this can be particularly damaging in the context of “at-risk populations” who are those residing at localities considered to be at highest risk of health-related, economic, and societal consequences of the pandemic. 

Effective communication with “at-risk” populations is integral to minimizing panic, illness, and potential fatality. Local governments and others therefore need to identify and plan the approach as well as the channels of communication in advance.

·      What communication challenges can the potential COVID-wastewater connection create/aggravate?
·      What are the SOPs for establishing a robust communication infrastructure that delivers coordinated and consistent  communication across multiple channels? 
·      What are some best practice communication engagement models for communication that we can learn from? 
·      What special measures are required for communication with “at risk” populations/ communities?