During the 2020-2023 COVID-19 Global Public Health Emergency of International Concern, rapid
progress was made with the application of Wastewater-Based Surveillance (WBS) (also known as
Wastewater-Based Epidemiology (WBE)) to provide population-scale evidence of SARS-CoV-2
shedding into wastewater. The information gained was used to help monitor, communicate, and
manage the COVID-19 pandemic.
Rapid and significant innovations in the field of WBS were realised in parallel in multiple
jurisdictions globally. Global collaboration resulted in step-change improvements in multiple
aspects of WBS simultaneously, including: health sector leadership; integration with public health
surveillance; social and ethical guidance; high-level tactical wastewater catchment sampling
strategies; wastewater sampling techniques; transport and storage of samples; laboratory
analysis; normalisation and standardisation; data analysis and interpretation; and communication
of results.
Innovations in WBS relating to COVID-19 continue to take place, and the benefits of those
improvements are now being applied to other targets, such as other pathogens and genes. There
are many journal articles and other publications describing these innovations. However, valuable
lessons from the COVID-19 pandemic for WBS have not been systematically documented into a
practical and readily digestible format.
The purpose of this ‘Cookbook’ is to provide practical and proven ‘recipes’ for WBS for SARS-CoV-2
for two reasons: firstly to help those considering new or extended WBS programmes targeting
SARS-CoV-2; and secondly to provide a valuable record of what has been learned from the 2020-
2023 period to help inform WBS programmes to respond to future pandemics and for surveillance
of other targets.
The Cookbook is structured into eight parts: 1. Introduction; 2. High-level Overview; 3. Health
Sector Perspectives; 4. Methods and Methodologies - From data to action; 5. Methods and
Methodologies - Measurement and testing; 6. Methods and Methodologies - Sampling; 6. Methods
and Methodologies - Transportation protocols; 8. Conclusions. Multiple authors have contributed to
each part, primarily from the European Union, as well as others from the global community of
practice.
The Cookbook has been drafted by a global team of authors, with one or more lead authors
identified for each chapter and working with their co-authors. The chapters were then subjected to
extensive peer review from the external review group. These authors and reviewers are
acknowledged in the Cookbook.