This interim guidance supplements the infection prevention and control (IPC) documents by summarizing WHO guidance on water, sanitation, hygiene (WASH) and waste management relevant to viruses, including coronaviruses. This document is an update to the interim guidance document entitled ‘Water, sanitation, hygiene, and waste management for the COVID-19 virus’, published on 23 March 2020. It is intended for water and sanitation practitioners and providers, and health-care providers who want to know more about WASH and waste risks and practices in relation to COVID19.
The provision of safe water, sanitation and waste management and hygienic conditions is essential for preventing and for protecting human health during all infectious disease outbreaks, including of coronavirus disease 2019 (COVID-19). Ensuring evidenced-based and consistently applied WASH and waste management practices in communities, homes, schools, marketplaces, and healthcare facilities will help prevent human-to-human transmission of pathogens including SARS-CoV-2, the virus that causes COVID-19.
This guidance was originally published in March 2020. This third edition provides additional details on risks associated with excreta and untreated sewage, hand hygiene, protecting WASH workers and supporting the continuation and strengthening of WASH services, especially in underserved areas. This additional information has been prepared in response to questions that the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) have received about the prevention and control of COVID19 in settings where WASH services are limited.
The most important information concerning WASH and the SARS-CoV-2 is summarized here.
• Frequent and correct hand hygiene is one of the most important measures to prevent infection with SARS-CoV-2. WASH practitioners should work to enable, inform and motivate more frequent and regular hand hygiene by building a supportive a These coronaviruses include: human coronavirus 229E (HCoV), human coronavirus HKU1, human coronavirus OC43, severe acute respiratory syndrome coronavirus environment to improve and sustain access to hand hygiene facilities and by using a multimodal strategy (refer to hand hygiene practices) to support good hand hygiene behaviour. Performing hand hygiene at the right time, using the right technique with either alcohol-based hand rub or soap and water is critical.
• Existing WHO guidance on the safe management of drinking-water and sanitation services also applies to the COVID-19 pandemic. Water disinfection and wastewater treatment can reduce viruses. Sanitation workers should have proper training and access to personal protective equipment (PPE) and in many scenarios, a specific combination of PPE elements is recommended.
• Many other infectious diseases can be prevented and health co-benefits realized by safely managing water and sanitation services, and by applying good hygiene practices and waste management.
Based on existing knowledge and research there is no indication that SARS-CoV-2 can persist in drinking water. For wastewater, some recent studies have found RNA fragments but not infectious virus (see section 2 for details) in wastewater. The morphology and chemical structure of this virus are similar to those of other coronaviruses a for which there are data both on their survival in the environment and on effective measures to inactivate them. This guidance draws on the existing evidence base and current WHO guidance on how to protect against possible exposure to viruses in wastewater, drinking-water and waste.