On-board toilets of long-haul flights: is sewage epidemiology effective for COVID-19 global surveillance?

The clinical detection of SARS-CoV-2 RNA in feces of infected people promptly lead to the idea of wastewater-based epidemiology (WBE) as a valuable strategy for COVID-19 environmental surveillance. This approach should be feasible when sampling the excreta collected by “dry” vacuum on-board toilets of long-haul flights. Aircraft toilet waste (ATW)-based surveillance possibly represents a reasonably time-saving and cost-benefit effective strategy for monitoring single flights, while obviating the need to swab all passengers.