Executive Summary : | The risk of COVID-19 to vulnerable populations, such as immunosuppression, old age, and poor housing and hygiene, is high due to their sub-optimal response to vaccines. Infected individuals have poor prognosis, recurrent episodes, long periods of infectivity, and higher viral loads, potentially leading to the emergence of newer variants. Maharashtra, one of the nine states with a high overall vulnerability index, has not been targeted for epidemiological monitoring due to the Delta variant's origin in the state and the possibility of future new variants. To address these knowledge gaps and the urgent need to study the virus in vulnerable settings, a study focuses on periodic genomic surveillance for SARS-CoV-2 variants in effluents in urban localities with vulnerable populations. The study will collect wastewater samples from various settings in Mumbai, such as cancer hospitals, kidney or liver transplant hospitals, old age homes, slums, and other vulnerable settings, every 15 days for 10 months. The samples will be processed for viral RNA isolation and subjected to genome sequencing by Illumina and Oxford Nanopore sequencing. The results of this study will help understand the sustainability of targeted environmental surveillance for detection of known and newly emerging variants in vulnerable populations and serve as a warning system for subsequent waves of SARS-CoV-2 infection. |