Recovery, Renewal, Resilience

During the pandemic public toilets have been closed with a view to reducing possible sites of COVID-19 transmission. This has resulted in reported increases in open defecation and urination, which could create another public health crisis. Also, the closure of public toilets can negatively impact people's wellbeing and mental health as some people may not feel comfortable using outdoor spaces for fresh air and exercise without knowing there is a public toilet available. Consider guidelines on:

• The safe opening of public toilets in 'BS 45005 Safe working during the COVID-19 pandemic - General guidelines for organizations'
• Revisions of BS 6465 Sanitary installations: Part 1 Code of practice for the design of sanitary facilities and scales of provision of sanitary and associated appliances, and Part 4 Code of practice for the provision of public toilets

Legionella is a type of bacteria that can become a health concern when found in man-made water systems. While buildings remain closed due to the pandemic, it is important that water systems are well maintained to prevent future health issues like Legionella. If breathed in through droplets in the air, the bacteria can cause Legionnaires' disease, a respiratory illness with some similar symptoms to COVID-19 e.g. a fever, cough, shortness of breath. The European Working Group for Legionella Infections (ESGLI) has put together a guidance document on how to best manage Legionella in building water systems during this COVID-19 outbreak. Consider ESGLI guidance to manage the safety of buildings' water systems:

https://www.rsph.org.uk/membership/webinars/how-to-ensure-your-building-water-system-is-safe-during-and-post-covid-19.html

Wastewater-based epidemiology groups in Australia, the Netherlands, Sweden, and the USA have already reported detecting traces of COVID-19 in wastewater. Although COVID-19 is not known to infect humans through sewage or wastewater, similar diseases can, and so monitoring the behaviour of COVID-19 in these environments is important. Consider integrating sewer surveillance and wastewater inspections into systems for COVID-19 monitoring:

• Develop a 'dashboard' of data to assess the correlations between all collated COVD-19-related indicators as seen in the Netherlands
• Provide information on potential transmission pathways and improve the early warning of new outbreaks by understanding the relationships between: wastewater analysis, the number registered infected people, and societal or behavioural traits

This should seek to maintain operations whilst minimising virus transmission. For example, operations in Paris:

• Wash and disinfect collection trucks every day
• Prioritise the collection of unauthorized garbage and street cleaning (using street washers and vacuum cleaners on pathways)
• Collect waste from streets e.g. each day ~1,000 municipal workers, ~250 garbage collection trucks, and ~100 road sweeping machines collect waste from the streets
• Clean ~140 public toilets in order to keep them open - thereby provide considerable health and dignity benefits to the most vulnerable. These facilities also have drinking water fountains
• Plan to manage the surge in the volume of waste when restaurants reopen (in Paris, the volume of daily waste has fallen by a third during closedown)