According to the latest reports, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which caused
coronavirus disease 2019 (COVID-19), was successfully isolated from the excreta (stool and urine) of
COVID-19 patients, suggesting SARS-CoV-2 could be transmitted through excreta contaminated water. As pit latrines and the use of untreated excreta as
fertilizer were common in rural China, we surveyed 27 villages of Jiangxi and Hubei provinces and found that pit latrines could be a potential source of SARS-CoV-2 water pollution. Recently, bats have been widely recognized as the source of SARS-CoV-2. There were many possible intermediate hosts of SARS-CoV-2, including pangolin, snake, bird and fish, but which one was still not clear exactly. Here, we proposed a hypothesis to illustrate the mechanism that SARS-CoV-2 might spread from the excreta of infected humans in pit latrines to potential animal hosts, thus becoming a sustainable source of
infection in rural China. Therefore, we believe that abolishing pit latrines and banning the use of untreated excreta as
fertilizer can improve the local living environment and effectively prevent
COVID-19 and other potential
waterborne diseases that could emanate from the excreta of infected persons. Although this study focused on rural areas in China, the results could also be applied to low-income countries, especially in Africa.