Temporal changes in alcohol consumption associated with the COVID-19 interventions in Belgium: a wastewater-based approach
Wastewater-based epidemiology (WBE) is a complementary approach to monitor alcohol consumption in the general population. This study aims to: (i) evaluate intra- and inter-year temporal changes in alcohol use during the first wave of the COVID-19 pandemic; and (ii) measure the effect of governmental COVID-19 restrictions on alcohol consumption.
Daily 24-h composite influent wastewater samples were collected from four wastewater treatment plants, corresponding to Belgian cities (Antwerp, Boom, Brussels, and Leuven). In each sample the human metabolic excretion product of ethanol, ethyl sulphate, was measured using a validated method based on liquid chromatography coupled to tandem mass spectrometry. Measured concentrations (ng/L) of ethyl sulphate were converted to per capita mass loads (mg/day/1000 inhabitants) by considering the daily flow rate and catchment population. Day-to-day temporal changes during the COVID-19 pandemic were assessed, and the effects of COVID-19 interventions alcohol consumption were investigated.
Alcohol use in Belgium remained stable compared to 2019. No significant intra-year changes were observed during the first stages of the COVID-19 pandemic, including first full lockdown (14 Mar 2020 until 4 May 2020) and exit strategy (4 May 2020 until 8 June 2020). However, average alcohol consumption in Leuven was two times higher after relaxation of the quarantine measures (i.e., after re-opening of catering industry and increasing the allowed number of social contacts on 8 Jun 2020) compared to the lockdown and exit strategy. Similar peaks in daily per capita alcohol consumption were also observed in the other locations after the gradual re-lifting of COVID-19 restrictions.
The present study shows the potential of WBE to rapidly assess the impact COVID-19 interventions had on alcohol consumption in Belgium. This study also indicates that WBE could be employed as a complementary data source to fill in some of the current knowledge gaps linked to lifestyle behaviour during the COVID-19 pandemic.