Researchers and governments alike have sampled wastewater for varied uses, from estimating population socioeconomics (1) to assessing vaccination rates. (2,3) But with more than (16,000) wastewater treatment plants across the United States, the country faces unique challenges in leveraging these data for research or policy. A new commentary in Environmental Health Perspectives proposes a road map for adapting wastewater surveillance--traditionally an academic exercise in the United States--to a policy tool that can respond to current and future public health crises. (4)
Traditionally, wastewater surveillance has been used to detect health indicators, such as stress hormones, illicit drugs, chronic disease biomarkers, and pathogens. (5) This surveillance enables public health officials to identify, at a population level, disease outbreaks, previously undetected health problems, and changes in health-related behavior. Officials can also estimate the seriousness of such problems and assess the effectiveness of interventions and control measures. (6)
For the new article, a team of health policy analysts at Mathematica applied their expertise in wastewater surveillance to the COVID-19 pandemic. Springboarding off a 2017 symposium--which positioned some communities to launch wastewater surveillance for the SARS-CoV-2 virus as soon as the first clinical cases of COVID-19 were detected--the team curated a data hub7 that collected credible resources on different aspects related to pandemic management. They then built a dynamic reporting tool to evaluate wastewater data alongside other public health data and worked with communities to help them implement wastewater surveillance.
"Thanks to COVID-19, there's been unprecedented attention paid to wastewater surveillance," says lead author Aparna Keshaviah, a senior biostatistician at Mathematica. "As federal agencies now work to build a national surveillance system, we wanted to help them think through ways to bring a systematic approach that works not just for the current...