Mar 22, 2022 - Health

Experts call for more investment in wastewater surveillance

Two-week change in COVID-19 levels detected in wastewater facilities
Data: CDC; Note: Facility locations are approximate; Map: Kavya Beheraj/Axios

Wastewater monitoring programs around the nation indicate a new surge of COVID-19 similar to Europe's may be on its way in the U.S. But public health authorities aren't getting a full picture because a hoped-for national early warning system remains a patchwork quilt.

State of play: More than 700 sites around the U.S. report wastewater surveillance data to the National Wastewater Surveillance System, set up by the CDC in 2020 to identify case surges and new variants.

Yes, but: Wastewater surveillance gained wide acceptance in the 1990s with efforts to eradicate polio. Experts say investment in this kind of testing is "critical" as research has shown it can be used to accurately track trends in COVID-19 transmission.

  • "[The CDC] and others should be focused on ramping up this critical surveillance tool — a minimum 100x around the US. The cost is pennies compared to the cost of being taken off guard (again)," tweeted Michael Mina, chief scientific officer at the biotech software company eMed.
  • It's additionally important with the broad adoption of at-home testing that doesn't make its way to health departments, Mark Osborn, who leads efforts to collect wastewater surveillance for the state of Minnesota, told Axios.
  • "Everyone will use a drain at some point during the day," he said. "We lose a bit of the analytics we had earlier in the pandemic where you had to go to a clinic to get tested and all those results went to the Department of Health."
  • But there are lingering privacy concerns over localized monitoring, including questions about how to safeguard the data and use genetic information recovered from samples.

The CDC did not respond to a request for comment about the program on Monday.

  • But officials told Politico the system is a supplement to other surveillance programs and still has value, even if it could be improved with expanded use.

What they're saying: "Not everyone evacuates when a Category 5 hurricane is forecast, but most people will bring in the lawn furniture and stock up on supplies," wrote Catherine Klapperich, the scientific director of the Boston University Clinical Testing Laboratory and Rebecca Weintraub, director of Better Evidence at Ariadne Labs on Monday in the Boston Globe.

  • "Yet when we have similarly reliable data predicting the next wave of COVID-19, few of us ever hear of it, let alone know the most prudent ways to respond to protect ourselves and others," they wrote.
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