Abstract
Wastewater surveillance, the measurement of pathogen levels in wastewater, is used to evaluate community-level infection trends, augment traditional surveillance that leverages clinical tests and services (e.g., case reporting), and monitor public health interventions (1). Approximately 40% of persons infected with SARS-CoV-2, the virus that causes COVID-19, shed virus RNA in their stool (2); therefore, community-level trends in SARS-CoV-2 infections, both symptomatic and asymptomatic (2) can be tracked through wastewater testing (3-6). CDC launched the National Wastewater Surveillance System (NWSS) in September 2020 to coordinate wastewater surveillance programs implemented by state, tribal, local, and territorial health departments to support the COVID-19 pandemic response. In the United States, wastewater surveillance was not previously implemented at the national level. As of August 2021, NWSS includes 37 states, four cities, and two territories. This report summarizes NWSS activities and describes innovative applications of wastewater surveillance data by two states, which have included generating alerts to local jurisdictions, allocating mobile testing resources, evaluating irregularities in traditional surveillance, refining health messaging, and forecasting clinical resource needs. NWSS complements traditional surveillance and enables health departments to intervene earlier with focused support in communities experiencing increasing concentrations of SARS-CoV-2 in wastewater. The ability to conduct wastewater surveillance is not affected by access to health care or the clinical testing capacity in the community. Robust, sustainable implementation of wastewater surveillance requires public health capacity for wastewater testing, analysis, and interpretation. Partnerships between wastewater utilities and public health departments are needed to leverage wastewater surveillance data for the COVID-19 response for rapid assessment of emerging threats and preparedness for future pandemics.
Highlights
Wastewater surveillance data have been used to deploy clinical testing resources, investigate possible irregularities in traditional surveillance, refine health messaging, and forecast clinical resource nee
Wastewater surveillance data provide information about symptomatic and asymptomatic SARS-CoV-2 infections. The accuracy of this surveillance approach is not influenced by health care access or clinical testing capacity
The following descriptions of states using wastewater surveillance data to track community trends of SARS-CoV-2 infection provide examples of public health action taken in Ohio and Utah
Summary
Using Wastewater Surveillance Data to Support the COVID-19 Response — United States, 2020–2021. Wastewater surveillance data provide information about symptomatic and asymptomatic SARS-CoV-2 infections The accuracy of this surveillance approach is not influenced by health care access or clinical testing capacity. The following descriptions of states using wastewater surveillance data to track community trends of SARS-CoV-2 infection provide examples of public health action taken in Ohio and Utah. The Ohio Wastewater Monitoring Network, a statewide network launched in June 2020, was designed to provide early warning of increasing SARS-CoV-2 infection in communities and continues to support and guide local and state public health actions to mitigate COVID-19. A notification is emailed if ODH observes a tenfold increase in SARS-CoV-2 levels over those detected in the past two samples These local groups use this early warning information, alongside wastewater dashboard data, to guide actions to limit further disease spread. Decreasing SARS-CoV-2 RNA levels in wastewater indicated that the declining case rates were accurate
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
