In fall 2021, The Rockefeller Foundation convened the Wastewater Action Group to share best practices and overcome barriers to translating wastewater data into public health action. With support from Mathematica, the group produced a series of five briefs – tracking data, measurement, data integration, sampling plans, and ethical monitoring based on key insights, experiences and examples of best practices to inform and support public health decision-makers who may be implementing or expanding an existing wastewater surveillance system in their communities.
The group is comprised of Foundation grantees, including epidemiologists and academic researchers from U.S.-based institutions in Houston, Louisville, Phoenix, Tulsa and Atlanta. They all recognize wastewater surveillance as a powerful public health tool that is:
- Timely – wastewater surveillance can provide early indications of community transmission of Covid-19 and of emerging variants. It is often able to do this before clinical data emerge, because people often don’t seek care unless they are severely ill.
- Cost-effective – wastewater sampling can often be done at a fraction of the cost of clinical testing. Variant detection at a population level versus a single clinical sample is a more efficient approach.
- Equitable – as a passive and anonymous monitoring system, wastewater can provide a more equitable snapshot of health in the community. Everyone contributes, so even populations that lack access to quality health care and may be overlooked by other health data systems are included.
- This document offers recommendations for how to communicate about wastewater-based surveillance to a variety of audiences who likely are unfamiliar with the concept.
- This document demonstrates that applying several assays for specific pathogens can help public health entities monitor the presence and spread of specific pathogens over time and by region.
- This document illustrates how wastewater monitoring can be used for public health surveillance by showing patterns of infection, especially when integrated with demographic and geographic data.
- This brief highlights the following key considerations when developing a wastewater sampling program: (1) Designing a sampling plan, (2) Sample collection types, (3) Adaptive sampling; and (4) Data quality and variability.
- This brief outlines that with proper planning, community engagement at every level, and regular, transparent communication, wastewater surveillance can be implemented and protect the health of vulnerable populations.