During the past three years of the pandemic, testing sewage for the virus that causes COVID has become a valuable tool. For example, surges of infections and new variants were discovered weeks before they appeared in clinics. The technology also warns of other health threats, such as seasonal viruses and rising opioid use.
But now our ability to protect public health in the long term is in jeopardy. Uncertainties in federal funding and uneven commitments from state health departments have created fears that the wastewater monitoring program may be shut down in the future.
The U.S. Centers for Disease Control and Prevention’s National Wastewater Monitoring System (NWSS) includes the majority of U.S. wastewater test stations and is “fully funded through 2025,” says program director Amy Kirby. said Mr. But then there will be a need for “new sources of sustainable funding,” Kirby said, ideally through the CDC’s regular budget rather than COVID-related resources. Along with logistical challenges and questions about how to interpret data from new sources, some state governments are reluctant to invest in technology, leading to an uneven national system.
Wastewater monitoring is valuable because it provides data for thousands of people in one sample. Unlike the number of COVID cases, it does not rely on individuals being tested in health facilities. Nathan LaCross, manager of the Utah Department of Health Wastewater Program, said: Sewage sampling has been particularly helpful in the last year, experts say, as more people opted for at-home testing that wasn’t counted by health agencies.
Wastewater monitoring may become even more important later this spring as the COVID federal public health emergency ends and individual tests become more expensive and less accessible. For nearly a year, LaCross said, laboratory data “has become increasingly unreliable” in providing accurate case counts. As such, he expects he will continue to rely on wastewater data in 2023.
Some researchers and health officials are working to expand wastewater programs beyond COVID and have found that the technology can track a range of health threats. For example, the WastewaterSCAN project tests for influenza, respiratory syncytial virus (RSV), mpox, norovirus, human metapneumovirus (HMPV), and SARS-CoV-2. Marlene Wolfe, principal investigator of the SCAN project and assistant professor at Emory University, said the pandemic “opened up the imagination” about new uses for wastewater.
The New York State Department of Health recently announced it would expand its wastewater program to include new diseases, adding at least 90 monitoring sites. David Larsen, an epidemiologist at Syracuse University who runs the New York State Program, sees this expansion in three directions: readiness to track emerging pathogens (such as mpox and H5N1); RSV, etc.) monitoring improvements, and filling. Other “knowledge gaps” in local public health departments. The final category could include anything from opioid use to dangerous fungi. Biobot Analytics, a leading company in wastewater testing, was founded in 2020 to monitor the opioid crisis before he transitions to COVID, while Utah’s health department is working to track the fungus. white earscan cause dangerous infections in sewage.
However, additional funding is needed to continue these projects at the national level, and there are signs that the federal government may be reluctant to fund them. His 2024 budget, proposed by the Biden administration, does not include any mention of the CDC’s wastewater monitoring system, and public health funding bills have repeatedly stalled in Congress. CDC programs for state epidemiology and laboratory efforts were severely underfunded before the pandemic, and new wastewater-specific funding is unclear, so some states are deferring oversight.
In Vermont, for example, the decision to wait for the state health department to start its own wastewater monitoring program was partly driven by funding concerns and the need to update data, said a department official. says. Instead, Vermont relies on a federal contract between her CDC and Biobot to provide wastewater testing to rural areas, tribal sites, and states that don’t yet have their own programs. This contract was recently extended for another six months. That’s a “comfort” for Vermont epidemiologist Lynn Blevins, who has found the Biobot data valuable.
State agencies have also struggled to convince them to send samples to sewage plants in some cases. This process is generally voluntary, and if the factory is understaffed, this can be a difficult sell. Rekha Singh, program manager for the Virginia Department of Health, said it has spent “a lot of time” getting more sites on board.
Even states that have built robust programs are grappling with best practices for interpreting and acting on data. According to Larsen, public health officials often don’t know what to do with wastewater data. This is because these numbers represent a large population and not a single case for which contacts can be traced. Researchers are studying how wastewater trends can predict hospitalization trends, and how new variants and environmental factors influence data and other analytical problems.
Answering these questions and providing more examples of public health benefits may help convince officials currently wary of wastewater monitoring that it is worth the investment. In the future, places that invest will be better prepared for the next pandemic, but places that fail to develop this infrastructure could be caught off guard, he notes.
