Wastewater Monitoring for Infectious Disease: Intentional Relationships between Academia, the Private Sector, and Local Health Departments for Public Health Preparedness

Int J Environ Res Public Health. 2023 Aug 25;20(17):6651. doi: 10.3390/ijerph20176651.

Abstract

The public health emergency caused by the COVID-19 pandemic stimulated stakeholders from diverse disciplines and institutions to establish new collaborations to produce informed public health responses to the disease. Wastewater-based epidemiology for COVID-19 grew quickly during the pandemic and required the rapid implementation of such collaborations. The objective of this article is to describe the challenges and results of new relationships developed in Detroit, MI, USA among a medical school and an engineering college at an academic institution (Wayne State University), the local health department (Detroit Health Department), and an environmental services company (LimnoTech) to utilize markers of the COVID-19 virus, SARS-CoV-2, in wastewater for the goal of managing COVID-19 outbreaks. Our collaborative team resolved questions related to sewershed selection, communication of results, and public health responses and addressed technical challenges that included ground-truthing the sewer maps, overcoming supply chain issues, improving the speed and sensitivity of measurements, and training new personnel to deal with a new disease under pandemic conditions. Recognition of our complementary roles and clear communication among the partners enabled city-wide wastewater data to inform public health responses within a few months of the availability of funding in 2020, and to make improvements in sensitivity and understanding to be made as the pandemic progressed and evolved. As a result, the outbreaks of COVID-19 in Detroit in fall and winter 2021-2022 (corresponding to Delta and Omicron variant outbreaks) were tracked in 20 sewersheds. Data comparing community- and hospital-associated sewersheds indicate a one- to two-week advance warning in the community of subsequent peaks in viral markers in hospital sewersheds. The new institutional relationships impelled by the pandemic provide a good basis for continuing collaborations to utilize wastewater-based human and pathogen data for improving the public health in the future.

Keywords: COVID-19; SARS-CoV-2; anonymity; collaboration; communication; dormitories; neighborhoods; nursing homes; pandemic; public health; sewersheds; wastewater.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • COVID-19* / epidemiology
  • Communicable Diseases*
  • Humans
  • Pandemics
  • Private Sector
  • Public Health
  • SARS-CoV-2
  • Wastewater

Substances

  • Wastewater

Supplementary concepts

  • SARS-CoV-2 variants

Grants and funding

This project was funded by the State of Michigan, Project AY of the WSU-MDHHS Master contract MA-2021, entitled “SARS-CoV-2 Epidemiology—Wastewater Evaluation and Reporting (SEWER) Network” (Principal Investigators: Jeffrey L. Ram and William Shuster) from the Michigan Department of Health and Human Services, using Federal Financial Assistance from the U.S. Department of Treasury under the Epidemiology and Laboratory Capacity: Enhancing Detection Expansion through Coronavirus Response and Relief (CRR) Supplemental Appropriations Act of 2021 (P.L. 116-260). Also funded by the Michigan Department of Environmental Quality, 2020-2021, William Shuster, principal investigator, as “Dorm-level wastewater monitoring for SARS CoV-2 material: a process-based approach to inform early-warning and control”.