Wastewater testing programs need better coordination, data standards, GAO says
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Wastewater surveillance systems are helping communities predict COVID-19 outbreaks, but lack of national coordination and standardized methods pose challenges to wider adoption, according to the Government Accountability Office.
More cities and states are using wastewater surveillance to detect the COVID-19 virus and other pathogens and chemicals in human waste, making it an effective method for detecting community-level outbreaks, according to an April 11 tech spotlight from the Government Accountability Office.
As home testing grows popular and fewer people seek tests from public health agencies, wastewater analysis is set to become an important factor for monitoring virus spread.
In small environments like college dormitories or long-term care facilities, officials can use wastewater to pinpoint infection rates in specific buildings and subsequently target clinical testing in those locations. In medium and large populations, the data can inform how health officials allocate resources to hot spots and enable large-scale surveillance and monitoring programs, GAO said.
Despite wastewater surveillance’s high potential as a public health tool, some aspects may need further development, GAO said.
A lack of standardization is hindering agencies’ ability to support wider use cases and produce more useful data. While many state health departments are testing wastewater, “the lack of a standardized approach complicates efforts to aggregate, interpret, and compare data across sites and develop large-scale public health interventions,” GAO said.
Rainwater and industrial discharge can often dilute samples, and contaminants like animal waste can complicate efforts to determine sample origin or quality.
The potential savings of wastewater surveillance are also unclear. “The general lack of cost-benefit analyses makes it difficult to determine how and when to use it,” GAO said.
Additionally, wastewater surveillance raises privacy issues and ethical concerns. Human genetic data can be identified in wastewater and potentially misused, GAO said. Also, communities whose wastewater indicates pathogen spread or illicit drug use may be stigmatized, it added.
Nevertheless, wastewater monitoring and surveillance programs have helped map COVID hot spots and identify trends in several states.
Virginia’s wastewater monitoring initiative launched in September 2021 to sample infection trends at the community level. Missouri’s Sewershed Surveillance Program obtained samples from more than half of the state’s population to create a map for residents to see where cases are highest. In Michigan, data and analysis from a coordinated network of labs, local health departments and universities populates a dashboard that shows regional and statewide COVID-19 wastewater monitoring data.