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. 2022 Dec;130(12):125002.
doi: 10.1289/EHP11519. Epub 2022 Dec 29.

Looking Forward: The Role of Academic Researchers in Building Sustainable Wastewater Surveillance Programs

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Looking Forward: The Role of Academic Researchers in Building Sustainable Wastewater Surveillance Programs

Catherine Hoar et al. Environ Health Perspect. 2022 Dec.

Abstract

Background: In just over 2 years, tracking the COVID-19 pandemic through wastewater surveillance advanced from early reports of successful SARS-CoV-2 RNA detection in untreated wastewater to implementation of programs in at least 60 countries. Early wastewater monitoring efforts primarily originated in research laboratories and are now transitioning into more formal surveillance programs run in commercial and public health laboratories. A major challenge in this progression has been to simultaneously optimize methods and build scientific consensus while implementing surveillance programs, particularly during the rapidly changing landscape of the pandemic. Translating wastewater surveillance results for effective use by public health agencies also remains a key objective for the field.

Objectives: We examined the evolution of wastewater surveillance to identify model collaborations and effective partnerships that have created rapid and sustained success. We propose needed areas of research and key roles academic researchers can play in the framework of wastewater surveillance to aid in the transition from early monitoring efforts to more formalized programs within the public health system.

Discussion: Although wastewater surveillance has rapidly developed as a useful public health tool for tracking COVID-19, there remain technical challenges and open scientific questions that academic researchers are equipped to address. This includes validating methodology and backfilling important knowledge gaps, such as fate and transport of surveillance targets and epidemiological links to wastewater concentrations. Our experience in initiating and implementing wastewater surveillance programs in the United States has allowed us to reflect on key barriers and draw useful lessons on how to promote synergy between different areas of expertise. As wastewater surveillance programs are formalized, the working relationships developed between academic researchers, commercial and public health laboratories, and data users should promote knowledge co-development. We believe active involvement of academic researchers will contribute to building robust surveillance programs that will ultimately provide new insights into population health. https://doi.org/10.1289/EHP11519.

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Figures

Figure 1 is a flowchart with three steps that are interconnected with each other. Step 1: Academics: pioneering methods and interpretation, including the advanced detection, quantification, and identification of infection agents in wastewater, with knowledge transfer and training leading to step 2. There is an icon of a syringe and a test tube. Step 2: Wastewater and Laboratory Services: Sustaining programs, including operationalizing programs to provide regular, timely results, with sample sharing leading back to step 1. Step 2 leads to step 3. There is an icon of a water pipe and a test tube. Step 3: Public Health Authorities: Implementing public health responses, including utilizing wastewater data to make decisions and implement public health responses, with researcher-informed data interpretation leading from step 1 and public health needs informing research leading back to step 1. There is an icon of three human stick figures.
Figure 1.
Framework for building robust and adaptive wastewater surveillance programs. In addition to undertaking basic research that underpins the basis of wastewater surveillance, researchers have a critical role to play in continuous methods development, technology transfer, research that informs data context and interpretation, and training the next generation of professionals.

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