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. 2023 Nov-Dec;29(6):854-862.
doi: 10.1097/PHH.0000000000001797. Epub 2023 Aug 1.

Establishing a Statewide Wastewater Surveillance System in Response to the COVID-19 Pandemic: A Reliable Model for Continuous and Emerging Public Health Threats

Milagros Neyra  1 , Dustin T Hill, Lydia J Bennett, Christopher N Dunham, David A Larsen; New York State Wastewater Surveillance Network Team*
Affiliations

Establishing a Statewide Wastewater Surveillance System in Response to the COVID-19 Pandemic: A Reliable Model for Continuous and Emerging Public Health Threats

Milagros Neyra et al. J Public Health Manag Pract. 2023 Nov-Dec.

Abstract

Context: The COVID-19 pandemic sparked efforts across the globe to implement wastewater surveillance for SARS-CoV-2.

Program: New York State (NYS) established the NYS Wastewater Surveillance Network to estimate the levels of COVID-19 community risk and to provide an early indication of SARS-CoV-2 transmission trends. The network is designed to provide a better understanding of public health burdens and to assist health departments to respond effectively to public health threats.

Implementation: Wastewater surveillance across NYS increased from sporadic and geographically spare in 2020 to routine and widespread in 2022, reaching all 62 counties in the state and covering 74% of New Yorkers. The network team focused on engaging local health departments and wastewater treatment plants to provide wastewater samples, which are then analyzed through a network-affiliated laboratory. Both participating local health departments and wastewater treatment plants receive weekly memos on current SARS-CoV-2 trends and levels. The data are also made publicly available at the state dashboard.

Evaluation: Using standard indicators to evaluate infectious disease surveillance systems, the NYS Wastewater Surveillance Network was assessed for accuracy, timeliness, and completeness during the first year of operations. We observed 96.5% sensitivity of wastewater to identify substantial/high COVID-19 transmission and 99% specificity to identify low COVID-19 transmission. In total, 80% of results were reported within 1 day of sample collection and were published on the public dashboard within 2 days of sample collection. Among participating wastewater treatment plants, 32.5% provided weekly samples with zero missing data, 31% missed 1 or 2 weeks, and 36.5% missed 3 or more weeks.

Discussion: The NYS Wastewater Surveillance Network continues to be a key component of the state and local health departments' pandemic response. The network fosters prompt public health actions through real-time data, enhancing the preparedness capability for both existing and emerging public health threats.

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Conflict of interest statement

The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Operations of the New York State Wastewater Surveillance Network, as of January 2023 Abbreviations: NYS, New York State; WWTP, wastewater treatment plant. This figure is available in color online (www.JPHMP.com).
FIGURE 2
FIGURE 2
Map of Wastewater Treatment Plants Participating in the New York State Wastewater Surveillance Network Characterized by Discharge Capacity in Million Gallons per Day, as of January 2023 Abbreviation: MGD, million gallons per day. This figure is available in color online (www.JPHMP.com).
FIGURE 3
FIGURE 3
Accuracy, Timeliness, and Completeness Metrics for the New York State Wastewater Surveillance Network, August 1, 2021, to January 31, 2023 Abbreviations: BCoV, bovine coronavirus; NPV, negative predictive value; PPV, positive predictive value. This figure is available in color online (www.JPHMP.com).
See this image and copyright information in PMC

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