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Volume 27, Number 9—September 2021
Online Report

SARS-CoV-2 Wastewater Surveillance for Public Health Action

Jill S. McClary-Gutierrez1, Mia C. Mattioli, Perrine Marcenac, Andrea I. Silverman, Alexandria B. Boehm, Kyle Bibby, Michael Balliet, Francis L. de los Reyes, Daniel Gerrity, John F. Griffith, Patricia A. Holden, Dimitrios Katehis, Greg Kester, Nathan LaCross, Erin K. Lipp, Jonathan Meiman, Rachel T. Noble, Dominique BrossardComments to Author , and Sandra L. McLellanComments to Author 
Author affiliations: University of Wisconsin–Milwaukee School of Freshwater Sciences, Milwaukee, Wisconsin, USA (J.S. McClary-Gutierrez, S.L. McLellan); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (M.C. Mattioli, P. Marcenac); University Tandon School of Engineering, Department of Civil and Urban Engineering, Brooklyn, New York, USA (A.I. Silverman); Stanford University Department of Civil and Environmental Engineering, Stanford, California, USA (A.B. Boehm); University of Notre Dame Department of Civil and Environmental Engineering and Earth Sciences, Notre Dame, Indiana, USA (K. Bibby); County of Santa Clara Department of Environmental Health, San Jose, California, USA (M. Balliet); North Carolina State University Department of Civil, Construction, and Environmental Engineering, Raleigh, North Carolina, USA (F.L. de los Reyes III); Southern Nevada Water Authority Applied Research and Development Center, Las Vegas, Nevada, USA (D. Gerrity); Southern California Coastal Water Research Project, Costa Mesa, California, USA (J.F. Griffith); University of California Bren School of Environmental Science and Management, Santa Barbara, California, USA (P.A. Holden); New York City Department of Environmental Protection, New York, New York, USA (D. Katehis); California Association of Sanitation Agencies, Sacramento, California, USA (G. Kester); Utah Department of Health, Salt Lake City, Utah, USA (N. LaCross); University of Georgia Department of Environmental Health Science, Athens, Georgia, USA (E.K. Lipp); Wisconsin Department of Health Services, Madison, Wisconsin, USA (J. Meiman); University of North Carolina at Chapel Hill Institute of Marine Sciences, Morehead City, North Carolina, USA (R.T. Noble); University of Wisconsin–Madison Department of Life Sciences Communication, Madison (D. Brossard); University of Wisconsin–Madison Morgridge Institute for Research, Madison (D. Brossard)

Main Article

Table 1

Summary of barriers, best practices, and future needs for public health agencies using wastewater surveillance data for public health action

Barrier Recommended best practices Future needs (key strategy areas)
Many public health agencies are not yet comfortable interpreting wastewater data
 • Communicate results interpretation alongside data limitations and known variability sources
• Collaborate with laboratories, wastewater utilities, environmental health departments, and communications experts
 Evaluation of wastewater data variability and uncertainty sources in a variety of systems (research)
Public health agencies want to see wastewater data in their own communities to gain confidence in utility
 • Provide case studies from community applications and perspectives
• Perform retrospective analyses on existing datasets
 Documentation of wastewater surveillance use cases for adoption in different communities and infrastructure systems (research and communication)
New knowledge and investment needed to sustain wastewater surveillance systems
 • Co-develop programs and methods with scientific experts and government agencies
• Share methods and experiences across research, wastewater, and public health
 Investment in physical laboratory capacity, personnel, and interagency collaboration frameworks (organizational structures and policy)
Ethics of wastewater surveillance data sharing and use not yet established • Evaluate sample anonymity
• Engage the public in collection and data use		 Development of ethical wastewater data use standards for surveillance and research (policy and research)

Main Article

1Current affiliation: University of Notre Dame Department of Civil and Environmental Engineering and Earth Sciences, Notre Dame, Indiana, USA

Page created: July 09, 2021
Page updated: August 18, 2021
Page reviewed: August 18, 2021
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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