A new report from the Government Accountability Office (GAO), found that water surveillance technology has allowed public health officials to detect community-level disease outbreaks and even identify COVID-19 outbreaks one to two weeks sooner than clinical testing. However, GAO found a lack of national coordination and standardized methods leads to challenges with wider adoption of the tech.

Wastewater surveillance has been used by public health officials to reveal COVID-19 outbreaks and the use of the technology has increased over the course of the pandemic through testing for viruses that enter the sewer systems in human waste.

“In the U.S., Federal, and local governments, universities, and companies have recently increased investments in wastewater surveillance in response to the COVID-19 pandemic,” wrote GAO. “As of February 2022, health departments in 43 jurisdictions, representing about 16 percent of the U.S. population, were using funds distributed by the Centers for Disease Control and Prevention (CDC) to support wastewater surveillance efforts.”

The CDC works with these jurisdictions to collect data that tracks COVID-19 levels and make data publicly available through its National Wastewater Surveillance System (NWSS) website. According to GAO, about 80 percent of the U.S. population could be monitored through such programs.

Among challenges in adoption include:

  • Difficulty in quantifying the value of wastewater surveillance systems due to a lack of cost-benefit analysis;
  • A lack of standardized methods for sample collection, analysis, and data sharing, making it more difficult to compare sites and focus mitigation efforts;
  • The origin of detected pathogens and chemicals may not always be clear; and
  • Using wastewater data could pose privacy concerns when linked with identifiable data, especially in small communities.

Should public health officials begin using wastewater surveillance technology – with challenges addressed – it could provide quicker public health responses and, along with other tools, be used to predict, prepare for, and initiate rapid responses. Additionally, local testing could provide opportunities to monitor and respond to pathogen spread and drug use.

Further, public health officials should be wary of gaps with wastewater surveillance and concerns. GAO said these gaps include aspects of the science needing further development, unclear cost savings, and privacy and ethical concerns – because wastewater contains human genetic data that could potentially be misused.

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