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Pages 7-20

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From page 7...
... The COVID-19 pandemic emergency spurred many researchers and utilities to volunteer their labor and donate resources in support of the effort, but the vision of a sustained national wastewater surveillance system necessitates a shift from volunteerism to a strategic national plan with well-defined roles supported by federal investments. Federal funding is needed to continue to advance sampling and analysis methods and data analysis tools to improve data quality, comparability, and actionability.
From page 8...
... At a federal level, CDC could set expectations and standards of practice that utilities be engaged as full partners, with compensation for their participation and education and data sharing to ensure that the utilities see the value of their contributions. Local public health agencies should work to build relationships with utilities, who can also provide important expertise essential to developing sound sampling designs and accurate data interpretation.
From page 9...
... The committee acknowledges that the word "surveillance" is a charged term also used in other contexts to describe careful watching by the police, although that use is not intended in this report. See Chapter 4 for a discussion about privacy considerations associated with implementing a ­national wastewater surveillance system.
From page 10...
... infectious disease for an individual person or household; rather, it detects the presence and changing quantities of a pathogen within the larger community. In the United States, 84 percent of households are connected to a wastewater treatment plant (U.S.
From page 11...
... ER AT T EW W AS FIGURE 1-1 Components of a community-level wastewater surveillance system. Infected persons can shed biomarkers of infection (see Box 1-1)
From page 12...
... (See Chapter 2 for an in-depth discussion of how wastewater surveillance has been useful in the COVID-19 pandemic.) In the remainder of this chapter, the committee discusses the development of the National Wastewater Surveillance System (NWSS)
From page 13...
... Even though clinical surveillance of acute flaccid paralysis was considered the gold standard for polio surveillance, throughout the latter half of the 20th century, numerous studies reported the use of wastewater surveillance in addressing poliovirus out breaks (Adu et al., 1998; Böttiger and Herrström, 1992; Gershy-Damet et al., 1987; Horstmann et al., 1973; Manor et al., 1999a,b; Marques et al., 1993; Pöyry et al., 1988; Thraenhart et al., 1977; van der Avoort et al., 1995; Zdrazílek et al., 1971)
From page 14...
... feeding into an individual wastewater treatment plant is termed its "sewershed." Sewersheds can range in size from very small to very large. Wastewater treat ment plants that submit samples to the National Wastewater Surveillance System serve populations that range in size from 100 to 4 million people, with a median of 45,000 people (A.
From page 15...
... INTRODUCTION 15 FIGURE 1-3-1  Map of sewersheds and sub-sewersheds used for SARS-CoV-2 in Jefferson County, Kentucky. NOTE: Triangles are wastewater treatment plants.
From page 16...
... The data are also used to monitor for early alerts of waves alongside other data such as emergency visits, general hospital bed use, and intensive care unit bed use. Tempe, The city quickly developed and implemented a wastewater Arizona surveillance program for SARS-CoV-2 by building off its existing opioid wastewater surveillance program.
From page 17...
... unless otherwise noted. is the first national-level wastewater disease surveillance system in the United States, and it coordinates with state-, tribal-, local-, and territoriallevel health departments to design and integrate wastewater surveillance data to inform public health decisions.
From page 18...
... A public health, commercial, or academic laboratory partner analyzes the samples, and the public health department interprets the data to identify trends regarding infection prevalence within a community, integrate the wastewater data with other surveillance data, and determine the appropriate public health response. The multidisciplinary nature of a national wastewater surveillance system requires extensive collaboration between and across health departments, testing laboratories, and wastewater utilities.
From page 19...
... .5 An additional $200 million in grants were made available from the ELC Enhancing Detection and Enhancing Detection Expansion program, supported by the Coronavirus Response and Relief Supplemental Appropriations Act of 2021.6 Finally, the NWSS was granted $384 million through the American Rescue Plan,7 starting in FY 2022 for use through 2025. In FY 2022, the NWSS supported wastewater surveillance initiatives in 42 states and 5 cities, with a total of $64 million in funding.
From page 20...
... Federal agencies also coordinate to prioritize federal research on wastewater sampling, analysis, and interpretation. Finally, NSSIL coordinates with several nongovernmen tal organizations, including the Association of Public Health Laboratories, the Association of State and Territorial Health Officials, the Water Envi ronment Federation, and the Water Research Foundation (see Figure 1-3)


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