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Pages 99-114

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From page 99... ... Even if courts did recognize a privacy interest in wastewater, they would still be unlikely to find that wastewater surveillance for infectious disease violates the Fourth Amendment. Provided that the wastewater data 4 Riverdale Mills Corp. Read the entire page →
From page 100... ... Ethical Concerns Arising from Community-Level Wastewater Surveillance Although legal concerns are minimal, two ethical issues arising from community-level wastewater surveillance merit close analysis: ensuring privacy and appropriate use of data. Privacy Considering whether wastewater surveillance unduly intrudes on people's privacy is ethically important because the ordinary moral and legal presumption in the United States is that individuals are entitled to control access to information about their health (Gable et al., 2020) Read the entire page →
From page 101... ... a court ruling that wastewater data can be subpoenaed or are admissible in criminal or civil proceedings unrelated to public health interventions -- for example, drug-related prosecutions; (2) any report of wastewater data sharing with law enforcement agencies, or use of wastewater surveillance infrastructure by law enforcement; (3) Read the entire page →
From page 102... ... . However, it is dubious whether such a high level of security is ethically required for community wastewater surveillance data, which are not individually identifiable. Read the entire page →
From page 103... ... Fostering public acceptance necessitates that concerns about data sharing and potential expansions of the scope of wastewater surveillance are addressed and requires good governance, accountability, and transparency (WHO, 2017) Read the entire page →
From page 104... ... If the rationale for an expansion in wastewater surveillance cannot be comfortably communicated to the public, that may be a sign that its ethical defensibility is questionable. ASSURING DATA QUALITY AND ACTIONABILITY Another important consideration to achieve the vision for a national wastewater surveillance system involves data quality and actionability. Read the entire page →
From page 105... ... Some level of methodological flexibility within the national wastewater surveillance system can be afforded as long as expectations for cross-validation with specific samples or standards are established and the data can be transformed by statistical methods into a comparable national-scale data set. Ongoing quality assurance and quality control will be important to provide the data required to correct for specific technical biases introduced by particular methods. Read the entire page →
From page 106... ... In summary, a national wastewater surveillance system can accommodate some degree of diversity in sampling and analytical approaches but only if additional investments are made in developing methods for standardizing data for purposes of comparison across geographic areas. Advancing Data Interpretation and Actionability In addition to generating reliable and comparable data, a national wastewater surveillance system needs to support timely interpretation of those data to support public health actions. Read the entire page →
From page 107... ... In summary, additional investments to accelerate access to wastewater surveillance data and to continue to improve available data analysis methods and robust tools in the NWSS would improve interpretation and enhance the actionability of wastewater surveillance. BUILDING BROAD AND SUSTAINABLE CAPACITY Ensuring that wastewater surveillance data are useful for informing public health action requires not only appropriate methods and tools to generate reliable data and information but also sufficient capacity among the partners that make up the wastewater surveillance system and a reasonable expectation that this capacity can be sustained. Read the entire page →
From page 108... ... Ongoing training and succession planning will be important to maintain the expertise. Increased investment in technology development that covers sampling devices and analytical methods would also strengthen the capacity of a national wastewater surveillance system. Read the entire page →
From page 109... ... State, tribal, local, and territorial health departments; public health laboratories; and local wastewater utilities can join one of three respective Communities of Practice dedicated to developing COVID-19 wastewater surveillance with the National Wastewater Surveillance System (NWSS) Read the entire page →
From page 110... ... Guidance and training on the analysis and interpretation of wastewater data would help build understanding and confidence in evaluating wastewater data patterns and using that information for public health decisions. Looking forward toward an expanded NWSS, public health guidance and training will need to include the following: • How to interpret the implications of wastewater surveillance data for disease epidemiology across a range of pathogens. Read the entire page →
From page 111... ... In summary, training public health practitioners and improving access to those with experience with wastewater surveillance implementation, analysis, and data interpretation is expected to increase the use of wastewater surveillance data for public health action. Expanding the Talent Pipeline Training within university programs in biomedical informatics, biostatistics, environmental engineering, epidemiology, microbiology, or other related fields is necessary to develop and maintain a workforce with the BOX 4-2 COVID-19 Wastewater Surveillance Centers of Excellence In August 2022, the Centers for Disease Control and Prevention (CDC) Read the entire page →
From page 112... ... Robust health informatics support that can set up and maintain complex systems is needed for automating and disseminating wastewater data efficiently. A wide range of health informatics is involved in wastewater surveillance that, ideally, would be integrated with other data streams within the public health system. Read the entire page →
From page 113... ... ACHIEVING INTEGRATION AND COLLABORATION Achieving the vision of an integrated, actionable wastewater surveillance program requires coordination and collaboration across many par Capacity Building • Transition NWSS from an emergency pandemic response to a sustained program • Support and train staff at utilities, laboratories, public health departments, NWSS data management • Assist workforce development • Provide state‐of‐the‐art equipment and tools Predictable and and access to commercial laboratory support A Robust National Sustained Wastewater Funding Surveillance System Advances in Science and Technology • Improve analytical approaches and reduce cost • Method validation criteria • New method development • Strategies to correlate and compare data • New algorithms for data analysis FIGURE 4-1 Areas for sustained investment to support the National Wastewater Surveillance System (NWSS) Read the entire page →
From page 114... ... will be necessary. Typically, the primary public health agency7 overseeing the wastewater surveillance program provides data interpretations and ensures that the wastewater data are integrated with other data sources (e.g., clinical testing, syndromic data) Read the entire page →

From page 99...

... Even if courts did recognize a privacy interest in wastewater, they would still be unlikely to find that wastewater surveillance for infectious disease violates the Fourth Amendment. Provided that the wastewater data 4 Riverdale Mills Corp.