Can Wastewater be Used to Improve our COVID-19 Surveillance Efforts?

Abstract

As the spread of COVID-19 continues to significantly impact daily life in the United States and globally, there is a need for a clear understanding of disease prevalence in communities. Traditional methods that rely on counting individual cases often result in underreporting due to limited access to testing or healthcare. This issue is further exacerbated by the spread of COVID-19 by asymptomatic or presymptomatic individuals who may not seek testing. Historically, wastewater surveillance has been used to provide population-level data on the prevalence of infectious diseases in communities. Data collected through wastewater surveillance has been used to advise public health control measures, such as vaccination campaigns, and to detect local outbreaks before cases are reported to public health authorities. For this reason, researchers around the globe have been analyzing wastewater samples for SARS-CoV-2 to assist in our response to the existing COVID-19 pandemic. This commentary discusses the potential utility of wastewater-based surveillance to advise public health control strategies for COVID-19 and discusses how it may be used to strengthen local surveillance efforts in Philadelphia.