Wastewater Surveillance to Inform Public Health Decision Making in Residential Institutions

Area of Science:

• Public Health
• Environmental Science
• Epidemiology

Background:

• Wastewater-based surveillance (WBS) is a valuable tool for monitoring population health.
• Residential institutions like colleges, prisons, and nursing homes utilized facility-level WBS during the COVID-19 pandemic.

Purpose of the Study:

• To investigate how decision-makers in US residential institutions interpreted and utilized WBS data.
• To understand the diverse applications and limitations of WBS in institutional public health responses.

Main Methods:

• Conducted in-depth, semistructured interviews with decision-makers across 6 diverse US residential institutions.
• Included universities, prisons, and skilled nursing facilities with over 70,000 residents and staff.

Main Results:

• WBS data demonstrated highly varied applications within institutions.
• Combined with clinical surveillance, WBS informed public health actions such as transmission reduction and resource allocation.
• WBS also supported institutional goals like stakeholder relations and stress reduction for decision-makers.

Conclusions:

• Diverse uses of WBS data can inform its expanded implementation in institutions.
• Findings support the development of community-scale WBS systems for public health monitoring.