Beyond COVID-19: Designing Inclusive Public Health Surveillance by Including Wastewater Monitoring

Wastewater-based epidemiology is a promising and expanding public health surveillance method. The current wastewater testing trajectory to monitor primarily at community wastewater treatment plants was necessitated by immediate needs of the pandemic. Going forward, specific consideration should be given to monitoring vulnerable and underserved communities to ensure inclusion and rapid response to public health threats. This is particularly important when clinical testing data are insufficient to characterize community virus levels and spread in specific locations. Now is a timely call to action for equitably protecting health in the United States, which can be guided with intentional and inclusive wastewater monitoring.