Wastewater surveillance of pathogens can inform public health responses. Comment from megan_b_diamond svscarpino and colleagues RockefellerFdn
Considerable hurdles must be overcome at each phase of wastewater monitoring before it reaches its full potential as a variant-surveillance approach. First, clinical sequences are often needed for the identification of novel variants and for guiding the development of primers for assays used to identify those variants in wastewater.
Delays in wastewater reporting and ad hoc communication of findings can hamper the value and early-warning potential of this approach. Much of the power of these data comes from the ability to generate qualitative and quantitative situational awareness, through real-time data, about the spread of diseases across geographies.
Wastewater monitoring and sequencing require substantial will and collaboration among key stakeholders, including utilities, public health agencies and labs, which do not often work together and may have differing priorities. Even when sequencing capacity is available and there is sufficient buy-in, communities may not be accepting of this technology.
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