Larsen, David

Dr. David A. Larsen is an Associate Professor at Syracuse University.

Titles from this speaker

Description: WEF-PHC22-Proceedings cover-2400x3200

Coupling freedom from disease principles and early warning from wastewater surveillance to improve health security

Abstract

Infectious disease surveillance is vitally important to maintaining health security, but these efforts are challenged by the pace at which new pathogens emerge. Wastewater surveillance can rapidly obtain population-level estimates of disease transmission, and we leverage freedom from disease principles to make use of non-detection of SARS-CoV-2 in wastewater to estimate the probability that a community is free from SARS-CoV-2 transmission. From wastewater surveillance of 24 treatment plants across upstate New York from May through December of 2020, we observed a reliable limit of detection of 0.3--0.5 cases per 10,000 population. No COVID-19 cases were reported 40% of the time following a non-detection of SARS-CoV-2 in wastewater, and cases were less than 1 daily case per 10,000 population 97% of the time following non-detection. Trends in the intensity of SARS-CoV-2 in wastewater correlate with trends in COVID-19 incidence and test positivity (>0.5), with the greatest correlation observed for active cases and a three-day lead time between wastewater sample date and clinical test date. Wastewater surveillance can cost-effectively demonstrate the geographic extent of the transmission of emerging pathogens, confirming that transmission is absent or under control and alerting of an increase in transmission. If a statewide wastewater surveillance platform had been in place prior to the onset of the COVID-19 pandemic, policymakers would have been able to complement the representative nature of wastewater samples to individual testing, likely resulting in more precise public health interventions and policies.

The following conference paper was presented at the Public Health and Water Conference & Wastewater Disease Surveillance Summit in Cincinnati, OH, March 21-24, 2022.

SpeakerLarsen, David

Presentation time

8:30:00

9:00:00

Session time

8:30:00

10:00:00

SessionTheory of Wastewater Surveillance

Session number15

Session locationDuke Energy Convention Center, Cincinnati, Ohio

Author(s)

Larsen, David

Author(s)D. Larsen1; M. Collins2; Q. Du3; T. Insaf4; P. Kilaru5; B. Kmush6; F. Middleton7; A. Stamm8; M. Wilder9; T. Zeng10; H. Green11

SourceProceedings of the Water Environment Federation

Document typeConference Paper

PublisherWater Environment Federation

Print publication date Mar, 2022

DOI10.2175/193864718825158297

Volume / Issue

Content sourcePublic Health and Water Conference

Word count16

Description: Ready and willing: New York State wastewater treatment plants show high capacity to...

Ready and willing: New York State wastewater treatment plants show high capacity to pull and ship samples as part of a public health wastewater surveillance network

Abstract

Background: Wastewater surveillance is an important and emergent public health tool that relies on robust infrastructure to work well including accessible wastewater sampling points, detailed information on sewer system service areas, and trained personnel. Wastewater treatment plants are perhaps the most convenient wastewater sampling points, as they already sample wastewater as part of their environmental safety requirements. To evaluate the capability of treatment plants of different sizes and characteristics to participate in surveillance efforts, we developed and distributed a survey to New York State treatment plant supervisors in the summer and fall of 2021. The goal of the survey is to assess the knowledge, capability, and attitudes toward wastewater surveillance as a public health tool. Objectives: Our objectives are twofold. First, we want to determine what data treatment plants have about their service areas and in what form including physical maps, geospatial information systems (GIS) data, and address lists. Knowledge of the service area (sewershed) is essential for linking wastewater surveillance data back to upstream populations. The second objective is a broader questionnaire to identify the capability and limitations to conduct surveillance across treatment plants of different sizes and in different communities from urban to more rural settings. This second objective also included an evaluation of the knowledge and attitudes that treatment plant supervisors have regarding wastewater surveillance to inform what kind of education and outreach efforts public health departments may have to engage in. Methods: A population of treatment plants was identified using New York State Department of Environmental Conservation information on municipal treatment plant locations. Contact information was obtained from state and regional offices. Of the 638 treatment plants identified, contact information was available for 377 of them. The plants were contacted between July and September of 2021 by email and phone to complete a survey asking about what data they have on their treatment plant service area and what they know about wastewater surveillance. A total of 93 treatment plants participated in the survey representing a 25% response rate and accounting for nearly 15% of all the municipal plants in the state. Summaries of responses were calculated as well as statistical comparisons between plants of different sizes. Results: Data on service areas is not universal with 23% of respondents reporting no data on their service areas. Regarding knowledge of surveillance for public health, 84% of respondents know that wastewater samples can track COVID-19 but only 51% are aware that it can also be used to track opioids. In addition, 39% of respondents agree that wastewater surveillance could be beneficial with their community with most respondents (44%) indicating they are unsure or have no opinion. We find high capacity for treatment plants to collect 24-hour composite samples with 69% of all treatment plants reporting ability to take at least one sample per week. Of the responses, 90% of larger plants surveyed (> 2 mg/d of flow) indicate ability to take one sample per week or more with 55% of smaller plants (< 2mg/d of flow) indicating the same ability. For grab samples, the capability is similar with 67% of respondents indicating ability to take samples at least once per week. For larger plants, 81% of respondents indicate ability to take grab samples at least once per week while 58% of smaller plants indicate the same ability. Discussion: Results suggest diverse capabilities across sewer systems with differences between treatment plants by size. Knowledge about surveillance is also mixed with most supervisors knowing that COVID-19 can be tested in wastewater but having less knowledge about surveillance capabilities for other things like opioids. Findings provide guidance for outreach activities with results suggesting education and communication with treatment plant personnel would be beneficial to increase awareness of what surveillance can do to benefit public health. Results also provide important insight into treatment plant capabilities as they are connected to internal factors such as size, which may help public health departments understand the limitations and ability of future participation. Overall, we find that most treatment plants in New York State, regardless of size, report ability to conduct surveillance at least once per week suggesting that statewide scaleup of surveillance programs could occur with most treatment plants simply needing the knowledge and guidance on what to surveil. Next steps include evaluation for additional patterns across population levels and urban v. rural dynamics to better aid health departments in targeting resources for training, education, and equipment.

The following conference paper was presented at the Public Health and Water Conference & Wastewater Disease Surveillance Summit in Cincinnati, OH, March 21-24, 2022.

SpeakerLarsen, David

Presentation time

15:45:00

16:00:00

Session time

15:45:00

16:45:00

SessionState Cases and Practice Innovations

Session number13

Session locationDuke Energy Convention Center, Cincinnati, Ohio

TopicOperations And Maintenance, Smart Data Infrastructure

Author(s)