Understanding and managing uncertainty and variability for wastewater monitoring beyond the pandemic: Lessons learned from the United Kingdom national COVID-19 surveillance programmes

Matthew J Wade, Anna Lo Jacomo, Elena Armenise, Mathew R Brown, Joshua T Bunce, Graeme J Cameron, Zhou Fang, Kata Farkas, Deidre F Gilpin, David W Graham, Jasmine M S Grimsley, Alwyn Hart, Till Hoffmann, Katherine J Jackson, David L Jones, Chris J Lilley, John W McGrath, Jennifer M McKinley, Cormac McSparron, Behnam F NejadMario Morvan, Marcos Quintela-Baluja, Adrian M I Roberts, Andrew C Singer, Célia Souque, Vanessa L Speight, Chris Sweetapple, David Walker, Glenn Watts, Andrew Weightman, Barbara Kasprzyk-Hordern

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Abstract

The COVID-19 pandemic has put unprecedented pressure on public health resources around the world. From adversity, opportunities have arisen to measure the state and dynamics of human disease at a scale not seen before. In the United Kingdom, the evidence that wastewater could be used to monitor the SARS-CoV-2 virus prompted the development of National wastewater surveillance programmes. The scale and pace of this work has proven to be unique in monitoring of virus dynamics at a national level, demonstrating the importance of wastewater-based epidemiology (WBE) for public health protection. Beyond COVID-19, it can provide additional value for monitoring and informing on a range of biological and chemical markers of human health. A discussion of measurement uncertainty associated with surveillance of wastewater, focusing on lessons-learned from the UK programmes monitoring COVID-19 is presented, showing that sources of uncertainty impacting measurement quality and interpretation of data for public health decision-making, are varied and complex. While some factors remain poorly understood, we present approaches taken by the UK programmes to manage and mitigate the more tractable sources of uncertainty. This work provides a platform to integrate uncertainty management into WBE activities as part of global One Health initiatives beyond the pandemic.

Original languageEnglish
Article number127456
JournalJournal of Hazardous Materials
Volume424
Issue numberPt B
Early online date8 Oct 2021
DOIs
Publication statusPublished - 15 Feb 2022

Bibliographical note

Funding Information:
The United Kingdom Government (Department of Health and Social Care) fund the sampling, testing, and data analysis of wastewater in England. The Scottish Government (Rural & Environmental Science and Analytical Services division, Covid Testing in the Health and Social Care division) funds the sampling, testing, and data analysis of wastewater in Scotland. The Welsh Government (Technical Advisory Cell) funds the sampling, testing, and data analysis of Wastewater in Wales. The initial phase of the ?SARS-CoV-2 wastewater surveillance and reporting SARS-CoV-2 in Northern Ireland project? was funded under the joint Science Foundation Ireland ? Department of Agriculture, Environment and Rural Affairs (DAERA) COVID-19 Rapid Response Funding Call (20/COV/8460-1). The second stage of the project is funded by DAERA in collaboration with the Public Health Agency NI (PHA-NI). The project partners include DAERA, PHA-NI, the NI Environment Agency, Department of Health, Department for Infrastructure, Belfast City Council and NI Water Ltd. We would also like to acknowledge NI Water for providing access to use spatial data for the NI Water's Wastewater Network. The following funding sources are acknowledged by the contributing authors: ?National COVID-19 Wastewater Epidemiology Surveillance programme (NE/V010441/1) UKRI-NERC COVID Response [DG, DJ, AS, VS, BK-H]; ?Building an Early Warning System for community-wide infectious disease spread: SARS-CoV-2 tracking in Africa via environment fingerprinting? (EP/V028499/1) GCRF/Newton Fund [BK-H].

Funding Information:
Wastewater surveillance in Northern Ireland (NI) has several unique challenges compared to other parts of the UK, which are related to the urban and rural distribution of population. NI has an extensive wastewater treatment network operated by Northern Ireland Water (NI Water). In total, there are 1114 STWs in the NI Water network, serving just under 80% of the NI population. Each STW serves a wastewater drainage catchment area of variable sizes. Up to 68% of the NI Population is served by the 40 largest STWs. However, these larger STWs serve predominantly urban, as opposed to rural communities, and tend to be disproportionately located in eastern parts of NI. The integrated wastewater testing and geographic surveillance programme for SARS-CoV-2 in NI is led by Queen’s University Belfast, funded by the Department of Agriculture, Environment and Rural Affairs (DAERA) in collaboration with the Public Health Agency NI (PHA-NI).

Appendix A. Supporting information
Supplementary data associated with this article can be found in the online version at doi:10.1016/j.jhazmat.2021.127456.

Keywords

  • Human pathogens
  • Measurement variability
  • Public health
  • Uncertainty analysis
  • Wastewater-based epidemiology

ASJC Scopus subject areas

  • Environmental Engineering
  • Environmental Chemistry
  • Waste Management and Disposal
  • Pollution
  • Health, Toxicology and Mutagenesis

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