Gable Lance, Ram Natalie, Ram Jeffrey L
School of Law, Wayne State University, Detroit, MI 48202, USA.
University of Maryland Francis King Carey School of Law, Baltimore, MD 21201, USA.
J Law Biosci. 2020 Jun 24;7(1):lsaa039. doi: 10.1093/jlb/lsaa039. eCollection 2020 Jan-Jun.
Scientists have observed that molecular markers for COVID-19 can be detected in wastewater of infected communities both during an outbreak and, in some cases, before the first case is confirmed. The Centers for Disease Control and Prevention and other government entities are considering whether to add community surveillance through wastewater monitoring to assist in tracking disease prevalence and guiding public health responses to the COVID-19 pandemic. This scientific breakthrough may lead to many useful potential applications for tracking disease, intensifying testing, initiating social distancing or quarantines, and even lifting restrictions once a cessation of infection is detected and confirmed. Yet, new technologies developed in response to a public health crisis may raise difficult legal and ethical questions about how such technologies may impact both the public health and civil liberties of the population. This paper describes recent scientific evidence regarding COVID-19 detection in wastewater, identifying public health benefits that may result from this breakthrough, as well as the limitations of existing data. The paper then assesses the legal and ethical implications of implementing policy based on positive sewage signals. It concludes that the first step to implementing legal and ethical wastewater monitoring is to develop scientific understanding. Even if reliability and efficacy are established, limits on sample and data collection, use, and sharing must also be considered to prevent undermining privacy and autonomy in order to implement these public health strategies consistent with legal and ethical considerations.
科学家们观察到，在新冠疫情爆发期间以及在某些情况下，在首例病例确诊之前，受感染社区的废水中都能检测到新冠病毒的分子标记物。美国疾病控制与预防中心以及其他政府机构正在考虑是否要通过废水监测增加社区监测，以协助追踪疾病流行情况并指导对新冠疫情的公共卫生应对措施。这一科学突破可能会带来许多有用的潜在应用，用于追踪疾病、加强检测、启动社交距离措施或隔离措施，甚至在检测到并确认感染停止后解除限制。然而，为应对公共卫生危机而开发的新技术可能会引发一些棘手的法律和伦理问题，即这些技术可能如何影响公众健康和民众的公民自由。本文描述了有关在废水中检测新冠病毒的最新科学证据，确定了这一突破可能带来的公共卫生益处以及现有数据的局限性。然后本文评估了基于污水阳性信号实施政策的法律和伦理影响。结论是，实施合法且符合伦理的废水监测的第一步是增进科学理解。即使确定了可靠性和有效性，为了在符合法律和伦理考量的情况下实施这些公共卫生策略，还必须考虑对样本及数据收集、使用和共享的限制，以防止侵犯隐私和自主权。
