Department of Physiology, School of Medicine, Wayne State University, Detroit, MI 48201, USA.
Department of Biochemistry, Microbiology, and Immunology, Wayne State University, Detroit, MI 48201, USA.
Int J Environ Res Public Health. 2023 Aug 25;20(17):6651. doi: 10.3390/ijerph20176651.
The public health emergency caused by the COVID-19 pandemic stimulated stakeholders from diverse disciplines and institutions to establish new collaborations to produce informed public health responses to the disease. Wastewater-based epidemiology for COVID-19 grew quickly during the pandemic and required the rapid implementation of such collaborations. The objective of this article is to describe the challenges and results of new relationships developed in Detroit, MI, USA among a medical school and an engineering college at an academic institution (Wayne State University), the local health department (Detroit Health Department), and an environmental services company (LimnoTech) to utilize markers of the COVID-19 virus, SARS-CoV-2, in wastewater for the goal of managing COVID-19 outbreaks. Our collaborative team resolved questions related to sewershed selection, communication of results, and public health responses and addressed technical challenges that included ground-truthing the sewer maps, overcoming supply chain issues, improving the speed and sensitivity of measurements, and training new personnel to deal with a new disease under pandemic conditions. Recognition of our complementary roles and clear communication among the partners enabled city-wide wastewater data to inform public health responses within a few months of the availability of funding in 2020, and to make improvements in sensitivity and understanding to be made as the pandemic progressed and evolved. As a result, the outbreaks of COVID-19 in Detroit in fall and winter 2021-2022 (corresponding to Delta and Omicron variant outbreaks) were tracked in 20 sewersheds. Data comparing community- and hospital-associated sewersheds indicate a one- to two-week advance warning in the community of subsequent peaks in viral markers in hospital sewersheds. The new institutional relationships impelled by the pandemic provide a good basis for continuing collaborations to utilize wastewater-based human and pathogen data for improving the public health in the future.
由 COVID-19 大流行引发的公共卫生紧急情况促使来自不同学科和机构的利益相关者建立新的合作关系,以便对该疾病做出明智的公共卫生应对。COVID-19 的基于污水的流行病学在大流行期间迅速发展,需要快速实施这种合作。本文的目的是描述在美国密歇根州底特律市,一所医学院和一所工程学院(韦恩州立大学)、当地卫生部门(底特律卫生局)和一家环境服务公司(LimnoTech)之间建立的新关系所面临的挑战和取得的成果,这些新关系旨在利用污水中的 COVID-19 病毒、SARS-CoV-2 的标志物来管理 COVID-19 疫情。我们的合作团队解决了与污水流域选择、结果沟通以及公共卫生应对相关的问题,并解决了技术挑战,包括核实污水管网图、克服供应链问题、提高测量速度和灵敏度以及培训新人员以在大流行条件下应对新疾病。合作伙伴之间认识到彼此的互补作用,并进行了清晰的沟通,使得在 2020 年获得资金支持后的几个月内,全市污水数据就可以为公共卫生应对提供信息,并随着大流行的发展和演变,不断提高灵敏度和理解能力。结果,2021-2022 年秋冬(对应 Delta 和 Omicron 变体爆发)底特律的 COVID-19 疫情在 20 个污水流域得到了追踪。比较社区和医院相关污水流域的数据表明,在医院污水流域病毒标志物随后出现高峰之前,社区中存在一到两周的预警。大流行所推动的新机构关系为利用基于污水的人类和病原体数据来改善未来公共卫生提供了良好的合作基础。