Wastewater surveillance is a tool that can be used as a proactive method to predict SARS-Cov-2 infection trends in a population. Recently, Katrina Smith Korfmacher, Ph.D., professor and director of the Community Engagement Core of the Department of Environmental Medicine and Jim McGrath, Ph.D., professor of the Department of Biomedical Engineering, were granted a pilot award by the Translational Immunology and Infectious Disease Institute (TIIDI) to work on developing technology that improves the RNA detection process by pre-concentrating viral genomes using the McGrath laboratory’s silicon membranes prior to analysis by PCR. If their hypothesis is successful, this innovation will advance wastewater-based detection approaches at a fraction of the cost, complexity, and time-to-result compared to current methods.
The new study would be particularly useful for small scale sampling efforts that have been developed at both the community scale (at wastewater treatment plans) and at institutions like colleges, prisons, and nursing homes. Korfmacher became aware of the need for more rapid, cost-effective approaches to capturing SARS-CoV-2 RNA in the course of studying wastewater surveillance programs at colleges. She and her colleagues synthesized initial wastewater surveillance efforts at 25 colleges and universities from across the country. One goal was to use wastewater surveillance systems at colleges as a model to offer insight into how to address the associated challenges at larger scales. The results of the study were published in the International Journal of Environmental Public Health in September 2021.
The genetic material from the SARS-CoV-2 virus is detectable in sewage waste for many days. Wastewater surveillance can detect people who are asymptomatically infected with COVID-19 and people often shed the virus in their feces before they experience COVID symptoms. Therefore, measuring SARS-Cov-2 RNA concentrations in sewage can provide an early indicator of infection trends in the population. In the case of college campuses, wastewater surveillance can help identify dorms with infected students, providing an early warning to target clinical testing, contact tracing, and isolation/quarantine to quell emergent outbreaks.
Wastewater monitoring for COVID-19 detection is an existing process in many areas including many municipalities in New York, including Monroe County. Colleges and universities across the country have also been integrating wastewater surveillance into their ongoing efforts to manage COVID on their campuses, including St. John Fisher College and the Rochester Institute of Technology.
Korfmacher’s study highlights the significance of social, cultural and institutional factors affecting how wastewater monitoring might be perceived and acted upon. For example, it was found that universities with cultural, ethnic, or interest-themed dormitories resisted sharing dorm-level data out of concern for stigmatizing those residences’ populations. On a larger scale, some communities may object to wastewater surveillance based on fear of stigmatizing their members and neighborhoods.
These experiences highlight the importance of awareness of social factors while designing a wastewater surveillance system. Partnering with social scientists who can assess the community’s characteristics, attitudes and values may help design a successful strategy for collecting, sharing, and using wastewater-derived data. The study suggests a public “town hall,” an ongoing Community Advisory Board, or formalized multi stakeholder partnership as a few ways to incorporate place-specific community characteristics into the design of systems.
In an effort to further these partnerships in the Rochester region, Korfmacher convened a Monroe County Wastewater Surveillance Working Group that has been meeting since July 2020, including St. John Fisher College, the Rochester Institute of Technology, Monroe County’s Frank E. Van Lare Wastewater Treatment Plant, the town of Webster’s wastewater treatment plant, staff from the Monroe County Departments of Health and Environmental Services, and others in the region. This group continues to meet biweekly to interpret local wastewater results, share information, and coordinate future plans.
Korfmacher co-led the projects along with Sasha Harris-Lovett, Ph.D., postdoctoral fellow and external relations specialist for the Berkeley Water Center at the University of California Berkeley. Todd Camenisch, Ph.D., professor and chair at Wegmans School of Pharmacy at St. John Fisher College and adjunct Professor of Environmental Medicine at the University of Rochester Environmental Health Sciences Center, was also a co-author on the paper.
Written by Hanyia Ahmed ‘22