Combining community wastewater genomic surveillance with state clinical surveillance: A framework for SARS-CoV-2 public health practice

AbstractStudy objectiveTo garner a framework for combining community wastewater surveillance with state clinical surveillance that influence confirmation of SARS-CoV-2 variants within the community, and recommend how the flow of such research evidence could be expanded and employed for public health response.Design, setting, and participantsThis work involved analyzing wastewater samples collected weekly from 17 geographically resolved locations in Louisville/Jefferson County, Kentucky from February 10 to November 29, 2021. Genomic surveillance and RT-qPCR platforms were used as screening to identify SARS-CoV-2 in wastewater, and state clinical surveillance was used for confirmation.Main resultsThe results demonstrate increased epidemiological value of combining community wastewater genomic surveillance and RT-qPCR with conventional case auditing methods. The spatial scale and temporal frequency of wastewater sampling provides promising sensitivity and specificity to be useful to gain public health screening insights about community emergence, seeding, and spread.ConclusionsBetter national surveillance systems are needed for future pathogens and variants, and wastewater-based genomic surveillance represents opportune coupling. This paper presents current evidence that complementary wastewater and clinical testing is enhanced cost-effectively when linked; making a strong case for a joint public health framework. The findings suggest significant potential for rapid progress to be made in extending this work to consider pathogens of interest as a whole within wastewater, which could be examined in either a targeted fashion as we currently do with SARS-CoV-2 or in terms of a global monitoring of all pathogens found, and developing evidence based public health practice to best support community health.Thumbnail BoxWhat is already known on this subject?The primary approach for the genomic surveillance of SARS-CoV-2 relies on the sequencing of clinical COVID-19 samples. Variants of SARS-CoV-2 can also be tracked in community wastewater.What this study adds?We propose that, for comprehensive community surveillance, the first line of community pathogen screening should involve geographically-resolved wastewater samples collected at a regular frequency and employ both Next Generation Sequencing (NGS) and RT-qPCR. These results could then be compared with state clinical surveillance. This framework is a more comprehensive and cost-effective approach for surveillance in practice to catch community emergence, seeding, and spread.Policy implicationsOur results present a framework that could support the implementation of better surveillance policies directed to solve future community pathogen and variant detection. We anticipate this work can help public health officials implement rational community sampling schemes and develop sensible coordination with other clinical surveillance. The utility of this for COVID-19 extends to many other infectious disease models and other public health hazards such as toxic exposures.

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Use and effectiveness of mHealth technologies in tracking the spread of infectious disease outbreaks and their implications for the COVID-19 pandemic: a systematic review protocol (Preprint)

10.2196/preprints.23192 ◽

2020 ◽

Author(s):

Madison Milne-Ives ◽

Simon Rowland ◽

Alison McGregor ◽

J Edward Fitzgerald ◽

Edward Meinert

Keyword(s):

Public Health ◽

Infectious Disease ◽

Systematic Review ◽

Public Health Practice ◽

Disease Outbreaks ◽

Digital Technologies ◽

World Health ◽

Health Practice ◽

Public Health Response ◽

Infectious Disease Outbreaks

BACKGROUND The World Health Organisation (WHO) defines mHealth as medical and public health practice supported by mobile devices. A number of mHealth devices, primarily apps designed to support contact tracing, have been utilised as part of the public health response to the Covid-19 pandemic. The value of mHealth devices in augmenting public health practice is however yet to be defined. OBJECTIVE The study aims to address three research questions: (1) What digital technologies are being used to track the symptoms and spread of infectious disease outbreaks and what strategies do they use to do so? (2) How effective and cost-effective are digital technologies at tracking the spread of infectious disease outbreaks and what are their strengths and limitations? (3) What are the user perspectives on the usability and effectiveness of these technologies? METHODS The PICOS template and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) will be followed for this systematic review. The review will be composed of a literature search, article selection, data extraction, quality appraisal, data analysis, and a discussion of the implications of the data for the current COVID-19 pandemic. RESULTS N/A CONCLUSIONS This systematic review will summarise the available evidence for use of mHealth devices for tracking the spread of infectious disease outbreaks. These results are potentially valuable for informing public health policy during infectious disease outbreaks such as the current Covid-19 pandemic.

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4.C. Round table: Recovering from the COVID-19 Pandemic: Identifying and Acting Upon Lessons Learned

European Journal of Public Health ◽

10.1093/eurpub/ckab164.257 ◽

2021 ◽

Vol 31 (Supplement_3) ◽

Author(s):

◽

Keyword(s):

Public Health ◽

Public Health Practice ◽

Lessons Learned ◽

European Countries ◽

Scientific Uncertainty ◽

Health Practice ◽

Public Health Response ◽

The Public ◽

Health Response ◽

Wide Range

Abstract The COVID-19 pandemic has revealed many gaps and vulnerabilities in health systems and pandemic preparedness in European countries. It has also led to innovation and rapid improvements in certain elements of public health practice. One defining characteristic of the COVID-19 pandemic has been the rapid advance of scientific knowledge, accompanied by high degrees of scientific uncertainty. Each phase (or “wave”) of the pandemic has presented unique challenges. This workshop involves public health practitioners from multiple European countries. They will reflect upon some over-arching lessons learned through their experiences in the field, while also alluding to important innovations in public health that should be safeguarded for the future. The panellists will also discuss how lessons learned can be systematically identified and acted upon, through approaches such as after-action reviews (AARs), in order to optimise the public health response to the ongoing COVID-19 pandemic as well as to future ones. The panel discussion format of this workshop adds value to EUPHA 2021 participant through hearing, in a relatively informal format, the experiences from senior staff at national public health agencies from a variety of European countries and contexts. This approach keeps a coherence between speakers will also highlighting the unique challenges posed by specific national contexts. This workshop will also consider how processes such as AARs can be formalised to become routine aspects of public health practice. Particular attention will be paid to challenges and solutions that are similar across national boundaries. During the workshop, the moderator will ensure that the panelists responses are short and succinct. The final 15 minutes will be dedicated to questions from the audience. Speakers/Panelists Flavia Riccardo ISS, Rome, Italy Ute Rexroth RKI, Berlin, Germany Tanya Melillo Directorate of Health Promotion and Disease Prevention, MSIDA, Malta Mario Fafangel National Institute of Public Health, Ljubljana, Slovenia Key messages In order to guide the public health response to the COVID-19 pandemic as well as to future pandemics, it is essential to systematically identify lessons learned as well as innovative good practices. Identifying lessons learned, however, is only a first step as it is essential to develop action plans that are supported and endorsed across a wide range of stakeholders.

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Translating Research and Surveillance into Action

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v6i1.5265 ◽

2014 ◽

Vol 6 (1) ◽

Cited By ~ 1

Author(s):

Wayne Loschen

Keyword(s):

Public Health ◽

Disaster Preparedness ◽

Disease Surveillance ◽

Public Health Practice ◽

Annual Conference ◽

Health Practice ◽

Public Health Response ◽

Making A Difference ◽

Surveillance Practice ◽

Public Health Epidemiology

The International Society for Disease Surveillance (ISDS) will hold its twelfth annual conference in New Orleans on December 12th and 13th, 2013. Led by the Society’s mission to improve population health by advancing the science and practice of disease surveillance, the conference brings together researchers and practitioners in public health, epidemiology, health policy, biostatistics and mathematical modeling, informatics, computer science, and related fields focused on biosurveillance and emerging challenges to public health practice. The theme of this year’s conference, Translating Research and Surveillance into Action, promotes the activities that are making a difference in the public health community. With abstracts submitted by authors from 36 countries, the conference will highlight research and successes in practice from around the world.Of the 211 abstracts submitted to the conference, 66 were chosen for oral presentation, 80 for posters, 4 for roundtable discussions, 4 for panels and 28 for a new presentation type, lightning talks. With 14 talks in 2 separate sessions, lightning talks will provide the audience with an information-packed series of 5 minute presentations. They will include themes like how to best use social media, what types of surveillance were performed during the 2013 Super Bowl, what algorithms work best for detection of outbreaks in resource-limited countries, and many other fantastic topics.In keeping with the conference theme of action, and due to the increasing frequency of major events requiring public health response (such as extreme weather and terrorist bombings), we are grateful to have Dr. David Abramson provide the opening keynote. Dr. Abramson is the deputy director of the National Center for Disaster Preparedness and can offer insight into how public health surveillance can be used before, during, and after disasters.We are also very pleased to have Dr. Gary Slutkin, the founder and executive director of the Cure Violence organization, speak at the conference. Dr. Slutkin will discuss his organization’s fascinating use of epidemiologic techniques applied to the problem of reducing gang violence in inner cities. We look forward to hearing their experience and the challenge of thinking about epidemiology and surveillance in a new light.I am looking forward to the 2013 ISDS Conference – it is one of the few places where public health practice, analytics, information technology, and policy seamlessly merge in a meaningful way. Every year I listen to inspiring success stories of surveillance practice, intriguing informatics techniques, brilliant analytical methods, and thoughtful policy discussions. And while all of those topics are remarkable by themselves, they are surpassed by the amazing people I meet and the connections that I make every year at ISDS!

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