As we look toward the long-term management of SARS-CoV-2 (the virus that causes COVID-19), and indeed the anticipated emergence of other novel viruses, the role of wastewater testing is taking on new significance. In fact, it may turn out to play an even greater part than clinical diagnostics in our overall strategy.
Authorities everywhere have begun to recognize its importance, and programs have already started springing up in counties and municipalities in the United States and other countries. According to the Environmental Protection Agency (EPA):
“Preliminary research from across the country and around the world indicates that monitoring wastewater for the presence of the genetic marker of SARS-CoV-2, its RNA, may be useful as a sensitive early indicator of low levels of infections in the community. Having an early warning system to alert public health officials about infection, or the lack of infection, could be helpful to direct resources, such as individual testing, to the communities that might need it most.”
How Labs Can Get Involved
The EPA has research in progress to develop optimal programs and methods for wastewater SARS-CoV-2 testing and has published guidance on its site for labs looking to get involved.
The Centers for Disease Control (CDC) has recognized the important role of wastewater testing as well, and has published guidance of its own.
Merging Two Areas of Expertise
Wastewater treatment plant labs and environmental monitoring labs have a complete understanding of what is involved in wastewater testing: sampling methods, containers, depth, flow, dilutions, filtration, control samples and the like. Labs that are familiar with COVID testing, on the other hand, likely haven’t the faintest clue about such things. Likewise, those clinical diagnostics labs understand molecular testing including sample handling and prep, RNA extraction, rtPCR analysis, HIPAA and CLIA requirements, etc.
Tell a clinical lab to collect wastewater and test for SARS-CoV-2 and they would be hopelessly unequipped. But the reverse isn’t quite as true. Wastewater testing labs know all of the details that factor into how to collect and prepare waste samples to render meaningful analysis. They need only add PCR instrumentation and protocols. And they are not constrained by the HSS human patient testing regulations that govern clinical labs. To date, there has been no evidence that SARS-CoV-2 materials found in waste present any risk of infection.
What Does COVID Wastewater Testing Look Like In Practice?
The result is that we are seeing three main processes for wastewater COVID testing:
- Collaboration: One of the most natural approaches sees a CLIA lab with PCR testing capabilities partner with a wastewater facility. This partnership can vary in the division of responsibilities. In the most common structure, the WW facility handles sample collection and prep while the clinical lab handles RNA prep, extraction and testing. Reporting is currently mandated to be sent to public health departments, who may take care of passing data to the CDC. Otherwise the clinical results must be sent to the CDC as well. Unfortunately, systems vary from state to state — but most states are working to consolidate and simplify reporting burdens for the labs. In another widely-used approach, WW facilities send samples to research programs, many of which are government funded through universities.
- Consulting: Labs who find themselves in a position to do so are offering their services to municipalities, counties or other entities with their own sewage systems.
- Wastewater Lab COVID Testing: This model is growing slowly and may turn out to be the most common, as the general concept of wastewater-based epidemiology becomes more accepted and established as a normal part of wastewater management. Indeed, the highest levels in the US government are laying the foundations to make epidemiology a normal part of wastewater management. The Centers for Disease Control and Prevention (CDC) and the US Department of Health and Human Services (HHS), in collaboration with agencies throughout the federal government, are creating the National Wastewater Surveillance System (NWSS) in response to the COVID-19 pandemic.
CDC is currently developing a portal for state, tribal, local, and territorial health departments to submit wastewater testing data into a national database for use in summarizing and interpreting data for public health action. Participation in a national database will ensure data comparability across jurisdictions. Data from wastewater testing are not meant to replace existing COVID-19 surveillance systems, but are meant to complement them by providing:
- An efficient pooled community sample.
- Data for communities where timely COVID-19 clinical testing is underutilized or unavailable.
- Data at the sub-county level.
Notice where the emphasis is: data. At the end of the day, that is all any lab is about. Everything else is, in reality, simply a means to the end of reporting results. And where a pandemic emergency is concerned — or the monitoring and prevention thereof — it’s even more imperative that the data be accurate, complete and timely. And there’s no denying it, the only way to be sure of that is through automation, specifically a LIMS (or LIS, in medical parlance). Eliminating paper and manual data entry eliminates transcription errors, misreading of handwriting, omissions and faulty calculations. And it helps ensure timely reporting that meets the formats and other requirements of public health and federal authorities.
COVIDLiMS for Environmental & Wastewater Labs
Wastewater-based epidemiology, introduced in 2005, is only now beginning to grow into clinical significance. Until recently, its use was largely limited to measuring illicit drug consumption. Consequently, LIMS/LIS designed specifically for COVID-19 testing are scarce. Re-purposing systems for this unique functionality can be difficult — or at least time-consuming —and expensive. One exception is COVIDLiMS for Environmental and Wastewater Laboratories from LabLynx, Inc. Environmental and wastewater labs have long used LabLynx’s foundational cloud-based LIMS, ELab. The recent introduction of COVIDLiMS for SARS-CoV-2 testing incorporates all of the functionality needed for both traditional wastewater testing and SARS-CoV-2 testing of wastewater.
Join the Fight
The opportunity is there. And beyond the financial rewards, labs have the chance to make a meaningful contribution to the battle against COVID — indeed any similar health threat — both now and for the long term, as an established part of public health systems. Why not get involved in this brave new industry?
As an industry leader in laboratory informatics, LabLynx can help you through the LIMS for COVID testing deployment process. We can tailor our COVIDLiMS solution to your lab’s unique needs in as little as a week. For more information, contact at firstname.lastname@example.org or call 866-LABLYNX (522-5969).
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