Four Models of Wastewater-Based Surveillance for SARS-CoV-2 in Jail Settings: How Monitoring Wastewater Complements Individual Screening

Abstract

ObjectiveTo describe four unique models of implementing Wastewater Based Surveillance (WBS) for SARS-CoV-2 in jails of graduated sizes and differing architectural designs.MethodsThis study summarizes how jails of Cook County (Illinois, average daily population [ADP] 6000), Fulton County (Georgia, ADP 3000, Washington DC (ADP 1600) and Middlesex County (Massachusetts, ADP 875) initiated WBS between 2020 and 2023.ResultsPositive signal for SARS-CoV-2 via WBS can herald new onset of infection in a previously uninfected housing unit of a jail. Challenges in implementing WBS included political will and realized value, funding, understanding of the building architecture, and the need for granularity in the findings.ConclusionsWBS has been effective for detecting outbreaks of SARS-CoV-2 in differing sized jails, both those with dorm-based and cell-based architectural design.Policy implicationsGiven its effectiveness in monitoring SARS-CoV-2, WBS provides a model for population-based surveillance in carceral facilities for future infectious disease outbreaks.

Surveillance via wastewater monitoring and nasal self-collection of specimens (The SWANSS Study): A CFIR-informed qualitative study with key carceral and healthcare stakeholders

“…FCJ was one of the sites in the program. Later that year, with funding from the Bill & Melinda Gates Foundation, the Center for the Health of Incarcerated Persons (CHIP) at Emory University and Northwell Health (New Hyde Park, NY) began the SWANSS implementation study of self-collected nasal swab collection of specimens for PCR testing in tandem with WBS [13]. Opt-out nasal swab screening by laboratory-based PCR was conducted from October 2021-May 2022 on a weekly basis, in randomly chosen housing units, averaging 300 tests per week.…”

“…WBS data can also be used in tandem with clinical testing data provided by Polymerase Chain Reaction (PCR) and antigen testing; it can hasten the response to an outbreak and guide public health decision making [10]. We have previously demonstrated that WBS combined with NST is convenient and accurate, and acceptable among residents of FCJ [12][13][14]. The rst objective of the SWANSS (Surveillance via Wastewater monitoring And Nasal Self-Collection of Specimens) study was to nd a correlation between WBS and NST in a carceral setting [14].…”

Multiplexed detection, partitioning, and persistence of wild type and vaccine strains of measles, mumps, and rubella viruses in wastewater

“…Numerous use cases for how wastewater monitoring has been used by public health officials for decision-making have been demonstrated, including as an early warning system that can indicate disease trends and hospitalizations before other surveillance data (e.g. clinical testing) [1][2][3][4][5][6][7] , as a source of information on disease trends where there is limited case data 6,[8][9][10][11] , and as a tool for detecting localized outbreaks within communities [12][13][14][15][16][17][18][19][20][21] and facilities [22][23][24][25][26][27][28][29][30][31] . Another important use case for wastewater monitoring is to detect vaccine-preventable diseases and direct immunization resources.…”