Optimizing Spatial Distribution of Wastewater-Based Disease Surveillance to Advance Health Equity

Abstract

AbstractIn 2022, the US Centers for Disease Control and Prevention commissioned the National Academies of Sciences, Engineering, and Medicine to assess the role of community-level wastewater-based disease surveillance (WDS) beyond COVID-19. WDS is recognized as a promising mechanism for promptly identifying infectious diseases, including COVID-19 and other novel pathogens. An important conclusion drawn from this initiative is that it is crucial to maintain equity and expand access to maximize the advantages of WDS for marginalized communities. To address this need, we propose an optimization framework that focuses on the strategic allocation of wastewater monitoring resources at the wastewater treatment plant level. The framework’s purpose is to obtain a balanced spatial distribution, inclusive population coverage, and efficient representation of vulnerable communities in allocating resources for WDS. This study offers an opportunity to improve wastewater surveillance by tailoring location selection strategies to address specific priorities, improving decision-making in public health responses.