Optimal selection of monitoring sites in cities for SARS-CoV-2 surveillance in sewage networks

Optimizing spatial distribution of wastewater-based epidemiology to advance health equity

In 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 epidemiology (WBE) beyond COVID-19. WBE is recognized as a promising mechanism for promptly identifying infectious diseases, including COVID-19 and other novel pathogens. An important conclusion from this initiative is the critical importance of maintaining equity and expanding access to fully realize the benefits of wastewater surveillance for marginalized communities. To address this need, we propose an optimization framework that strategically allocates wastewater monitoring resources at the wastewater treatment plant (WWTP) level, ensuring more effective and equitable distribution of surveillance efforts to serve underserved populations. The purpose of the framework is to obtain a balanced spatial distribution, inclusive population coverage, and efficient representation of disadvantaged groups in the allocation of resources for WBE. Furthermore, the framework concentrates on areas with high population density and gives priority to vulnerable regions, as well as identifying signals that display significant variations from other monitored sources. The optimization objective is to maximize a weighted combination of these critical factors. This problem is formulated as an integer optimization problem and solved using simulated annealing. We evaluate various scenarios, considering different weighting factors, to optimize the allocation of WWTPs with monitoring systems. This optimization framework provides an opportunity to enhance WBE by providing customized monitoring strategies created to address specific priorities and situations, thus enhancing the decision-making processes in public health responses.

Information-theoretic sensor placement for large sewer networks

Utility operators face a challenging task in managing sewer networks to proactively enhance network monitoring. To address this issue, this paper develops a framework for optimized placing of sensors in sewer networks with the aim of maximizing the information obtained about the state of the network. To that end, mutual information is proposed as a measure of the evidence acquired about the state of the network by the placed sensors. The problem formulation leverages a stochastic description of the network states to analytically characterize the mutual information in the system and pose the sensor placement problem. To circumvent the combinatorial problem that arises in the placement configurations, we propose a new algorithm coined the one-step modified greedy algorithm, which employs the greedy heuristic for all possible initial sensor placements. This algorithm enables further exploration of solutions outside the initial greedy solution within a computationally tractable time. The algorithm is applied to two real sewer networks, the first is a sewer network in the south of England with 479 nodes and 567 links, and the second is the sewer network in Bellinge, a village in Denmark that contains 1020 nodes and 1015 links. Sensor placements from the modified greedy algorithm are validated by comparing their performance in estimating unmonitored locations against other heuristic placements using linear and neural network models. Results show the one-step modified greedy placements outperform others in most cases and tend to cluster sensors for efficiently monitoring parts of the network. The proposed framework and modified greedy algorithm provide wastewater utility operators with a sensor placement method that enables them, for the first time, to design the data acquisition and monitoring infrastructure for large sewer networks.

Enhancing reclaimed water distribution network resilience with cost-effective meshing

Water Distribution Networks (WDNs) are critical infrastructures that ensure a continuous supply of safe water to homes. In the face of challenges, like water scarcity, establishing resilient networks is imperative, especially in regions vulnerable to water crises. This study evaluates the resilience of network designs through graph theory, including its hydraulic feasibility using EPANET software, an aspect often overlooked. Novel mathematical algorithms, including Resilience by Design (RbD) and Resilience-strengthening (RS) algorithms, provide cost-effective and resilient network designs, even with budget constraints. A novel metric, Water Availability (WA), is introduced to offer a comprehensive measure of network resilience, thereby addressing ongoing discrepancies in resilience evaluation methods. Practical benefits are illustrated through a case study in which a resilient-by-design reclaimed water network is created, and an existing equivalent non-resilient network is improved. The resilient-by-design network demonstrates remarkably better results compared to the equivalent non-resilient design, including up to a 36 % reduction in the probability of service disruptions and a nearly 65 % decrease in the annual average unserved water due to service disruptions. These findings underscore the enormous advantages of a resilience-focused network design approach. When compared to the equivalent non-resilient design, the resilient-by-design network generated effectively safeguards up to a significant 91,700m3 of water from the impacts of water disruption events over a 50-year operational period. In addition, the resilient-by-design WDN solution incurs a subtle decrease in overall costs compared to consuming tap water from the drinking WDN baseline over a 50-year operational period. These findings highlight the cost-effectiveness of the approach, even offering financial benefits. This paper builds on our previous research by expanding its scope to include resilience considerations, providing algorithms that can be easily adapted from reclaimed to drinking WDNs. Ultimately, we contribute to the enhancement of water resource management and infrastructure planning in ever-evolving urban environments.

Advancing Public Health Surveillance: Integrating Modeling and GIS in the Wastewater-Based Epidemiology of Viruses, a Narrative Review

This review article will present a comprehensive examination of the use of modeling, spatial analysis, and geographic information systems (GIS) in the surveillance of viruses in wastewater. With the advent of global health challenges like the COVID-19 pandemic, wastewater surveillance has emerged as a crucial tool for the early detection and management of viral outbreaks. This review will explore the application of various modeling techniques that enable the prediction and understanding of virus concentrations and spread patterns in wastewater systems. It highlights the role of spatial analysis in mapping the geographic distribution of viral loads, providing insights into the dynamics of virus transmission within communities. The integration of GIS in wastewater surveillance will be explored, emphasizing the utility of such systems in visualizing data, enhancing sampling site selection, and ensuring equitable monitoring across diverse populations. The review will also discuss the innovative combination of GIS with remote sensing data and predictive modeling, offering a multi-faceted approach to understand virus spread. Challenges such as data quality, privacy concerns, and the necessity for interdisciplinary collaboration will be addressed. This review concludes by underscoring the transformative potential of these analytical tools in public health, advocating for continued research and innovation to strengthen preparedness and response strategies for future viral threats. This article aims to provide a foundational understanding for researchers and public health officials, fostering advancements in the field of wastewater-based epidemiology.

Small-scale wastewater-based epidemiology (WBE) for infectious diseases and antibiotic resistance: A scoping review

Wastewater analysis can serve as a source of public health information. In recent years, wastewater-based epidemiology (WBE) has emerged and proven useful for the detection of infectious diseases. However, insights from the wastewater treatment plant do not allow for the small-scale differentiation within the sewer system that is needed to analyze the target population under study in more detail. Small-scale WBE offers several advantages, but there has been no systematic overview of its application. The aim of this scoping review is to provide a comprehensive overview of the current state of knowledge on small-scale WBE for infectious diseases, including methodological considerations for its application. A systematic database search was conducted, considering only peer-reviewed articles. Data analyses included quantitative summary and qualitative narrative synthesis. Of 2130 articles, we included 278, most of which were published since 2020. The studies analyzed wastewater at the building level (n = 203), especially healthcare (n = 110) and educational facilities (n = 80), and at the neighborhood scale (n = 86). The main analytical parameters were viruses (n = 178), notably SARS-CoV-2 (n = 161), and antibiotic resistance (ABR) biomarkers (n = 99), often analyzed by polymerase chain reaction (PCR), with DNA sequencing techniques being less common. In terms of sampling techniques, active sampling dominated. The frequent lack of detailed information on the specification of selection criteria and the characterization of the small-scale sampling sites was identified as a concern. In conclusion, based on the large number of studies, we identified several methodological considerations and overarching strategic aspects for small-scale WBE. An enabling environment for small-scale WBE requires inter- and transdisciplinary knowledge sharing across countries. Promoting the adoption of small-scale WBE will benefit from a common international conceptualization of the approach, including standardized and internationally accepted terminology. In particular, the development of good WBE practices for different aspects of small-scale WBE is warranted. This includes the establishment of guidelines for a comprehensive characterization of the local sewer system and its sub-sewersheds, and transparent reporting to ensure comparability of small-scale WBE results.

Development of a computational model to inform environmental surveillance sampling plans for Salmonella enterica serovar Typhi in wastewater

Typhoid fever-an acute febrile disease caused by infection with the bacterium Salmonella enterica serotype Typhi (S. Typhi)-continues to be a leading cause of global morbidity and mortality, particularly in developing countries with limited access to safe drinking water and adequate sanitation. Environmental surveillance, the process of detecting and enumerating disease-causing agents in wastewater, is a useful tool to monitor the circulation of typhoid fever in endemic regions. The design of environmental surveillance sampling plans and the interpretation of sampling results is complicated by a high degree of uncertainty and variability in factors that affect the final measured pathogens in wastewater samples, such as pathogen travel time through a wastewater network, pathogen dilution, decay and degradation, and laboratory processing methods. Computational models can, to an extent, assist in the design of sampling plans and aid in the evaluation of how different contributing factors affect sampling results. This study presents a computational model combining dynamic and probabilistic modeling techniques to estimate-on a spatial and temporal scale-the approximate probability of detecting S. Typhi within a wastewater system. This model may be utilized to inform environmental surveillance sampling plans and may provide useful insight into selecting appropriate sampling locations and times and interpreting results. A simulated applied modeling scenario is presented to demonstrate the model's functionality for aiding an environmental surveillance study in a typhoid-endemic community.

Seamless integration of sewer system topology and tree location data: An algorithm to diagnose the potential impact of tree roots on pipes and propose rearrangement solutions

Wastewater networks are subject to several threats leading to wastewater leakages and public health hazards. External elements such as natural factors and human activities are common causes of wastewater leakages and require more in-depth analysis. Prevention and rehabilitation work is essential to secure wastewater networks and avoid pipe failures. This work presents a new algorithm that allows for the seamless integration of sewer topology and tree location data to diagnose the potential impact of tree roots on pipes. The algorithm also proposes tree rearrangement options that balance the cost of tree rearrangement with the cost of pipe repair. The paper also showcases a real-world case study in the city of Girona to evaluate the performance of the presented algorithms for a specific case focusing on tree roots as a natural factor. Results show that it is possible to optimally rearrange a number of the trees with the greatest impact, significantly minimizing pipe failures and wastewater leakages (82% risk reduction with only rearranging a 12% of the most impactful trees). The rearrangement solution not only protects the environment and prevents public health hazards, but also achieves a positive economic payback during the operational period of the pipes, saving up to 1.33M€ for a tree rearrangement of 7%. The presented methodology is applicable to other natural or human factors.

Optimal Selection of Sampling Points within Sewer Networks for Wastewater-Based Epidemiology Applications

Wastewater-based epidemiology (WBE) has great potential to monitor community public health, especially during pandemics. However, it faces substantial hurdles in pathogen surveillance through WBE, encompassing data representativeness, spatiotemporal variability, population estimates, pathogen decay, and environmental factors. This paper aims to enhance the reliability of WBE data, especially for early outbreak detection and improved sampling strategies within sewer networks. The tool implemented in this paper combines a monitoring model and an optimization model to facilitate the optimal selection of sampling points within sewer networks. The monitoring model utilizes parameters such as feces density and average water consumption to define the detectability of the virus that needs to be monitored. This allows for standardization and simplicity in the process of moving from the analysis of wastewater samples to the identification of infection in the source area. The entropy-based model can select optimal sampling points in a sewer network to obtain the most specific information at a minimum cost. The practicality of our tool is validated using data from Hildesheim, Germany, employing SARS-CoV-2 as a pilot pathogen. It is important to note that the tool's versatility empowers its extension to monitor other pathogens in the future.

The relationship between dynamic monitoring network plans and eco-efficiency - New evidence from atmospheric quality monitoring policy in China

China's rapid economic development in recent decades has come at a considerable environmental cost. This paper explores whether atmospheric quality monitoring policy (AQMP) improves eco-efficiency by using AQMP as a natural experimental group. We assessed the eco-efficiency of 285 cities in China from 2009 to 2019 using the super-efficient SBM model and estimated the impact of AQMP using the propensity score method Difference-in-Difference (PSM-DID) model. The key findings of this paper are as follows: First, AQMP can enhance eco-efficiency, promoting sustainable urban development. Second, governmental and non-governmental organizations play contrasting roles in either fostering or reversing the positive effects of AQMP. Factors like innovation, clean energy adoption, and industrial structure have a positive mediating influence. Finally, the impact of AQMP on eco-efficiency varies across cities, displaying heterogeneity. Specifically, AQMP has a positive effect on eco-efficiency in resource-rich cities, small and medium-sized urban centers, smart cities, and coastal areas. These findings carry significant implications for the establishment of dynamic monitoring networks and the advancement of eco-efficiency in emerging countries, including China.

Analyzing community wastewater in sub-sewersheds for the small-scale detection of SARS-CoV-2 variants in a German metropolitan area

Wastewater surveillance of SARS-CoV-2 proved useful, including for identifying the local appearance of newly identified virus variants. Previous studies focused on wastewater treatment plants (WWTP) with sewersheds of several hundred thousand people or at single building level, representing only a small number of people. Both approaches may prove inadequate for small-scale intra-urban inferences for early detection of emerging or novel virus variants. Our study aims (i) to analyze SARS-CoV-2 single nucleotide variants (SNVs) in wastewater of sub-sewersheds and WWTP using whole genome sequencing in order to (ii) investigate the potential of small-scale detection of novel known SARS-CoV-2 variants of concern (VOC) within a metropolitan wastewater system. We selected three sub-sewershed sampling sites, based on estimated population- and built environment-related indicators, and the inlet of the receiving WWTP in the Ruhr region, Germany. Untreated wastewater was sampled weekly between October and December 2021, with a total of 22 samples collected. SARS-CoV-2 RNA was analyzed by RT-qPCR and whole genome sequencing. For all samples, genome sequences were obtained, while only 13 samples were positive for RT-qPCR. We identified multiple specific SARS-CoV-2 SNVs in the wastewater samples of the sub-sewersheds and the WWTP. Identified SNVs reflected the dominance of VOC Delta at the time of sampling. Interestingly, we could identify an Omicron-specific SNV in one sub-sewershed. A concurrent wastewater study sampling the same WWTP detected the VOC Omicron one week later. Our observations suggest that the small-scale approach may prove particularly useful for the detection and description of spatially confined emerging or existing virus variants circulating in populations. Future studies applying small-scale sampling strategies taking into account the specific features of the wastewater system will be useful to analyze temporal and spatial variance in more detail.

Detection of SARS-CoV-2 in Environment: Current Surveillance and Effective Data Management of COVID-19

Since diagnostic laboratories handle large COVID-19 samples, researchers have established laboratory-based assays and developed biosensor prototypes. Both share the same purpose; to ascertain the occurrence of air and surface contaminations by the SARS-CoV-2 virus. However, the biosensors further utilize internet-of-things (IoT) technology to monitor COVID-19 virus contamination, specifically in the diagnostic laboratory setting. The IoT-capable biosensors have great potential to monitor for possible virus contamination. Numerous studies have been done on COVID-19 virus air and surface contamination in the hospital setting. Through reviews, there are abundant reports on the viral transmission of SARS-CoV-2 through droplet infections, person-to-person close contact and fecal-oral transmission. However, studies on environmental conditions need to be better reported. Therefore, this review covers the detection of SARS-CoV-2 in airborne and wastewater samples using biosensors with comprehensive studies in methods and techniques of sampling and sensing (2020 until 2023). Furthermore, the review exposes sensing cases in public health settings. Then, the integration of data management together with biosensors is well explained. Last, the review ended with challenges to having a practical COVID-19 biosensor applied for environmental surveillance samples.

An innovative approach for predicting pandemic hotspots in complex wastewater networks using graph theory coupled with fuzzy logic

Early prediction of COVID-19 infected communities (potential hotspots) is essential to limit the spread of virus. Diagnostic testing has limitations in big populations because it cannot deliver information at a fast enough rate to stop the spread in its early phases. Wastewater based epidemiology (WBE) experiments showed promising results for brisk detection of 'SARS CoV-2' RNA in urban wastewater. However, a systematic and targeted approach to track COVID-19 virus in the complex wastewater networks at a community level is lacking. This research combines graph network (GN) theory with fuzzy logic to determine the chances of a specific community being a COVID-19 hotspot in a wastewater network. To detect 'SARS-CoV-2' RNA, GN divides wastewater network into communities and fuzzy logic-based inference system is used to identify targeted communities. For the propose of tracking, 4000 sample cases from Minnesota (USA) were tested based on various contributing factors. With a probability score of greater than 0.8, 42% of cases were likely to be designated as COVID-19 hotspots based on multiple demographic characteristics. The research enhances the conventional WBE approach through two novel aspects, viz. (1) by integrating graph theory with fuzzy logic for quick prediction of potential hotspot along with its likelihood percentage in a wastewater network, and (2) incorporating the uncertainty associated with COVID-19 contributing factors using fuzzy membership functions. The targeted approach allows for rapid testing and implementation of vaccination campaigns in potential hotspots. Consequently, governmental bodies can be well prepared to check future pandemics and variant spreading in a more planned manner.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00477-023-02468-3.

Optimal design of water reuse networks in cities through decision support tool development and testing

Water scarcity and droughts are an increasing issue in many parts of the world. In the context of urban water systems, the transition to circularity may imply wastewater treatment and reuse. Planning and assessment of water reuse projects require decision-makers evaluating the cost and benefits of alternative scenarios. Manual or semi-automatic approaches are still common practice for planning both drinking and reclaimed water distribution networks. This work illustrates a decision support tool that, based on open data sources and graph theory coupled to greedy optimization algorithms, is able to automatically compute the optimal reclaimed water network for a given scenario. The tool provides not only the maximum amount of served reclaimed water per unit of invested cost, but also the length and diameters of the pipes required, the location and size of storage tanks, the population served, and the construction costs, i.e., everything under the same architecture. The usefulness of the tool is illustrated in two different but complementary cities in terms of size, density, and topography. The construction cost of the optimal water reclaimed network for a city of approximately 100,000 inhabitants is estimated to be in the range of €0.17-0.22/m³ (for a payback period of 30 years).

When case reporting becomes untenable: Can sewer networks tell us where COVID-19 transmission occurs?

Monitoring SARS-CoV-2 in wastewater is a valuable approach to track COVID-19 transmission. Designing wastewater surveillance (WWS) with representative sampling sites and quantifiable results requires knowledge of the sewerage system and virus fate and transport. We developed a multi-level WWS system to track COVID-19 in Atlanta using an adaptive nested sampling strategy. From March 2021 to April 2022, 868 wastewater samples were collected from influent lines to wastewater treatment facilities and upstream community manholes. Variations in SARS-CoV-2 concentrations in influent line samples preceded similar variations in numbers of reported COVID-19 cases in the corresponding catchment areas. Community sites under nested sampling represented mutually-exclusive catchment areas. Community sites with high SARS-CoV-2 detection rates in wastewater covered high COVID-19 incidence areas, and adaptive sampling enabled identification and tracing of COVID-19 hotspots. This study demonstrates how a well-designed WWS provides actionable information including early warning of surges in cases and identification of disease hotspots.

Optimal allocation and operation of sewer monitoring sites for wastewater-based disease surveillance: A methodological proposal

Wastewater-based epidemiology (WBE) is drawing increasing attention as a promising tool for an early warning of emerging infectious diseases such as COVID-19. This study demonstrated the utility of a spatial bisection method (SBM) and a global optimization algorithm (i.e., genetic algorithm, GA), to support better designing and operating a WBE program for disease surveillance and source identification. The performances of SBM and GA were compared in determining the optimal locations of sewer monitoring manholes to minimize the difference among the effective spatial monitoring scales of the selected manholes. While GA was more flexible in determining the spatial resolution of the monitoring areas, SBM allows stepwise selection of optimal sampling manholes with equiareal subcatchments and lowers computational cost. Upon detecting disease outbreaks at a regular sewer monitoring site, additional manholes within the catchment can be selected and monitored to identify source areas with a required spatial resolution. SBM offered an efficient method for rapidly searching for the optimal locations of additional sampling manholes to identify the source areas. This study provides strategic and technical elements of WBE including sampling site selection with required spatial resolution and a source identification method.

Wastewater treatment plant operators report high capacity to support wastewater surveillance for COVID-19 across New York State, USA

Wastewater surveillance for infectious disease expanded greatly during the COVID-19 pandemic. As a collaboration between sanitation engineers and scientists, the most cost-effective deployment of wastewater surveillance routinely tests wastewater samples from wastewater treatment plants. To evaluate the capacity of treatment plants of different sizes and characteristics to participate in surveillance efforts, we developed and distributed a survey to New York State municipal treatment plant supervisors in the summer and fall of 2021. The goal of the survey was to assess the knowledge, capacity, and attitudes toward wastewater surveillance as a public health tool. Our objectives were to: (1) determine what treatment plant operators know about wastewater surveillance for public health; (2) assess how plant operators feel about the affordability and benefits of wastewater surveillance; and (3) determine how frequently plant personnel can take and ship samples using existing resources. Results show that 62% of respondents report capacity to take grab samples twice weekly. Knowledge about wastewater surveillance was mixed with most supervisors knowing that COVID-19 can be tracked via wastewater but having less knowledge about surveillance for other public health issues such as opioids. We found that attitudes toward wastewater testing for public health were directly associated with differences in self-reported capacity of the plant to take samples. Further, findings suggest a diverse capacity for sampling across sewer systems with larger treatment plants reporting greater capacity for more frequent sampling. Findings provide guidance for outreach activities as well as important insight into treatment plant sampling capacity as it is connected to internal factors such as size and resource availability. These may help public health departments understand the limitations and ability of wastewater surveillance for public health benefit.

Wastewater-based epidemiology (WBE) for SARS-CoV-2 - A review focussing on the significance of the sewer network using a Dublin city catchment case study

Wastewater-based epidemiology (WBE) has been employed by many countries globally since the beginning of the COVID-19 pandemic in order to assess the benefits of this surveillance tool in the context of informing public health measures. WBE has been successfully employed to detect SARS-CoV-2 at wastewater treatment plants for community-wide surveillance, as well as in smaller catchments and institutions for targeted surveillance of COVID-19. In addition, WBE has been successfully used to detect new variants, identify areas of high infection levels, as well as to detect new infection outbreaks. However, due to to the large number of inherent uncertainties in the WBE process, including the inherent intricacies of the sewer network, decay of the virus en route to a monitoring point, levels of recovery from sampling and quantification methods, levels of faecal shedding among the infected population, as well as population normalisation methods, the usefulness of wastewater samples as a means of accurately quantifying SARS-CoV-2 infection levels among a population remains less clear. The current WBE programmes in place globally will help to identify new areas of research aimed at reducing the levels of uncertainty in the WBE process, thus improving WBE as a public health monitoring tool for future pandemics. In the meantime, such programmes can provide valuable comparisons to clinical testing data and other public health metrics, as well being an effective early warning tool for new variants and new infection outbreaks. This review includes a case study of sampled wastewater from the sewer network in Dublin, Ireland, during a peak infection period of COVID-19 in the city, which evaluates the different uncertainties in the WBE process.

Data analytics during pandemics: a transportation and location planning perspective

The recent COVID-19 pandemic once again showed the value of harnessing reliable and timely data in fighting the disease. Obtained from multiple sources via different collection streams, an immense amount of data is processed to understand and predict the future state of the disease. Apart from predicting the spatio-temporal dynamics, it is used to foresee the changes in human mobility patterns and travel behaviors and understand the mobility and spread speed relationship. During this period, data-driven analytic approaches and Operations Research tools are widely used by scholars to prescribe emerging transportation and location planning problems to guide policy-makers in making effective decisions. In this study, we provide a review of studies which tackle transportation and location problems during the COVID-19 pandemic with a focus on data analytics. We discuss the major data collecting streams utilized during the pandemic era, highlight the importance of rapid and reliable data sharing, and give an overview of the challenges and limitations on the use of data.