Show us the data: global COVID-19 wastewater monitoring efforts, equity, and gaps.

A year since the declaration of the global coronavirus disease 2019 (COVID-19) pandemic, there were over 110 million cases and 2.5 million deaths. Learning from methods to track community spread of other viruses such as poliovirus, environmental virologists and those in the wastewater-based epidemiology (WBE) field quickly adapted their existing methods to detect SARS-CoV-2 RNA in wastewater. Unlike COVID-19 case and mortality data, there was not a global dashboard to track wastewater monitoring of SARS-CoV-2 RNA worldwide. This study provides a 1-year review of the "COVIDPoops19" global dashboard of universities, sites, and countries monitoring SARS-CoV-2 RNA in wastewater. Methods to assemble the dashboard combined standard literature review, Google Form submissions, and daily, social media keyword searches. Over 200 universities, 1400 sites, and 55 countries with 59 dashboards monitored wastewater for SARS-CoV-2 RNA. However, monitoring was primarily in high-income countries (65%) with less access to this valuable tool in low- and middle-income countries (35%). Data were not widely shared publicly or accessible to researchers to further inform public health actions, perform meta-analysis, better coordinate, and determine equitable distribution of monitoring sites. For WBE to be used to its full potential during COVID-19 and beyond, show us the data.

The need of an environmental justice approach for wastewater based epidemiology for rural and disadvantaged communities: A review in California.

Amid the 2019 coronavirus disease pandemic (COVID-19), the scientific community has a responsibility to provide accessible public health resources within their communities. Wastewater based epidemiology (WBE) has been used to monitor community spread of the pandemic. The goal of this review was to evaluate the need for an environmental justice approach for COVID-19 WBE starting with the state of California in the United States. Methods included a review of the peer-reviewed literature, government-provided data, and news stories. As of June 2021, there were twelve universities, nine public dashboards, and 48 of 384 wastewater treatment plants monitoring wastewater for SARS-CoV-2 within California. The majority of wastewater monitoring in California has been conducted in the urban areas of Coastal and Southern California (34/48), with a lack of monitoring in more rural areas of Central (10/48) and Northern California (4/48). Similar to the access to COVID-19 clinical testing and vaccinations, there is a disparity in access to wastewater testing which can often provide an early warning system to outbreaks. This research demonstrates the need for an environmental justice approach and equity considerations when determining locations for environmental monitoring.

Water, Health, and Environmental Justice in California: Geospatial Analysis of Nitrate Contamination and Thyroid Cancer.

Environmental health hazards are known to disproportionately burden marginalized communities. Agriculture, wastewater, and industrial waste contaminate surface and groundwater, used for drinking, with nitrates. High nitrate concentrations in drinking water have been linked to methemoglobinemia and, recently, thyroid cancer. With a large proportion of the nation's agriculture grown in California, thyroid cancer linked to nitrate water contamination is of concern. This research entailed geographic and statistical analysis of water, nitrate, health, and disadvantaged communities (DACs) in California. DACs are Californian defined areas that experience a combination of hardships from socioeconomic, health, and environmental fields. Our analysis of the California Cancer Registry and California Water Board's well data shows statistically significant correlation (p < 0.05) between nitrate contamination (wells >5 and 10 ppm NO3-N per square mile and percentage of total wells) and thyroid cancer incidence. DACs had twice the rate of thyroid cancer compared with non-DACs, and higher numbers of nitrate-contaminated wells and hot spots compared with the state averages. Almost half (47%) of the Central Valley's area contained DACs and 27% of wells >10 ppm NO3-N contaminants. Our study provides a method for other states and countries to conduct preliminary geospatial analysis between water contamination and health with open data. Maps and analysis from this research can inform the public, advocacy groups, and policy leaders of health-related concerns in relation to nitrate water contamination and environmental justice in California. DACs should be provided cost-effective drinking water monitoring and treatment, and governments should incentivize nitrate loading reductions in agriculture, industry, and wastewater. Future research is recommended with more localized, private health data on thyroid cancer incidence.