Watching Epidemiology Go Down the Drain: Wastewater Surveillance and Public Health

Abstract

Wastewater-based epidemiology has been a powerful tool for community-level surveillance of SARS-CoV-2 virus during the COVID-19 pandemic. Individual diagnostic testing is inherently biased due to assumptions of access and voluntary participation. While wastewater surveillance offers a different set of biases, it has revolutionary potential to guide effective resource allocation through low-resolution monitoring at unprecedented scale and low cost. As governments build capacity for these tools, conversations are needed about the many biomarkers of human health, behaviour, and identity that can be detected through our sewage systems. While the potential for abuse of this information is low, wastewater epidemiology is inherently distasteful and invasive; it uses data collected from our most private moments to glean insights into other deeply personal information, like our health and consumption habits, and can be correlated with income and cultural identity. The potential exists for misuse of these data, particularly when combined with other personal information or in controlled settings like prisons. Researchers and institutions must be accountable not just for the data they produce, but also how law enforcement, government, and industry partners use those data.