Operator:
Thank you for standing by. At this time, all participants are in a listening mode until the question and answer session of today’s conference. At that time, you may press star one on your phone to ask a question. I would like to inform all parties that today’s conference is being recorded. If you have any objections, you may disconnect at this time. I will now turn today’s call over to Benjamin Haynes. Thank you. You may begin.
Benjamin Haynes:
Thank you Denise. Good morning and thank you all for joining us for today’s briefing on wastewater surveillance. We are joined by Dr. Amy Kirby, team lead for the National Wastewater Surveillance System. Following Dr. Kirby’s opening remarks, we will open it up for your questions. I’d now like to turn the call over to Dr. Kirby.
Dr. Amy Kirby:
Thank you, Ben. I’m here today to discuss the latest public health tool that’s providing critical information on COVID-19 trends, as well as giving us a glimpse into a new frontier of infectious disease surveillance in the U.S. Estimates suggests between 40 and 80% of people with COVID-19 shed viral RNA in their feces, making wastewater and sewage an important opportunity for monitoring the spread of infection. Seeing the value of collecting this type of data during the COVID-19 pandemic, CDC initiated the National Wastewater Surveillance System. Or NEWS for short, in September of 2020. What started as a grassroots effort by academic researchers and wastewater utilities has quickly become a nationwide surveillance system with more than 34,000 samples collected representing approximately 53 million Americans. Currently, CDC is supporting 37 states, four cities and two territories to help develop wastewater surveillance systems in their communities. More than 400 testing sites around the country have already begun their wastewater surveillance efforts.
Dr. Amy Kirby:
But the real power of this program will be more evident in the coming weeks when hundreds more testing sites will begin submitting data. The information generated by wastewater surveillance offers public health officials with better understanding COVID-19 trends in communities. Because increases in wastewater generally occur before corresponding increases in clinical cases, wastewater surveillance serves as an early warning system for the emergence of COVID-19 in a community. These data are uniquely powerful because they capture the presence of infections from people with and without symptoms. And they’re not affected by access to healthcare or availability of clinical testing. These built-in advantages can inform important public health decisions, such as where to allocate mobile testing and vaccination sites. Public health agencies have also used wastewater data to forecast changes in hospital utilization, providing additional time to mobilize resources and preparation for increasing cases. Now, wastewater data are available for the first time on CDCs COVID Data Tracker. Visitors to the site will be able to see changes in virus levels in wastewater over the previous 15 days for each participating community, as well as the percentage of tests from the past 15 days that are positive.
Dr. Amy Kirby:
Updated daily, the wastewater sampling locations, which are also called sewer sheds, are color coded based on the rate that SARS CO-V 2 levels are increasing or decreasing. You can also see information on the county served and the size of the population for each sewer shed. While data from wastewater surveillance can reveal new insights about COVID-19 prevalence, at both the community and national levels, there are some things that can’t tell us. Interpretation of data is limited in communities with minimal or no sewer infrastructure and in communities with transient populations, such as areas with high tourism. Additionally, wastewater surveillance cannot be used to determine whether a community is free from infections. For these reasons, wastewater surveillance is best used in combination with case based surveillance to maximize its value. We’ve already seen examples of cities and counties using their wastewater testing to better understand the trajectory of a surge of infections. Now more communities will have the opportunity to use this tool to help guide their public health decision making.
Benjamin Haynes:
Thank you, Dr. Kirby. Denise, we are now ready for questions.
Operator:
Thank you. The first question is from Erin Billups with Spectrum News Network. Your line is open.
Erin Billups:
Hi. Just wondering, one, what, if anything, can be done to maybe get more communities on board with this and plugged into this system and also what role this early warning system will help play moving forward. Is this one way that the country can move sort of out of a pandemic stage into a new normal by using the wastewater treatment samples that are collected?
Dr. Amy Kirby:
Sure. So let me touch on the first question. First about getting more communities onboard. So, we have developed a suite of resources to help our health departments build this capacity. And we have additional states building their systems now, and we expect the expect those to be available through COVID data tracker in the next few months. In addition, we have a commercial testing contract that will provide twice weekly testing to an additional 500 sites nationwide as those states build their systems. The second question about how this can be integrated into surveillance overall surveillance plans is a very good one and something that we are working closely with the rest of the COVID response here at CDC to find ways that wastewater surveillance can help provide situational awareness for what’s going on in a community. As well as serving as that early warning system that a new increase may be coming in a community.
Benjamin Haynes:
Next question, please.
Operator:
Next question comes from Tom Howell with The Washington Times.
Tom Howell:
Hey, thanks for doing the call. Can you explain whether this wastewater surveillance has been done for previous pathogens or diseases and what did you learn from that experience? Thanks.
Dr. Amy Kirby:
Wastewater surveillance has been used for many decades actually to track polio in communities, not in the U.S., but definitely overseas as part of the polio eradication efforts. And they use it essentially the same way we do – so to look for communities for polio is circulating and then use that as a trigger for additional clinical surveillance in those communities.
Benjamin Haynes:
Next question, please.
Operator:
That is from Fran Fritz with Very Well Health. Your line is open.
Fran Kritz:
Thank you. I’m sorry. Can you explain what is new today? What is it new that you’re announcing? There has been surveillance, so what is happening that you are announcing today?
Dr. Amy Kirby:
So the big news today is that the CDC data from the National Wastewater Surveillance System is available on COVID Data Tracker for the first time. And the advantage of this CDC supported dashboard is that it allows you to compare data across states directly. The data that’s available on different state level dashboards doesn’t have the same analyses behind it and so it’s not directly comparable the way it is on the CDC dashboard.
Fran Kritz:
Thank you.
Benjamin Haynes:
Denise, I think we have one more question pending.
Operator:
Thank you. That is from Lena Sun. Your line is open.
Lena Sun:
Okay. Thank you for doing this, Dr. Kirby. Could you explain again, how many sites are currently feeding into the data that’s on the dashboard now and how many more will you be having to come online in the future. You know, and that, that future is that in a weeks, or is that gonna be in a few months that you will be expanding the system? And when you get to that point, how much coverage will you have in the country? Will we have half the country, three-fourths, you know, something in every state? If you could just sort of put that in context, please. Thank you.
Dr. Amy Kirby:
We currently have over 400 sites that are providing data to CDC and that data will be shared on COVID data tracker. In the next few weeks, we expect to add at least an additional 250 sites to that total. And then over the next few months, as we see our additional state systems getting fully implemented, we expect additional sites coming on board from that as well.
Lena Sun:
So when you to the 250 extra sites, what kind of coverage will we have in the United States then? Will you have a look into every state?
Dr. Amy Kirby:
We will not have a look into every state, but we will have a look into most states, as well as territories and tribal communities. I will have to get back to you as an exact number. I don’t have that available right now.
Benjamin Haynes:
Next question, please.
Operator:
That is from Denise Chow with NBC News.
Denise Chow:
Hi, thank you very much for doing this. You mentioned that this could function as kind of an early warning system. I was wondering if you could explain a little bit about what we know about when after infection people, or we might start to see viral particles show up in wastewater. Is it fairly shortly after? Do people still shed viral particles long after they’re infectious? Just kind of that timeline. Thank you.
Dr. Amy Kirby:
Yeah, that’s a great question. So what we see is shedding in feces starts very early after someone is infected. It’s in fact, one of the first signs that we see of infectionwhich is really important for this early warning capability for wastewater. We see those rates go up very, very high. So lots of virus shed into feces very early in the infection and then it tails off. People do continue shedding excuse me, shedding virus in their feces for up to a couple of weeks after infection, but at very low rates and that is not contributing significantly to the signal that we see in wastewater.
Benjamin Haynes:
Next question, please.
Operator:
Next question is from Alice Parks with TIME.
Alice Parks:
Thank you, Dr. Kirby. I was wondering if you could address a bit, the system has, you know, been up for a while. Can you talk a little bit about the data that supports it and you know, why it took to this point to add the data to a COVID data tracker? Was it a matter of being reassured about that signal and making sure that correlation, that association was scientifically valid?
Dr. Amy Kirby:
So we’ve seen from very early days in the pandemic that rates of detection in wastewater correlate very well with other their clinical indicators, like pace rates and hospitalization and test positivity. That data continues to come in and it continues to be a very solid indicator of what’s going on in the community. We have been building the system with our states again since September of 2020 and our state partners have had this data available to use since then. We have been building the capacity to get this data into CDC and share it and we think that now is the point where there’s enough data in our system that it is a good time to make it available to the public.
Benjamin Haynes:
Next question, please.
Operator:
Next question is Lisa Kreiger, with San Jose Mercury News your line is open.
Lisa Krieger:
Yes. Thank you. There was an interesting paper yesterday in Nature Communications about the detection of genetic lineages in some of the sewer sheds that were unfamiliar. You know, they hadn’t been captured by sequencing of patients viruses. And, you know, there’s a suggestion that maybe the lineages are coming from virus infected animals. Do you happen to know what percent of these wastewater samples are sequenced? And who’s monitoring that from a federal perspective?
Dr. Amy Kirby:
So we do have many of our states are sequencing their wastewater samples and that data will be coming into CDC within the next few weeks. So, we will have that available to monitor, as well. That is a very powerful method for tracking variants of concern in wastewater and we’re either to use that to be able to monitor, you know, again, seeing that early warning of new variants of concern entering our communities,
Lisa Krieger:
Just to follow up, have you seen anything, are you currently tracking that and have you seen anything that’s I guess cryptic, is the phrase they use, that’s interesting.
Dr. Amy Kirby:
We are not tracking cryptic lineages through NEWS but we are in contact with the researchers that publish that paper and are watching that work very closely.
Benjamin Haynes:
Next question, please.
Operator:
That is from Julie Steenhuysen with Reuters. Your line is open.
Julie Steenhuysen:
Thank you. Can you tell me is this going to be strictly for COVID or will this be part of future surveillance for other pathogens of pandemic significance?
Dr. Amy Kirby:
Yeah, so this system was stood up for COVID as part of the COVID response, but wastewater surveillance can be applicable to a wide variety of health concerns. And so we are right nowworking to expand the National Wastewater Surveillance platform to use this to gather data on other pathogens and we expect that work to commence by the end of this year. And our targets include antibiotic resistance, foodborne infections, like E. Coli, salmonella, norovirus influenza and the emerging fungal pathogen, Candia Auris.
Julie Steenhuysen:
Thank you.
Benjamin Haynes:
Next question, please.
Operator:
That comes from Dennis Thompson with Health Day. Your line is open.
Dennis Thompson:
Is there some place online where we can see a comprehensive list of the cities and sites that are doing this tracking for you right now? You know, will that list be updated so that we can see who’s added in the future?
Dr. Amy Kirby:
Yeah, the best way to see that is through the data download feature on COVID data tracker. And so that will give you a line list of all of the sites and communities that are providing data.
Benjamin Haynes:
Next question, please.
Operator:
That comes from Dana McIntyre with the Augusta Press. Your line is open.
Dana McIntyre:
Thank you. How are the samples tested? What’s the mechanism, what’s the process for the testing and have commu