While Western governments were spending billions on contact tracing and other expensive, ineffective, antiquated means to quantify and identify the spread, intensity, and exposure areas of COVID-19, African countries lacked the resources to do anything but implement a smart, cost-effective protocol that not only worked but has become a recognized tool for managing future viral spread. For example, this protocol spotted waves of infection weeks before conventional nasal swab testing for health officials in Malawi providing a month’s advance notice of its COVID-19 wave.
In his recent book, “The Wisdom of Plagues”, former New York Times reporter Donald G. McNeil, Jr. insists this protocol must be included when confronting future pandemics. This same protocol has an extensive track record in assessing many other health dynamics in a geographically identified population.
The U.S. Department of Justice Federal Bureau of Prisons (FBOP) mandates that future prison construction:
“Incorporate modern mechanical systems to reduce the risk of exposure to COVID-19 and other contagions; [and] … Optimize the cost of operation by applying innovative designs…” Project Summary – Proposed Development of a New Federal Correctional Institution and Federal Prison Camp, Letcher County, Kentucky – Prepared by: Federal Bureau of Prisons, Washington, DC – February 2024
The aforementioned protocol responds to the FBOP mandate: sewage surveillance.
Sewage surveillance allows the detection of the most miniscule presence of various infections, alcohol, drugs, dietary intake, and countless other conditions in a population. With sewage surveillance:
- The overall health of a population can be monitored to include the presence and concentration of a virus or disease.
- The presence and pervasiveness of alcohol (or any other prohibited or controlled internally consumed substance) can be assessed without inspecting rooms or administering sobriety tests.
- Prescription drugs, beyond authorized prescriptions, will be identified (if any) as well as the presence of illegal drugs.
- There will be early warning of any infection that is superior to other tracking or testing options.
- Test results give visibility to the management of a facility without compliance audits or the possibility of local authorities watering down data for reporting to regional or central office leadership.
Sewage surveillance has significant efficiencies in time and personnel. Further, it allows for comprehensive and targeted testing of the prison population with zero disruption of daily operations.
Currently, a prison warden awaits a health incident to alert him/her of the presence of previously unidentified drugs or a new concentration of a known drug. Sewage surveillance gives advance warning.
While it would be otherwise impossible to prove, sewage surveillance can be used to confirm certain housing units, or an entire facility, are 100% free of illegal drugs.
Disclosure of specific data (e.g. that a housing unit is drug-free) could be used to motivate and manage group compliance in a population.
Sewage surveillance can be expanded to include monitoring the healthy lifestyle of a population by assessing diet and the need for certain wellness screening to include cancer detection.
The various providers of sewage surveillance technology confirm that capabilities are available, and published research studies, in Europe, assure the data is powerful and can be applied in a correctional setting.
It is one thing for a prison warden to report controlling/preventing illegal drugs and infectious diseases; it is another to, at a glance, have data confirming (or challenging) that representation. Management and contract compliance will be data supported with sewage surveillance.
NOTES
Sources of additional background information
“What lies beneath,” The Economist, September 10th 2022, page 63
Postigo,C., de Alda, M.L., & Barcelo, D. (2011) Evaluation of drugs of abuse use and trends in a prison through wastewater analysis. Environmental International, 37(1), 49-55
van Dyken, E., Lai, F.Y., Thai, P.K., Ort, Christoph, Prichard, Jeremy, Bruno, Raimondo, Hall, Wayne, Kirkbride, Paul & Mueller, Jochen (2014) Monitoring substance use in prisons: Assessing the potential value of wastewater analysis. Science and Justice – Journal of the Forensic Society, 54, no. 5, pp. 338-345
van Dyken, E., Lai, F.Y., Thai, P.K., Ort, C., Bruno, R., Hall, W., Kirkbride, K.P., Mueller, J.F., & Prichard, J. (2016). Challenges and opportunities in using wastewater analysis to measure drug use in a small prison facility. Drug and alcohol review, 35(2), 138 147
Prichard J., Ort C., Bruno R., Gartner C., Kirkbride P., Hall W., Lai F.Y., Carter S., Thai P., Mueller J., Salinas A. (2010) Developing a method for site-specific wastewater analysis: implications for prisons and other agencies with an interest in illicit drug use. Journal of Law, Information and Science, Vol. 20, no. 2, pp. 15-27
Brewer A.J., Banta-Green C.J., Ort C., Robel A.E., Field (2016) Wastewater testing compared to random urinalyses for the surveillance of illicit drug use in prisons. Drug and Alcohol Review, Vol. 35, no. 2, pp. 33-137.
Experts and Industry Contacts
Dr. Nuhu Amin
Associate Scientist
Enteric and Respiratory Infections
Infectious Diseases Division
International Centre for Diarrhoeal Disease Research
GPO Box 128
Dhaka 1000
Bangladesh
nuhu.amin@icddcrb.org
Professor Colleen Nuaghton
COVIDPoops19 Project
School of Engineering
University of California, Merced
5200 North Lake Road
Merced, California 95343
cnaughton2@ucmerced.edu
Anna Mehrotra
Director, Wastewater Surveillance Program
Water Environment Federation
601 Wythe Street
Alexandria, Virginia 22314-1304
amehrotra@wef.org
Dr. Douglas Manuel
Faculty of Medicine
University of Ottawa
75 Laurier Avenue East
Ottawa, ON K1N 6N5
Canada
dmanuel@uottawa.ca
Dr. Bernd Manfred Gawlik
Portfolio Leader, Water Quality
Joint Research Centre
European Commission
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1050 Brussels
Belgium
bernd.gawlik@ec.europa.eu
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Yaffa Shir-Raz
Health Journalist and risk communication researcher
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