Maryland quietly ended its wastewater testing program for COVID-19 in May, but some beneficiaries of the program are hoping to find a way to continue.
The state’s wastewater testing program launched in November 2020 after a successful pilot period. When rates of COVID-19 found in the wastewater increased five times from one day to the next, it indicated an outbreak, leading the Maryland Department of the Environment, which facilitated the program, to seek intervention.
The program involved using a continuous sampler, a pump that automatically takes a sample of wastewater approximately every hour.
“This is a pump that looks like R2D2,” said Suzanne Dorsey, assistant secretary of MDE. “Getting into the nitty gritty, we worked with scientists and tuned (the timing of the samples) to what my engineers call ‘the big flush’” — when most people use the bathroom.
“So, one of the times that we took more samples was between six o’clock and 10 o’clock in the morning,” she said.
Initially, the pilot program tested wastewater treatment plants that included the waste of thousands of residents across different neighborhoods or even cities. Later, though, the $1 million program, called the COVID-19 Sewer Sentinel Initiative, grew to include a unique, hyperlocal element; MDE partnered with the Housing Opportunities Commission in Montgomery County, the Housing Authority of Baltimore City and correctional facilities throughout the state to test wastewater on a building-to-building level, specifically at congregate housing facilities inhabited by vulnerable populations.
As far as MDE can tell, this was the only program of its kind in the United States. But when the program concluded at the end of last May, these partners didn’t know where to turn to continue testing their wastewater, which the HABC says was an important tool for helping to prevent outbreaks.
“The real-time effort that we had with having this information, this resource, at our fingertips is that we could say to not just our residents but also our staff, you have to be careful when going out to do a work order,” said Monica Watkins, executive vice president and chief operating officer for HABC.
When cases were on the rise at a particular facility or community, HABC worked with the Baltimore City Health Department to provide testing to residents, sent out notices of where residents could get tested elsewhere in the city and provided increased personal protective equipment for staff members.
Testing at several wastewater treatment plants across the state has now been taken over by the Centers for Disease Control and Prevention’s wastewater surveillance program, but the federal agency will not be taking over the HABC program.
Birthe Veno Kjellerup, an associate professor at the University Maryland, College Park’s A. James Clark School of Engineering who completed research related to the state’s wastewater testing program, said she “completely (does) not understand” why the program came to an end.
“It is actually much more than the wastewater sewer study that ended … it was the collaboration,” she said, which spanned numerous government agencies, plus university partners and the contractor that conducted the testing and provided equipment, Columbia, Maryland-based IEI.
According to both Kjellerup and Watkins, the program ended because the state did not have the funding to renew it.
But some jurisdictions are continuing their wastewater testing programs — or even beginning new initiatives in the near future.
Montgomery County is preparing to begin its first COVID-19 wastewater testing initiative, which, just like MDE’s program, will be executed in partnership with UMD and IEI.
“Wastewater surveillance has been proven to be a useful tool on surveillance of various types of diseases in the past,” a Montgomery County Department of Health and Human Services spokesperson said in an email. “CDC started to apply such tool for COVID-19 surveillance more than (one-and-a-half) years ago.”
The program is anticipated to be one year long with the possibility of an extension. The county will select sites for wastewater surveillance shortly after finalizing its contract for the program. Data will be reported to DHHS weekly.
Kjellerup, who also led wastewater testing efforts at UMD’s campus previously in the pandemic, is planning to publish a research paper on some of what she calls the “softer” elements and lessons of the program, such as how the team effectively communicated with the residents of the buildings in which the testing was taking place.
At first, for example, residents worried that references to COVID-19 in the wastewater meant that there was a risk of getting the illness from their drinking water. The HABC worked to remedy that misconception as quickly as possible.
The team also worked to make it clear that they would be only testing for COVID-19; even though wastewater testing can detect other illnesses in feces, they wanted residents to be able to trust that they were being completely candid about what they were studying and why.
“When we say something – the researchers – we stick to our word … there are a lot of bad examples in science and public health where that’s not the case, and that’s where a lot of the distrust came from,” she said, adding that she’s worried the trust that the HABC and MDE built in the community would dissipate with the program’s conclusion.
“The collaboration with the housing authority has gained a lot of trust, and they have kept the number of cases … down with having this monitoring.”