{"id":409852,"date":"2022-05-21T01:27:35","date_gmt":"2022-05-21T01:27:35","guid":{"rendered":"https:\/\/uat.esri.com\/en-us\/industries\/blog\/?post_type=blog&#038;p=409852"},"modified":"2025-05-13T17:27:10","modified_gmt":"2025-05-13T17:27:10","slug":"how-gis-brings-wastewater-surveillance-to-life","status":"publish","type":"blog","link":"https:\/\/www.esri.com\/en-us\/industries\/blog\/articles\/how-gis-brings-wastewater-surveillance-to-life","title":{"rendered":"How GIS Brings Wastewater Surveillance to Life"},"content":{"rendered":"<p class=\"undefined block-editor-paragraph\">What do you think happens to the water flushed down your toilets and sinks? Did you ever consider that your communities\u2019 wastewater might provide insight into its overall health? In some cases, communities across the nation are using <a href=\"https:\/\/www.esri.com\/en-us\/what-is-gis\/overview\">geographic information systems (GIS)<\/a> to support wastewater surveillance systems to monitor local wastewater for the occurrence of diseases and health threats like polio, hepatitis, opioid use, antibiotic resistance, and recently, COVID-19. <a href=\"https:\/\/covid.cdc.gov\/covid-data-tracker\/#wastewater-surveillance\" target=\"_blank\" rel=\"noreferrer noopener\">According to the CDC<\/a>, there are more than 700 wastewater sampling sites in the US currently testing for viral shedding for the SARS-CoV-2 virus that causes COVID-19. Those sites are distributed across nearly 75% of the nation\u2019s states and territories, monitoring the waste of approximately 30% of the U.S. population.<\/p>\n\n<p class=\"undefined block-editor-paragraph\">Communities with wastewater surveillance programs enjoy a number of benefits. A single sample could represent hundreds, thousands, or even millions of people in an area, making it a very efficient and cost-effective surveillance method. The testing process is quick too, giving public health officials more lead time for making decisions, allocating resources to where they are needed most, and communicating any potential health concerns with stakeholders. Not only is this process convenient and non-intrusive but it is also equitable and inclusive, as everyone served by the sewershed is surveyed. Wastewater surveillance also provides anonymity as community wastewater is tested in aggregate with results representing the entire area rather than specific individuals.<\/p>\n\n<p class=\"undefined block-editor-paragraph\">Many organizations are turning to GIS to improve wastewater surveillance programs by:<\/p>\n\n<ul class=\"wp-block-list\">\n<li>Determining the best sites to conduct wastewater testing<\/li>\n\n<li>Prioritizing areas with limited access to care and\/or testing facilities<\/li>\n\n<li>Supporting timely responses by clarifying where, what kind, and how much support is needed<\/li>\n<\/ul>\n\n<p class=\"undefined block-editor-paragraph\"><strong>Site Selection: Determining Where to Surveil<\/strong><\/p>\n\n<p class=\"undefined block-editor-paragraph\">It may be safe to assume that site selection for a wastewater surveillance system should be based on an area that is already experiencing high occurrences of the health threat of interest (e.g., COVID-19, antibiotic resistance, substance misuse). However, this simplistic view comes with a risk of \u201cattentional bias\u201d in which important information may be ignored if the focus is too obvious or narrow. With GIS, health departments can consider multiple contextual and risk factors that help them take a more holistic approach. Not only does this improve the decision-making about surveillance site selection but opens the door to applying predictive spatial analytics to determine where an outbreak or threat may occur in the future.<\/p>\n\n<p class=\"undefined block-editor-paragraph\">GIS makes it simple to understand where large populations reside, which communities are at a greater risk for severe illness, and places where clinical or public health resources may be unavailable or underused. Location-intelligence allows you to map social vulnerability, age, and other factors that help identify at-risk groups and target locations for testing sites that serve the greatest need.<\/p>\n\n<p class=\"undefined block-editor-paragraph\">For example, GIS would help in selecting the best sites for COVID-19 wastewater testing as location intelligence would locate where in a community there has been low vaccination rates, high hospitalization rates, low testing rates, and a high prevalence of service workers. These factors can all contribute to high COVID-19 rates. So, testing wastewater in these areas before an outbreak occurs allows governments and organizations to be proactive.<\/p>\n\n<p class=\"undefined block-editor-paragraph\">For example, <a href=\"https:\/\/www.esri.com\/about\/newsroom\/blog\/ucsd-senses-maps-covid-19\/\" target=\"_blank\" rel=\"noreferrer noopener\">UC San Diego was able to detect COVID-19<\/a> in their wastewater before individuals started showing symptoms. The university tied their wastewater testing results to a live map they created with GIS, which showed, in real-time, which buildings on their campus presented a positive COVID-19 reading. The campus was then able to quickly communicate these results and encourage testing among those at risk (people living or working in the affected building). The use of GIS allowed the university to curb the spread of COVID-19 on their campus, preventing potential closures.<\/p>\n\n<p class=\"undefined block-editor-paragraph\"><strong>Access to Care: Prioritizing Vulnerable Populations<\/strong><\/p>\n\n<p class=\"undefined block-editor-paragraph\">Access to health care and services can be impacted by barriers such as social, racial, economic, and physical factors. Because these factors vary across places, some communities have more difficulty accessing services than others. In some cases, a geographically targeted wastewater surveillance system can ensure that those communities do not fall through the cracks. Esri\u2019s Living Atlas of the World provides a layer of data known as the CDC\u2019s Social Vulnerability Index (SVI). The Social Vulnerability Index uses U.S. Census data to identify and map communities that will most likely need support before, during and after emergency events like disease outbreaks. The Social Vulnerability Index ranks communities across 15 social factors and four thematic areas including socioeconomic status, household composition and disability, minority status and language, and housing type and transportation. All factors contribute to a community\u2019s cumulative vulnerability to adverse health impacts.<\/p>\n\n<p class=\"undefined block-editor-paragraph\">By mapping the SVI data it becomes easier to prioritize vulnerable communities when selecting wastewater surveillance sites.<\/p>\n\n<p class=\"undefined block-editor-paragraph\"><strong>Proactive Response with Real-Time Data<\/strong><\/p>\n\n<p class=\"undefined block-editor-paragraph\">In times of crisis, real-time data is essential for decision making, resource allocation, and communication between departments. GIS can visually display data in an easy-to-read format, which can then be used to create targeted solutions. For example, in 2017 the <a href=\"https:\/\/www.esri.com\/about\/newsroom\/blog\/tempe-ariz-maps-and-monitors-opioid-use\/\" target=\"_blank\" rel=\"noreferrer noopener\">City of Tempe, Arizona<\/a> experienced a 20% increase in opioid related overdose deaths and began using a wastewater surveillance system to monitor and test areas in the city for the presence of opioids and other substances. The city was able to monitor their wastewater treatment plant and see the prevalence of drugs in an area, an estimated number of users, and even an estimated number of overdoses.<\/p>\n\n<p class=\"undefined block-editor-paragraph\">All this information was then fed into a <a href=\"https:\/\/data.tempe.gov\/apps\/tempegov::opioid-wastewater-collection-data-dashboard\/explore\" target=\"_blank\" rel=\"noreferrer noopener\">public ArcGIS Dashboard<\/a>, a visual display that presents data in an easy to read format, and shared with the public, city leaders and city departments like the Fire Medical Rescue department. Not only was GIS used to help raise awareness on the opioid epidemic, but it allowed city leaders to respond to this health crisis almost immediately and with location-driven solutions. It also provided real-time communication to warn the public and emergency responders of possible deadly strains of synthetic fentanyl found in the community wastewater.<\/p>\n\n<p class=\"undefined block-editor-paragraph\">With long time experience in wastewater surveillance for opioids, Tempe was able to pivot quickly when COVID-19 arose, creating new surveillance dashboards reflecting <a href=\"https:\/\/data.tempe.gov\/apps\/tempegov::tempe-covid-19-wastewater-collection-data-dashboard-v3\/explore\" target=\"_blank\" rel=\"noreferrer noopener\">overall viral shedding<\/a> as well as various <a href=\"https:\/\/tempegov.maps.arcgis.com\/apps\/dashboards\/3699509be3e244fe92b9676ad7ab8158\" target=\"_blank\" rel=\"noreferrer noopener\">equity metrics<\/a>.<\/p>\n\n<p class=\"undefined block-editor-paragraph\">Wastewater surveillance is also employed at the state level. The <a href=\"https:\/\/experience.arcgis.com\/experience\/44e9cdefa15f41648c6b6f382cdccf2d\" target=\"_blank\" rel=\"noreferrer noopener\">state of Missouri<\/a> has been tracking COVID-19 in about 100 sewersheds representing nearly half of their population. They\u2019re sharing geographic and temporal trends as well as the variants of interest as they wax and wane across the state.<\/p>\n\n<p class=\"undefined block-editor-paragraph\"><strong>Wastewater Surveillance: An Essential Tool for Public Health<\/strong><\/p>\n\n<p class=\"undefined block-editor-paragraph\">The use of GIS for wastewater surveillance programs enhances site selection, ensures equitable approaches to vulnerable communities that may not have access to care or testing and facilitates timely responses to health crises. Wastewater testing can provide situational awareness about what is happening in a community and promote smarter response by clarifying where, what kind, and how much support is needed.<\/p>\n\n<p class=\"undefined block-editor-paragraph\"><a href=\"https:\/\/www.esri.com\/en-us\/industries\/health\/overview#start\" target=\"_blank\" rel=\"noreferrer noopener\">Connect with our team <\/a>&nbsp;if you\u2019d like to learn more about how GIS can support your wastewater surveillance efforts.<\/p>","protected":false},"author":802,"featured_media":0,"parent":0,"menu_order":0,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[141,881,2892],"tags":[287,339,2922,2912,2902],"class_list":["post-409852","blog","type-blog","status-publish","format-standard","hentry","category-health","category-public-health-preparedness","category-wastewater-surveillance","tag-gis","tag-health","tag-health-equity","tag-surveillance","tag-wastewater","industry-health-and-human-services"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v25.9 (Yoast SEO v25.9) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>How GIS Brings Wastewater Surveillance to Life<\/title>\n<meta name=\"description\" content=\"Communities with wastewater surveillance programs enjoy a number of benefits. 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In addition to her degrees in Medicine, Medical Informatics and Public Health, Dr. Geraghty is also a board-certified public health professional (CPH) and a Geographic Information Systems Professional (GISP).","sameAs":["@estegeraghty","https:\/\/www.linkedin.com\/in\/este-geraghty\/","https:\/\/x.com\/https:\/\/twitter.com\/estegeraghty"],"honorificPrefix":"Dr.","honorificSuffix":"MD, MS, MPH, CPH, GISP","birthDate":"1964-12-15","gender":"female","award":["HIMSS Most Influential Women in Health IT 2021"],"jobTitle":"Chief Medical Officer","worksFor":"Esri","url":"https:\/\/www.esri.com\/en-us\/industries\/blog\/author\/egeraghty"}]}},"text_date":"May 21, 2022","author_name":"Este Geraghty","author_page":"https:\/\/www.esri.com\/en-us\/industries\/blog\/author\/egeraghty","custom_image":"https:\/\/www.esri.com\/en-us\/industries\/blog\/app\/uploads\/2022\/05\/wastewater-green-valley-ccs-bg.png","primary_product":"Health and Human Services","tag_data":[{"term_id":287,"name":"GIS","slug":"gis","term_group":0,"term_taxonomy_id":287,"taxonomy":"post_tag","description":"","parent":0,"count":180,"filter":"raw"},{"term_id":339,"name":"health","slug":"health","term_group":0,"term_taxonomy_id":339,"taxonomy":"post_tag","description":"","parent":0,"count":9,"filter":"raw"},{"term_id":2922,"name":"health equity","slug":"health-equity","term_group":0,"term_taxonomy_id":2922,"taxonomy":"post_tag","description":"","parent":0,"count":9,"filter":"raw"},{"term_id":2912,"name":"surveillance","slug":"surveillance","term_group":0,"term_taxonomy_id":2912,"taxonomy":"post_tag","description":"","parent":0,"count":1,"filter":"raw"},{"term_id":2902,"name":"wastewater","slug":"wastewater","term_group":0,"term_taxonomy_id":2902,"taxonomy":"post_tag","description":"","parent":0,"count":13,"filter":"raw"}],"category_data":[{"term_id":141,"name":"Health","slug":"health","term_group":0,"term_taxonomy_id":141,"taxonomy":"category","description":"","parent":0,"count":34,"filter":"raw"},{"term_id":881,"name":"Public Health Preparedness","slug":"public-health-preparedness","term_group":0,"term_taxonomy_id":881,"taxonomy":"category","description":"","parent":0,"count":9,"filter":"raw"},{"term_id":2892,"name":"Wastewater Surveillance","slug":"wastewater-surveillance","term_group":0,"term_taxonomy_id":2892,"taxonomy":"category","description":"","parent":0,"count":1,"filter":"raw"}],"product_data":{"errors":{"invalid_taxonomy":["Invalid taxonomy."]},"error_data":[]},"primary_product_link":"https:\/\/www.esri.com\/en-us\/industries\/blog\/industry\/health-and-human-services","short_description":"Wastewater surveillance can provide insight into a communities overall health. 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