Predicting inflection points in the disease curve through wastewater-based epidemiology: learnings from SARS-CoV-2 monitoring in Bengaluru, India
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Swasti, India
Swasti, Bengaluru, India
Catalyst Management Services, Bengaluru, India
Molecular Solutions Care Health, Bangalore, India
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A360
Background: The covid-19 pandemic was a watershed event for wastewater-based highlighted the inability of existing disease surveillance systems to provide sufficient forewarning on the existing scale of disease spread and underscored the need for effective Early Warning Systems (EWSS). In keeping with WBE’S potential, the covid action collab [1] launched the precision pandemic health surveillance [2] in May 2021 for equitably tracking sars-cov-2 spread in Bengaluru, India. Methods: Wastewater samples were collected from 28 networked and 46 non-networked sites. Inclusion of non-sewered sites enabled equitable disease surveillance at the wider-population level. The samples were tested for Sars-CoV-2 using a quantitative RT-PCR kit. For detecting early warning signals, the exponential weighted moving average filter was used on longitudinal viral load data. A 70% weight was assigned to the latest data-points and 30% weightage to older data. Furthermore, control chart limits and an internally-designed heuristic model were used. Whole genome sequencing was used for genomic epidemiology. Results: The program used the aforementioned methodology to identify emerging warning signals by distinguishing the ‘noise’ from the ‘signals,’ arriving at more accurate predictions of future disease pathways and foretelling the timespan in which a contained outbreak would begin to also identified the inflection points in the epidemiological curve, which are the points of most significant inference for public health action. Basis these points, the epidemiological curve was disaggregated into four stages-normalcy, escalation, progression and de-escalation-with actionable insights for authorities at each stage. Conclusions: An EWSS enables early implementation of disease mitigation strategies. Going forward, the learnings can be harnessed by other cities for effective monitoring of covid-19 and other infectious diseases. The successful deployment of es as an ethical and equitable surveillance platform enables systems to capture the health concerns of vulnerable population groups and thus, it has great usability for showcasing the complete epidemiological arc of diseases which have a disproportionate impact on such communities. Links:------[1][2]