Public health surveillance is absolutely essential to protect and sustain community health. Health departments monitor community health status and investigate new health hazards all the time. They perform health surveys, and investigate clusters of mysteriously ill citizens. Covid-19 brought the functions of testing, tracing and surveillance through state and local health departments to an unprecedented scale. With Covid-19, early on we turned away from a narrow clinical health care approach, focusing on those who were sick, to a broader public health, population-based strategy. Public health authorities tested not only those with symptoms, but also a sample of those who were asymptomatic. Surveillance was and is our warning system.
Covid-19 has introduced us to many bold new approaches to surveillance. We can now monitor our water and air and words. Using technologies that were in development before Covid-19, health surveillance will continue to expand in three ways as we see it.
Using wastewater epidemiology--the study of sewage--we are increasingly tracking the spread of diseases. The sewer system is analogous to the human gastrointestinal system. Just as clinicians can make medical judgements about a patient’s health based on a stool sample, we now learn about a community’s disease state by sampling wastewater that comes from sinks and toilets. It turns out that when Covid-19 levels rise in wastewater, daily cases rise soon after. Testing for Covid-19 (or its future viral version) in a city—are rates rising or falling?—can help make decisions about whether schools should stay open, for instance. Over the past few years, the same testing technology has been telling us whether there is an unexpected amount of opioid use in a town, and in the future might monitor stress hormone levels or nutritional deficiencies among citizens.
Read the full post on The Turning Point.