Volume 30, Number 10—October 2024
EIN Research Letter
Infectious Disease Physicians’ Knowledge and Practices Regarding Wastewater Surveillance, United States, 2024
Carly Adams, Libby Horter
, Susan E. Beekmann, Philip M. Polgreen, Jessica N. Ricaldi, Souci Louis, and Scott Santibañez
, Susan E. Beekmann, Philip M. Polgreen, Jessica N. Ricaldi, Souci Louis, and Scott Santibañez
Table 3
Thematic summary of specific examples provided by infectious disease physicians to open-ended question of how wastewater surveillance has affected or could affect their clinical practice, Emerging Infections Network, February–March 2024*
| Themes identified and subset of example responses, respondents providing free-text responses, n = 192 | No. (%) respondents |
|---|---|
| Situational awareness | 91 (47) |
| “In the absence of reliable Covid test reporting, we integrate wastewater with emergency department and admission data to assess risk.” | |
| “Identify potential outbreaks early.” | |
| “I look to tell immunocompromised patients’ risk for COVID.” | |
| “It has helped with discussions with my patients and their families.” | |
| “Raises or lowers my clinical suspicion based on prevalence.” | |
| “Potential early indicator of disease activity in the community.” | |
| “Include the information in communicable diseases reports for my organization and county.” |
|
| IPC decisions | 47 (24) |
| “Wastewater surveillance has helped us direct IPC and public health resources and can be very helpful.” | |
| “We have used this information to support decisions to determine need for staff masking during respiratory virus season.” | |
| “We are using it to inform masking policy and to a lesser extent visitation policy at our hospital.” | |
| “Providing hospital personal protective equipment guidance.” | |
| “For many COVID protocols particularly when de-implementing, such as when we were planning to discontinue pre procedure and inpatient admissions screening, this was one of the metrics we used.” |
|
| Diagnostic testing and differential diagnoses | 29 (15) |
| “Increases/decreases suspicion for certain infections prior to results of testing.” | |
| “Determining which respiratory virus panel is worth offering.” | |
| “Knowing something is increasing before clinically evident has helped inform testing in our emergency department.” | |
| “Affects decision to retest for COVID in patients with consistent symptoms with a negative initial test, who might be eligible for remdesivir or Paxlovid.” |
|
| Vaccinations | 24 (13) |
| “Serves as educational and clinical tools to emphasize need for vaccination.” | |
| “To encourage flu, mpox, and COVID vaccinations when the uptick is seen in the community.” | |
| “Influenza activity and initiation of vaccination schedules.” |
|
| Healthcare preparedness | 19 (10) |
| “Predicting COVID needs”. | |
| “Hospital surge planning and resource allocation.” | |
| “Used for staffing.” | |
| “During the past few years, I used it as a leading indicator to help with hospital planning as part of my role as Medical Director for Infection Control in my Hospital System.” |
|
| Clinical management | 18 (9) |
| “Increasing resistance genes in our area may lower my threshold to use broader empiric antibiotics.” | |
| “Incidence of resistant organisms can guide therapy.” | |
| “Management of vulnerable patient populations such as transplant recipients and other immunocompromised.” | |
| “Lower thresholds towards treatment.” |
|
| Variant/emerging infections detection | 8 (4) |
| “Watching for SARS-CoV-2 variant emergence.” | |
| ,“Perhaps detection of new strains of influenza.” | |
| “Best use would be for novel pathogens of interest or antibiotic resistance in specific facilities.” |
|
| No effect | 14 (7) |
| “No impact.” | |
| “Unless there is practical and evidenced based guidance that is tied to wastewater surveillance results, I do not believe this will be useful for my clinical practice.” |
*The Infections Disease Society of America Emerging Infections Network is a provider-based emerging infections sentinel network established in 1995 to assist the Centers for Disease Control and Prevention and other public health authorities with surveillance for emerging infectious diseases and related phenomena. The electronic survey was distributed via 3 email messages in February and March 2024 to all US EIN infectious disease physician members. IPC, infection prevention and control.
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Page updated: September 24, 2024
Page reviewed: September 24, 2024
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