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SALT LAKE CITY — Wastewater surveillance for COVID-19 isn't ending anytime soon.
The Utah Department of Health and Human Services continues to rely on what's flushed down the toilet from some 34 sewage treatment plants across the state to track the spread of the still-deadly virus.
Now, additional support could be coming from Washington, D.C., for programs in Utah and around the country that are part of the National Wastewater Surveillance System, launched by the Centers for Disease Control and Prevention after the pandemic started in 2020.
Sen. Mitt Romney, R-Utah, negotiated the inclusion of his recently introduced legislation intended to strengthen and expand the nation's wastewater surveillance into a broader pandemic preparedness bill that won committee approval last week.
"This provision will bolster Utah's already sophisticated wastewater monitoring technology by ensuring it receives the funding needed to continue to invest in new research and technology," Romney's office said in a news release.
Nathan LaCross, manager of the state's wastewater surveillance program, said it was "gratifying" to see the Senate take a "very important step" toward further developing a detection system that can be used for many other pathogens.
When it comes to COVID-19, LaCross said wastewater monitoring is "one of the relatively few sources of reliable data available these days," given the "drastic downturn" in the number of Utahns getting tested for the virus.
LaCross, an epidemiologist, said he understands why many Utahns may have "that feeling that it's behind us. Our response has changed." But, he added, that doesn't mean the virus is going away.
The latest weekly numbers for Utah posted Thursday on the state's coronavirus.utah.gov website show about a 15% increase in the seven-day average of cases, to just under 48 statewide, and a single death, a Salt Lake County man between 65 and 84 years old.
At the same time, the amount of virus detected through wastewater surveillance is increasing at 20% of the sewage treatment plants where samples are collected, and there were elevated levels of the virus at four sites.
Utah started collecting information from wastewater at the start of the pandemic in March 2020, giving public health officials "a pretty good handle" on COVID-19's patterns and trends in the state, LaCross said.
"It's taken a while to get there," he said, because there needs to be enough historic data available to "make sense of the new stuff. So again, it's not something that you can really just switch on when something happens and get useful results."
The state shifted away from depending on daily case counts early last year after mass testing sites were so overwhelmed by a surge driven by the omicron variant that Gov. Spencer Cox urged Utahns with symptoms to stay home instead of being swabbed.
Utah's wastewater surveillance program, which is entirely federally funded, is currently in the process of switching to a more precise type of testing, LaCross said. He said the state is holding off on testing for more pathogens until the new system is up and running.
There are discussions about adding influenza, RSV, and Mpox, formerly known as monkeypox, to what's tested for in wastewater, he said, while other possibilities include antimicrobial resistance genes and opiates.
But LaCross said the state has ruled out monitoring wastewater for polio "for now," despite a sample collected in February 2022 in northern Utah for an out-of-state researcher testing positive for poliovirus.
While the data collected from wastewater does not identify individual cases, he said it helps public health officials target resources such as information about necessary precautions to areas where that's most needed, he said.
Romney's original bipartisan bill, co-sponsored by Sen. Angus King, I-Maine, offered funding in the form of grants to state, local and tribal governments as well as investments to develop best practices for wastewater data collection.
Called the Public Health Response and Emergency Detection Through Integrated Wastewater Surveillance Act or the PREDICT Act, Romney's bill is now part of legislation passed last week by the Senate Health, Education, Labor and Pensions Committee.
Just how much money could be made available for wastewater surveillance efforts in that legislation, a reauthorization of the Pandemic and All-Hazards Preparedness and Response Act due to expire Sept. 30, remains to be seen.
"It's not perfect. I'm sure we'll have new lessons to learn as well," Romney said at the committee hearing, calling the legislation he and others helped negotiate "a fair effort to learn from the experiences of the past."
