Written by Jada Phillips, MD candidate, University of Missouri-Columbia School of Medicine and the James A. Harding Research Scholar in the 2022 Institute for Public Health Summer Research Program
Fangqiong Ling, PhD, WashU assistant professor of energy, environmental & chemical engineering, presented a seminar on July 7 based on the United Nation’s Sustainable Development Goal 6 (SDG 6) – Ensuring available and sustainable management of water and sanitation for all. Access to clean water and sanitation is fundamentally linked to the success of a society. It is vital for a safe environment, agricultural proliferation, health, and much more. Unfortunately, according to the World Health Organization (WHO), globally, at least 2 billion people use a drinking water source contaminated with feces. With the task of explaining the various implications of this disparity and importance of SDG 6 to the Summer Research Program – Public & Global Health Track cohort, Ling began her talk stating, “Infrastructure is fundamental to safe drinking water, sanitation, and hygiene.” This has proven to be true, tracing back to the infamous cholera epidemic in Soho, London in 1854, which originated from a contaminated water pump.
The proper infrastructure for a water system includes tap water undergoing thorough rounds of filtering and chemical treatments before being supplied to the population. The utilized water must be collected within a wastewater treatment plant to remove and reduce waste before water is sent back into the environment. This process is essential for maintaining public health of an urban community. Without it, society is increasingly exposed to harmful chemicals and is vulnerable to the transmission of diseases, like cholera and hepatitis A.
Ling’s discussion also explored the possibilities that proper water systems could provide a rather innovative future in public health using sewer water!
Being that we live in a world that has been combating a viral pandemic for the past nearly three years, most people have had the shared experience of getting their nostrils swabbed and communicating with contact tracers. However, what if there was a way to get the same data without Q-tips and constant phone calls? In September of 2020, the CDC launched the National Wastewater Surveillance System. This allowed for a more passive, less invasive and sustainable way for the CDC to monitor and prevent the spread of COVID-19. This strategy also allows for the monitoring of other sectors of public health, like illicit drug use and antimicrobial resistance within a geographical population. With this new technology, microorganisms alone serve as biosensors and provide real-time epidemiologic data.
There are various benefits of utilizing microorganisms in urban infrastructure as a tool for public health, including decreasing reporting bias and test fatigue. Additionally, this technology is accessible! Since water systems are already in place, the implementation of this would be low-cost and actionable within most urban societies. Though water systems are extremely complex and vary across different locations, research cited by Ling has shown an overall positive correlation between COVID-19 wastewater levels and epidemiologic indicators across different water infrastructures. This indicates that microorganisms as biosensors can be used universally as a metric of public health and epidemiologic data. In Ling’s words, “Sewage is a new frontier of public health.”