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The search is on for new strains of COVID-19 in Arizona's wastewater

The Arizona Department of Health Services plans to increase its wastewater surveillance program, to detect new strains of COVID-19. The agency is also hoping to expand the program to be able to detect other pathogens, including RSV, influenza and mpox, among others.

Wastewater surveillance was widely used, here and elsewhere, during the pandemic, as a sort of early-warning system. It can be used to detect where there could be an outbreak, although this method cannot specify who may be infected.

The Show spoke with Dr. Reshma Neupane, food and water borne program manager at the Arizona Department of Health Services, about how they are trying to make sure that as a virus like COVID-19 continues to mutate and evolve, their equipment and technology are able to keep up with it.

DR. RESHMA NEUPANE: Yeah, I mean, you know, that's something in wastewater surveillance in general is evolving. So we make sure that, you know, our lab team, I know they're really good with kind of being up to date to make sure the instrument and the processes that they're kind of using is up to date and accurate. And I know they've been doing a lot of conversations with other state partners, CDC and within their team to ensure that workflow processes is still accurate for, for wastewater testing.

MARK BRODIE: Was this something that a lot of folks were doing before COVID like was wastewater surveillance a big deal in the epidemiology world prior to say 2020, 2021.

NEUPANE: It, yes, it had been used before prior to COVID, but I know it kind of became a very common tool to be used once we experienced COVID. So it was being used for kind of, you know, detecting other levels like opioids. I know that was something that was being tested before. So and other other levels that people were, you know, testing for and labs were tested for. But, you know, once COVID pandemic hit, it kind of became an extra tool in our toolbox to kind of, you know, test for COVID-19 to, to kind of give an idea of what that COVID-19 is looking like within our community. 

BRODIE: Is it safe to say that that COVID kind of gave this type of technology, this type of surveillance a boost, at least in the public mind that, hey, this is another tool. This is another way we can be, we can be looking for stuff. 

NEUPANE: Yes, II I believe so. I think like I said, you know, it kind of wastewater kind of evolved after after our 2020 pandemic. And I think that kind of gave others an idea that, hey, you know, maybe this could be used for detecting other pathogens additional pathos. 

BRODIE: So I know that ADHS is looking into using this kind of surveillance, the same kind of surveillance to look for other kinds of pathogens, other kinds of illnesses. What is on the list? Like what, what makes something a good candidate to be looked at using this kind of this kind of method?

NEUPANE: Yes, we are certainly looking to expand to other pathogens. But that right, the question would be whether or not testing for that disease will be effective. So that's gonna be a discussion with our other, you know, certain program areas and our county health departments to ensure that that testing would be beneficial for the public. So that's how we are kind of, you know, planning to kind of go about expanding to other diseases.

BRODIE: What has to happen when you add a new pathogen, like what, what do you have to do or for whomever is doing the surveillance, what has to happen to add a new pathogen to the surveillance? 

NEUPANE: You know, that's something I know. CDC has come up with a priority list of certain path pathogens that, you know, kind of they're interested in testing. So it kind of right now, it it depends on what the need is. And what our need is at the state level. But like I said, we also collaborate with county partners to kind of decide whether that can be effective tool. And you know, I wanna also mention that you, you don't wanna, I think it would be best to use wastewater data or surveillance with additional like public health data, like clinical cases, hospitalizations. And then we wanna think of wastewater surveillance as a additional tool in our toolbox. 

BRODIE: So it's something you can use. Not the only thing you use.

NEUPANE: Yeah, exactly.

BRODIE: In terms of the technology, let's say you were to add something like RSV or influenza, something like that, that was going to be something that you, that you look for. What do you need to do to sort of add that to the list of things that you're you're looking for in the wastewater.

NEUPANE: We certainly need to have those resources. I'm certainly not a lab expert, but we certainly need to have some of those resources available to be able to test fluent RSV for wastewater testing.

BRODIE: OK. What do you think is the ultimate potential of wastewater surveillance for either for diseases, for drug use and other kinds of substance use? Like how big of a role, how big of a tool in the toolbox could this ultimately be do you think?

NEUPANE: I think it's still evolving. I think we're learning something new about wastewater every day. But I do think it has the potential, like I said, I think and what we talked about, you know, it's not the only tool, but it can serve an important tool while being used with other public health data. So it might serve as an early indicator. Like I said, you know, it might because it has the potential to capture individuals, areas who do not have access to testing or, you know, who are not able to go out there and get tested. So it kind of wastewater gives them a view of how the virus or the pathogen that we're testing for is spreading within the community. So it certainly has that potential to be that early indicator.

BRODIE: Sure.. All right. That is Dr. Reshma Neupane with the Arizona Department of Health Services. Thank you so much for your time. I really appreciate it.

NEUPANE: Thank you so much. I hope you have a wonderful day.

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Mark Brodie is a co-host of The Show, KJZZ’s locally produced news magazine. Since starting at KJZZ in 2002, Brodie has been a host, reporter and producer, including several years covering the Arizona Legislature, based at the Capitol.