Municipalities should embrace their waste

A wastewater treatment plant in Springfield. From City of Springfield website.

A couple of years ago, I was at a conference at Ohio State’s Moritz School of Law on harm reduction strategies for the opioid crisis. One of the speakers was Dr. Dan Rosenblum, a health economist from Dalhousie University in Nova Scotia who specializes in both development economics and illicit drug markets.

At this conference in particular, Rosenblum was talking on his work analyzing overdose data from Ohio’s state crime labs, sussing out which chemicals were present in the bodies of overdose victims after death.

One thing that made my ears perk up as a policy analyst was when Rosenblum started talking about crime lab capacity. He talked about the backlog at Ohio crime labs and how the chemicals that were in the bodies of victims often were not identified until six months after the death occurred.

According to Rosenblum, this was not a technical limitation, but a backlog due to resource constraints. He said testing like this should be something that can happen in only a day or two if the resources were in place.

After his talk, I approached him and asked him the obvious questions: What are the benefits of getting this testing speed and how much would it costs us to achieve it?

The benefit of rapid testing of overdose victims is that the public health system can get a quick read on which drugs are permeating which communities. This means PSAs about fentanyl flooding a community, law enforcement on watch for specific types of drugs, and hospitals EMTs ready to treat with that danger in mind.

The costs? Rosenblum gave me a ballpark of $10 million a year. If this system of rapid testing could save one life a year, it would be well worth it under standard benefit-cost analysis assumptions.

This logic doesn’t stop with the opioid crisis. Today, we find ourselves in an even more massive public health crisis running alongside Ohio’s still-existent opioid epidemic. And we have a tool for rapid testing a detection of COVID-19: wastewater testing.

Yep, that’s right: by monitoring sewage wastewater, coronavirus outbreaks can be detected anywhere from a few days to a week before cases and hospitalizations increase in a local area. This means the public health system can get the jump on the virus by issuing public alerts, shifting staffing, and trying to lessen the load on strained hospitals to avoid the worst stages of triage protocol.

The costs of this program are even lower than the opioid crime lab, being funded by a $2 million federal CARES Act grant. It also has the potential to save more lives due to the massive scale of COVID-19.

In Ohio, there are currently 60 wastewater treatment plants taking part in the program, but some local governments have declined for one reason or another. What we know is that knowing quickly where COVID-19 is popping up could be the difference between life and death for edge cases in a health system that is currently hitting peak hospital bed strain. Rapid wastewater testing could be a low-cost, high-benefit intervention just at the time that we desperately need it.

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