The COVID-19 pandemic has been a source of ongoing challenges and presents an increased risk of illness among rural populations, especially tribal communities. The Centers for Disease Control and Prevention (CDC) and the US Department of Health and Human Services (HHS) have determined that surveillance of wastewater streams for the presence of SARS-CoV-2, the virus that causes COVID-19, can be an effective way to provide information on the presence and level of viral transmission in communities as well as trends in infection rates. It may also provide tribal and public health leaders with more advance awareness of outbreaks or increases in transmission, compared to relying on testing of individuals. Sustainable wastewater surveillance requires coordination between tribal leaders, health officials (tribal, federal and state), utilities, labs, and clinical researchers. Data collected from wastewater samples can also be incorporated into public-education and tribal community outreach campaigns.
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