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Public health policy impact evaluation: A potential use case for longitudinal monitoring of viruses in wastewater at small geographic scales

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  • Elana M G Chan
  • Amanda Bidwell
  • Zongxi Li
  • Sebastien Tilmans
  • Alexandria B Boehm

Abstract

Public health policy impact evaluation is challenging to study because randomized controlled experiments are infeasible to conduct, and policy changes often coincide with non-policy events. Quasi-experiments do not use randomization and can provide useful knowledge for causal inference. Here we demonstrate how longitudinal wastewater monitoring of viruses at a small geographic scale may be used in a quasi-experimental design to evaluate the impact of COVID-19 public health policies on the spread of COVID-19 among a university population. We first evaluated the correlation between incident, reported COVID-19 cases and wastewater SARS-CoV-2 RNA concentrations and observed changes to the correlation over time, likely due to changes in testing requirements and testing options. Using a difference-in-differences approach, we then evaluated the association between university COVID-19 public health policy changes and levels of SARS-CoV-2 RNA concentrations in wastewater. We did not observe changes in SARS-CoV-2 RNA concentrations associated with most policy changes. Policy changes associated with a significant change in campus wastewater SARS-CoV-2 RNA concentrations included changes to face covering recommendations, indoor gathering bans, and routine surveillance testing requirements and availability.

Suggested Citation

  • Elana M G Chan & Amanda Bidwell & Zongxi Li & Sebastien Tilmans & Alexandria B Boehm, 2024. "Public health policy impact evaluation: A potential use case for longitudinal monitoring of viruses in wastewater at small geographic scales," PLOS Water, Public Library of Science, vol. 3(6), pages 1-19, June.
    • Handle: RePEc:plo:pwat00:0000242
    DOI: 10.1371/journal.pwat.0000242
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