South Korean WasteWater Surveillance ● National infectious Disease Surveillance (NIDS) ○ Diagnosis by Clinician-immediate reporting ○ Simple epidemiologic investigation ■ Submitted to KCDC online ○ Collected and analyzed ○ Reporting in mandatory and real-time ○ Wastewater signals could be added ■ Pre-diagnostic alert layer ○ Inform KCDC epidemiological investigations ■ could be before patient diagnosis spikes ○ NIDS platform to improve early detection ● National Health Insurance Claims-Based Surveillance(NHICS) ○ medical service usage and diagnosis ■ ICD-10 code ○ Claims reviewed ○ HIRA collects data, redistribute them ○ Wastewater alters can be cross validated ■ Claims data spike for diagnosis ■ Acts as secondary confirmation ■ Promote health insurance queries in certain regions ● Effective for Public health surveillance ○ Two data stream ■ Different parts of outbreak timeline ■ Support early warning ● clinical diagnosis ● Health claims ● all in timely fashion ■ Integrating environmental surveillance Use of Wastewater for a good cause? ● Finding and monitoring pesky virus and bacteria before they can cause disease even if they are not waterborne