Wastewater-based epidemiology (WBE) was able to provide early indicators of an infectious event during the COVID-19 pandemic in Germany, complementing individual testing for outbreak detection. WBE also enables regional surveillance and can assist public health systems (PHS) in evaluating the effectiveness of infectious disease control measures. The German Federal Ministry of Health (BMG) sees great benefit for the PHS in further development of WBE, even beyond COVID- 19. However, in order to bring the full potential of WBE into broad application, new analytical, technical, epidemiological, and institutional research questions need to be addressed.

The overall objective of the project WBEready applied for herewith is the scientific extension of a roadmap for the development of a future-oriented WBE with adaptive monitoring capacities in the PHS. To this end, the current screening in the AMELAG (Wastewater monitoring for epidemiological situation surveillance) project is to be expanded to include numerous other pathogens in addition to SARS-CoV-2, including circulating and emerging human pathogenic viruses as well as antimicrobial resistances, and the foundations are to be laid by answering open research questions in order to prepare for new requirements in the PHS in a targeted and cost-efficient manner (preparedness).

Central questions are if new target parameters are suitable for the WBE set-up, which requirements are epidemiologically necessary and how WBE can support the institutional work of the PHS. In order to address the relevant research questions, the association area of Emschergenossenschaft and Lippeverband with focus on the Ruhr area will be investigated as a real laboratory with regard to the usable wastewater infrastructure (agglomerations, sewer networks, hospitals, wastewater treatment plants of different size classes) under consideration of socio-economic parameters.