The myriad ways sewage surveillance is helping fight COVID around the world
This is a news item from Nature, which I hope is open sourced:
The myriad ways sewage surveillance is helping fight COVID around the world
Wastewater tracking was used before the pandemic to monitor for polio and illicit drug use, but interest in the field and its applications has now ballooned.
One of my earliest memories as a child was being amazed by toilet bowls, not only how they worked without requiring electricity (that I could see) but also where the "stuff" went.
It appears that fascination never really went away; I find myself thinking about this sewage all the time, not only in the very practical (and sometimes expensive) issue of maintaining my home septic system, but also in connection with broad environmental issues, and equally important, human development goals; about two billion human beings on this planet lack access to improved sanitation, something I find unacceptable in the extreme. Understanding sewage - in many ways one of the worst waste problems in the world - only dangerous fossil fuel waste and biomass combustion waste is responsible for more unnecessary deaths - is extremely important to address the rising fresh water crisis, the collapse of ecosystems in the oceans, and, more subtly, addressing an issue that is going to hit future generations very, very, very hard as a result of our inattention, phosphorous flows.
The extremely advanced development of what has become late in life, my absolute favorite analytical chemistry technique, mass spectrometry, has allowed us to understand things about sewage we never could access previously, in particular the environmental fate of many different kinds of products, not only "personal care products" like soap and cosmetics and pharmaceutical metabolites and unmetabolized excreted pharmaceuticals, collectively abbreviated "PPCP" in the literature, but also the fate of things like paints, flame retardants, fire fighting foams, fabric protection agents...the list goes on and on.
And now the study of sewage is providing insight, using qPCR, the spread of Covid.
Some excerpts from the news item cited at the outset of this brief post:
The information garnered is helping scientists to track down cases, predict surges, identify where to target testing, and estimate overall numbers of infected people in cities or regions. Although sewage surveillance has been used for several decades to identify polio outbreaks and target immunization programmes, and, more recently, to detect illicit drug use, the pandemic has brought new focus and investment in it as a means of tracking public health.
“There was always an interest in wastewater epidemiology, but now it’s taken flight,” says Ana Maria de Roda Husman, an infectious-diseases researcher at the Netherlands National Institute for Public Health and the Environment in Bilthoven.
Since early 2020, SARS-CoV-2 sewage projects have taken off around the world as wastewater experts pivoted to concentrate on the crisis. But the scale and focus of surveillance programmes varies, depending on how severely countries or communities have been hit by the pandemic.
The number of ways sewage surveillance is being used is dizzying. In the United Arab Emirates, researchers have been testing sewage from commercial aircraft to see whether incoming flights were carrying infected passengers1. Scientists in Hong Kong are monitoring sewage in apartment buildings to find undetected infections, and, in Yellowknife, health officials are testing wastewater to discover which viral variants have made it to their city, just 400 kilometres from the Arctic Circle.
Early-warning system
One common application of such surveillance programmes is as an early-warning system. People who are infected start shedding virus fragments a few days before they show symptoms, and de Roda Husman uses this to predict hospitalization numbers a few days ahead of time.
Other groups are using wastewater to find and suppress outbreaks on a much smaller scale...
...Challenges for developing countries
However, more than 70% of sewage-surveillance programmes are in high-income countries2, which have poured resources into wastewater epidemiology. Many researchers in the developing world are struggling.
“Testing in India is incredibly challenging as sewage systems are fragmented,” says Sudipti Arora, an environmental scientist at the Dr. B. Lal Institute of Biotechnology in Jaipur, India. Only about one-third of all towns have sewer networks, she says. “Consequently, slums and rural areas remain largely untested...”
...Many scientists working in the field say that a rare positive outcome of the pandemic might be that it will normalize the use of wastewater to monitor public health — whether for future pandemics or to track other health indicators, such as hormones that indicate stress or levels of caffeine consumption.
“Wastewater epidemiology was under the radar,” says Karthikeyan. “Now, it’s come to the forefront.”
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