Biobot, a Boston-based company founded by two researchers from Massachusetts Institute of Technology, quickly shifted from monitoring and analyzing opioid use in communities to rolling out a campaign to test wastewater at water treatment facilities nationwide.
The program, which ran from March through May, included 400 water facilities in 42 states. “We began to see how our data could be a leading indicator,” said Jennings Heussner, business development associate for Biobot. “When we see a spike in viral titer (or viral load) in wastewater, there will be a corresponding spike in clinically reported cases some four to 10 days later,” he said.
Taylor Maddalene, an academic professional in the UGA School of Engineering prepares wastewater samples for analysis.
Credit: University of Georgia
Credit: University of Georgia
Georgia was not among the states that participated in the pilot, but in early September, the White House Coronavirus Task Force suggested the state explore the use of wastewater surveillance for early virus detection and community intervention. Weeks later, after the state reported fewer COVID-19 cases per 100,000 people than the national average, the Task Force moved Georgia from the most severe category for COVID-19 cases. But within the past few weeks, seven-day rolling averages for daily new coronavirus cases have been ticking upward.
Wastewater epidemiologists believe the predictive qualities of wastewater testing can help municipalities get a jump-start on managing outbreaks in the future, particularly as the country continues to reopen. But sewage sampling is very complex, said Lipp.
Wastewater includes not only human waste, but household waste and other materials. It is easier to detect COVID-19 in the wastewater samples when caseloads are high. The test is not as sensitive when cases are lower. While it isn’t possible to quantify the number of cases in a community, it is possible to measure trends. “Everyone would like to take a sewage sample and tell you how many people in the population are affected, but the science is not there yet,” said Lipp.
Scientists are also continuing to research how samples should be collected, specifically if it is sufficient to draw samples from wastewater treatment facilities or if a raw sample, such as from the sewers that feed into treatment plants, should also be part of the sample collection.
There are also questions about the frequency of testing, including how many times per week and how many times per day samples should be gathered. Standardizing these practices would make it easier to create a national database that could help predict where the next outbreak will be, said researchers.
Countries in Europe and Asia already have national programs in place. Some states, including Colorado and Ohio, have implemented wastewater surveillance systems to track COVID-19, but the U.S. has only just begun to build the groundwork for a national tracking system.
As of mid-August, efforts were underway at the Centers for Disease Control and Prevention to create a national database for state, tribal and local health departments to submit wastewater testing data that could be used to support public health action.
The CDC did not respond to the AJC’s request for an update on the status or scope of the National Wastewater Surveillance System.