Fever, cough, shortness of breath, and loss of taste and smell are just a few of the symptoms people experience after they get COVID-19. For public health officials that are trying to manage the disease, however, it’s not sniffles and taste buds that turn heads. It’s sewage.
“Increase in virus concentration found in wastewater has … been a key indicator of a forthcoming COVID surge,” epidemiologist Dr. John Brownstein, chief innovation officer at Boston Children's Hospital, told ABC News in September 2022.
“In fact, given the challenges in case estimation and the decline in testing, wastewater surveillance may be one the last remaining high-quality datasets public health can rely on.”
Collecting wastewater data for monitoring diseases and other contaminants is nothing new, but the COVID-19 pandemic and the resurgence of poli – which recently began spreading in New York after decades of absence – have put renewed focus on drawing data from wastewater to improve the health of people, communities and the environment.
There are articles dating back to the 1970s about using wastewater data to detect diseases like polio in the community, according to Dr. Robert Delatolla, a professor in the Department of Civil Engineering at Canada’s University of Ottawa.
“There's been a long history of it,” he said, adding that the late 1990s and early 2000s saw advances in analytical methods to allow for testing of chemicals at remarkably low concentrations – at the scale of nanograms.
By the time the COVID-19 pandemic hit, it was possible to identify all sorts of pharmaceuticals, medicines and illicit drugs in communities by way of analyzing wastewater data, according to Delatolla, whose research group uses modern analytical methods to advance the understanding of wastewater technologies at the meso, micro and molecular scale. In April 2020, they established Canada’s first system to successfully detect SARS-CoV-2, the virus that causes COVID, in wastewater. This just weeks after Dutch researchers similarly detected it at a wastewater treatment plant outside of Amsterdam.
Canada and the Netherlands are just two of many countries that have ramped up wastewater data collection and analysis to detect COVID-19 while also opening the doors to detect other public health threats. The University of California Merced’s CovidPoops19 project estimates that for surveillance of COVID-19 alone there are approximately 3,700 global monitoring sites spanning more than 280 universities across 70 countries.
Waste Not, Want Not
University researchers aren’t the only ones in the wastewater monitoring game. Biobot Analytics describes itself as the first company in the world to commercialize data from sewage. Its cloud-based platform for government customers uses wastewater data to provide trend analysis, early warnings and testing at scale. The company’s one-day turnaround to estimate COVID-19 prevalence in a population demonstrates the power of using cloud-based computing for wastewater monitoring and analysis: By processing more data faster, public health organizations can get a more accurate, timely picture of disease prevalence in communities.
“Wastewater testing can detect outbreaks because at least one infected person in the outbreak will likely shed enough virus in stool to be detected,” Biobot explained in a May 2022 white paper.
“For example, in a study at the University of North Carolina at Charlotte in late 2020, when wastewater monitoring was in place, clusters of one to three infected people were routinely detected. When wastewater monitoring was not available, clusters grew to five to 10 people before they were detected.”
Back in Ottawa, data from Delatolla’s research group is collected, tested and validated, then plotted, graphed and presented in a format that can be easily understood by public health officials and policymakers. Researchers can automatically transfer the data and generate a report anywhere in Canada. And because data is uploaded to GitHub, anyone in the world can access it via the cloud and use it to understand the spread of disease.
In the province of Ontario, Delatolla’s data flows automatically to a network of 175 monitoring sites, as well as to Ottawa Public Health. The province uses it to create a wastewater dashboard that is a “testament to computing power,” according to Delatolla. It can graph disease incidents based off wastewater in the whole province broken down into six regions. Sites collecting wastewater range in size from small communities of 5,000 people to large cities like Ottawa, whose population is nearly 1 million.
“We’re able to get really good resolution,” Delatolla said.
The Next Frontier
Based on their success with COVID-19, public health officials are beginning to turn to wastewater to detect other viruses, too. As previously mentioned, for example, public health officials in New York recently detected the polio virus in local wastewater. Meanwhile, Delatolla’s group has begun monitoring Canadian sewage not only for COVID-19 and potentially polio, but also for respiratory syncytial virus (RSV), monkeypox and influenza.
Although Delatolla’s lab is laser-focused on disease, wastewater also can be mined for medications, including, for example, antibiotics.
“There's a lot of warning about antimicrobial resistance,” Delatolla said. “Antimicrobial resistance is very much linked to wastewater.”
Scientists can even use wastewater to detect and track the opioid epidemic, which scientists at Boston College are using a new sensor developed by electrochemical company Giner Labs.
“Wastewater testing is an emerging strategy that can defeat limitations and stigma associated with individual drug testing, and it provides a more objective measure of drug use at the neighborhood level,” Avni Argun, vice president for advanced materials at Giner Labs, told Boston College in a May 2022 interview.
Thanks to climate change, the impacts of which could include increased exposure to pathogens, wastewater analysis is only going to become more prevalent and more important, according to Delatolla.
“People all over the world are using our data,” he said. “We want wastewater to be well integrated in the world of open science.”
Gary Hilson has more than 20 years of experience writing about B2B enterprise technology and the issues affecting IT decisions makers. His work has appeared in many industry publications, including EE Times, Embedded.com, Network Computing, EBN Online, Computing Canada, Channel Daily News, and Course Compare. Find him on Twitter.
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