Testing Wastewater May Provide Early COVID-19 Warning

Catching a disease at its earliest onset is the goal of most preventative medicine initiatives. For example, early detection screenings for colon cancer saves lives every year, catching the disease before it can spread and do more damage. In the same way that a mammogram can help detect breast cancer, early detection of the COVID-19 virus could help communities prepare for an onset of the disease. Scientists have discovered that the coronavirus can be detected in feces, and are working with wastewater treatment plants to use this as an opportunity to help contain the COVID-19 virus.

How Are Cities Using Wastewater to Get the Jump on COVID-19?

Gouri Sreepati, M.D., is a board-certified gastroenterologist at Gastroenterology Associates of S.W. Florida, P.A., says that wastewater treatment plants are becoming the latest tool in the front line battle against the COVID pandemic. She states, “We know for a fact that COVID-19 can be found in the feces of the patient’s much before they develop the actual symptoms.”

Wastewater treatment plants have taken this science and used it to our advantage to monitor the health of their communities. If they find an influx of the virus in the water samples they take, it could signal that the community is about to experience a surge of ill patients. It’s a way to get some advance notice for when a hospital may see a patient influx.

Wastewater, also known as sewage, includes household and commercial grey waters that may contain human fecal waste. That wastewater can be tested for SARS-CoV-2, the virus that causes the COVID-19 illness. Wastewater testing can detect the level of both symptomatic or asymptomatic infections. About 80% of U.S. households use municipal sewage collection services.

In the past, communities used stool sample testing to check the wastewater from communities to determine high zone density of opioid use. This technique has also been used to track other diseases such as polio. By checking wastewater, scientists have determined which communities are experiencing an increase in drug addiction and substance abuse. These same techniques are applied to the COVID-19 virus to give hospitals a head start on preparing for a high volume of new patients. It can also send important signs to community leaders to begin an early pandemic shut down to stop the spread of the virus quickly.

What Are the Benefits of Testing Wastewater for COVID-19?

The U.S. Centers for Disease Control & Prevention (CDC) has joined forces with the U.S. Department of Health and Human Services (HHS) and other federal agencies to initiate the National Wastewater Surveillance System (NWSS). The NWSS is developing a web portal where local and state health departments can submit wastewater testing results into a national database.

Dr. Sreepati points out the benefits of this approach, “It helps us to look for COVID much before the patients actually present with the disease. This information can be used to see if there’s going to be a resurgence of the disease in that area.”

Today, more than 400 communities around the U.S. are using this technique to track the physical health of about 10% of the population. While the technology can’t tell if an entire population has rid itself of the virus, it can help detect future flare-ups that could serve as an early warning system for hospitals, communities, and business leaders in a particular region. It could give hospitals an extra week to 10-days to staff up, add more PPEs, and more to prepare for an influx of new, very ill patients.

These tools could also help track how the virus mutates and changes over time. It provides epidemiologists with valuable data to help them stay one step ahead of a virus that, in the U.S. is now the third leading cause of death.

Can COVID Spread Through My Stool?

In May 2020 research showed evidence of COVID-19 DNA in fecal matter, but not live virus. This contradicts an earlier March study that suggested live SARS-CoV-2 could be transmitted through fecal material. In August, another study was published that showed that the COVID-19 cells from the stool of a sick patient can infect cells in a petri dish.

Given the contradictory nature of these studies, it’s obvious that more research is needed to determine if an active infectious coronavirus can transmit through human poop. It’s important to recognize that the virus that causes COVID-19 was just recently discovered, so scientists simply don’t have all of the answers quite yet.

To date, most of the studies show that the virus genetic material can be found in feces, but not the active virus. It raised the idea that the infectious virus could be blown into the air by a flushing public toilet. This makes hand washing even more important and it even speaks to giving an ill family member their own bathroom (if you have more than one in your home) if they even have mild COVID symptoms or test positive for the illness.

Currently, we know the COVID-19 virus is active in the sneezes, coughs, or spittle of an infected person. No matter what scientists determine in the future, practicing cleanliness and good hygiene is important.

How Can I Keep from Spreading the Virus?

COVID-19 spreads easily between infected people. Protecting yourself and others from the virus, which can cause a fever, cough, respiratory distress, and even death, is critical. While we’re still not certain if the virus can be spread by feces, we do now that people in close contact (within six feet) can spread the disease through droplets that carry the virus. You can catch the disease if you breathe in those droplets or touch a recently contaminated surface and touch your face, mouth, nose, or eyes. Some people that carry the virus never even exhibit symptoms and can pass the disease on to other people and make them very sick, or, they too could be asymptomatic. These variables in such a virulent disease can make for difficulty in establishing guidelines to prevent the spread. So, the best way to stay safe and keep those around you from becoming ill, follow these precautions:

Wash hands throughout the day for at least 20-seconds with soap and water and after using the restroom or after coughing or sneezing
Use hand sanitizer with at least 60% alcohol on the ingredients label
Avoid touching your face
Wear a cloth mask and socially distance by six feet when in public or meeting people that don’t live in your home
Do not share personal items
Frequently clean all high touch areas in your home

Understand the symptoms of the virus and make a plan for if you contract it. Gastroenterology Associates of Southwest Florida, P.A. is standing by if you have any questions about your health. Stay safe out there!

Testing Wastewater May Provide Early COVID-19 Warnings