Monday, April 27, 2020

Measuring Community Spread of Covid-19

The disease we all call Covid-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There have been reports of finding the virus, SARS CoV-2 , in faeces . On Jan. 11, Chinese authorities shared the genetic sequence of the virus, and scientists realized that that human wastewater might contain the novel coronavirus.

In a letter published in Lancet on April 1, 2020 Willemijn Lodder and Ama Maria de Roda Husman two scientists from the Centre for Infectious Disease Control, National Institute for Public Health and the Environment detailed their recent work to measure the spread of Covid-19 in communities.

Beginning on Feb 17, 2020, the scientists took samples once a week from human wastewater collected at Amsterdam Airport and reported on April 1, 2020 in Lancet that. “Samples tested positive for the virus RNA 4 days after the first cases of coronavirus disease 2019 (COVID-19) were identified in the Netherlands on Feb 27, 2020 (unpublished data).

“Furthermore, human wastewater sampled near the first Dutch cases in Tilburg, Netherlands, also tested positive for the presence of viral RNA within a week of the first day of disease onset (unpublished data). These findings indicate that wastewater could be a sensitive surveillance system and early warning tool, as was previously shown for poliovirus.”

"It is not known if SARS-CoV-2 is viable under environmental conditions that could facilitate faecal–oral transmission. However, evidence exists of potential community spread, with the virus spreading easily and sustainably in the community in some affected geographic areas”

Now more than a dozen research groups worldwide are analyzing wastewater inflows for the SARS-CoV-2, the virus causing Covid-19 as a way to estimate the total number of infections in a community. The method could also be used to detect a new surge of the coronavirus if it returns to communities when restrictions are lifted and determine the community spread of the coronavirus since most individuals will never be tested. Without a vaccine, no effective treatments and with a world population without herd immunity, we need to track this virus.

Biobot Analytics, a startup in the Boston area that analyzes wastewater to gain insights into public health, has begun requesting sewage samples from wastewater treatment facilities across the U.S. to test for SARS-CoV-2, the virus causing Covid-19.

The company’s technology, developed by CEO Mariana Matus who received her PhD from MIT in 2018 was originally geared toward using sewage to estimate drug consumption in communities. Biobot developed a device to gather representative samples of sewage. Wastewater sampling can be used to track opioid use, nutrition, environmental contaminants, antibiotic resistance, and the spread of infectious diseases. The resulting insights can be used to understand the health and well-being of small communities or large cities.

The U.S. CDC says: “The virus that causes COVID-19 has been found in the feces of some patients diagnosed with COVID-19. Scientists also do not know how much risk there is that the virus could be spread from the feces of an infected person to another person. However, they think this risk is low based on data from previous outbreaks of diseases caused by related coronaviruses, such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).”

Biobot Analtiics' SARS-CoV-2/ Covid-19 testing program, is a pro bono collaboration with researchers at MIT, Harvard, and Brigham and Women’s Hospital. The teams will process sewage samples from treatment facilities across the U.S., then use a laboratory technique known as a reverse transcription polymerase chain reaction to determine the presence of SARS-CoV-2.

The collaborators believe the program could complement existing testing methods in addition to helping guide community responses, measure the effectiveness of interventions, and provide an early warning for the re-emergence of the outbreak when the restrictions are lifted. Communities should start sampling immediately.

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