COVID-19 wastewater treatment efforts face long-term questions

WASHINGTON — In February 2020, environmental engineers Aaron Bivins and Kyle Bibby started an informal collaboration with a few fellow researchers, hoping to share tips and strategies on monitoring wastewater for signs of the nascent pandemic. of COVID-19.

As of April 2022, this group had more than 1,300 analysts and professionals globally, with a Slack account promoting new research and making introductions – all as part of an effort to facilitate early sharing of information that did not exist at the federal level.

“I’ve had calls with teams all over the country, just to brainstorm ideas and troubleshoot,” said Bivins, an assistant professor at Louisiana State University.

The informal conversations highlight how national wastewater monitoring efforts grapple with questions about sustainable funding, geographic boundaries, and what states should do with the data.

Public health experts hope the technology will help monitor threats beyond COVID-19, like opioids and influenza, but the strategy requires resources and political buy-in. And while Congress has enacted billions in pandemic funding for states, only a handful have used the money to establish sewage oversight.

Most states have instead turned to a Centers for Disease Control and Prevention grant program that has distributed $35.8 million since September 2020 as part of its Cooperative Epidemiology and Laboratory Capacity Agreement.

The administration also works with public service organizations. In April, the CDC awarded an 11-month, $10.2 million contract to Massachusetts-based Biobot Analytics, transferring 226 sites that wastewater treatment company LuminUltra Technologies established under a deal prior.

But health officials will have to play the long game. LuminUltra has recruited less than half of the 500 utilities under contract, and the technology is not reaching many rural areas without communal sewage systems.

Biobot founder Newsha Ghaeli is confident the company can live up to expectations. Biobot previously won a three-month, 300-site contract to help launch the CDC program last May, which Ghaeli called proof of Biobot’s ability to deliver.

And while it’s not a “walk in the park,” the company has worked with all 50 states in addition to territories and tribes, Ghaeli said. Biobot will focus on streamlining the process, especially for factories participating in duplication programs.

“We want to try to reduce the operational burden that this represents as much as possible,” she said.

Traditionally, there has been little collaboration between wastewater and health departments, said Emily Remmel, director of regulatory affairs at the National Association of Clean Water Agencies, so there was a lot of uncertainty around the program at the time. start. But now the barriers focus on resources.

“It’s just staffing and whether or not they have the capacity to go out once a week, take a grab sample, turn around, ship it,” she said. “It’s a lot of logistics. What if FedEx doesn’t pick it up? Things like that.”

The prospect of broader surveillance initiatives also raises concerns about increased regulation in an uncertain environment, Remmel said. If the EPA decides to put in place additional monitoring requirements at sites to track antimicrobial resistance, for example, how do they address issues such as distinguishing between livestock and human waste?

Turn data into action

The Government Accountability Office highlighted many of these issues in a recent report, citing the need to promote the use of cost-benefit analyzes and how states can use the data. The calculation is higher for rural areas.

“The vast majority of processing plants are quite small,” said Bibby, associate department chair at Notre Dame University College of Engineering. “And they handle small amounts of wastewater, and those may not even have a single full-time staff there.”

But Julianne Nassif, director of environmental health at U.S. Public Health Laboratories, predicts the recent CDC funding will trigger a sea change in wastewater monitoring for COVID-19 and beyond.

“We expect it to be used quite widely across the country in the years to come,” she said.

Health officials will then have to figure out how to use the data. Sewer content differences can vary widely, depending on factors such as industrial plants present in the area or whether the city has recently held a major public event.

Researchers are also unable to determine how much virus infected people shed in their waste. These differences are not reflected in the CDC’s Public Wastewater Dashboard, making comparisons difficult.

“If I measure something here in DC, how do I compare that to something that’s measured elsewhere?” said Jeseth Delgado Vela, assistant professor at Howard University’s College of Engineering and Architecture. “Or is this comparison even important?”

Establishing a standardized and comprehensive system will take time. Otakuye Conroy-Ben, an assistant professor of engineering at Arizona State University, has spent the pandemic recruiting tribal organizations to implement sewage monitoring. His team is working with five tribes, and three more are pending.

Infrastructure, geographic and relationship-building issues slow down work. Conroy-Ben, a member of the Oglala Lakota Nation, worked to gain tribal approval for over a year.

“I was hoping to have a lot more tribes in this project, but it’s just a lot of groundwork and a lot of administrative work to get a project like this going,” she said.

Potential Benefits

For large cities, the benefits are clear. Houston has installed 177 sampling sites since May 2020 at sewage treatment plants, lift stations and manholes, and is already using the system to track flu cases.

Loren Hopkins, environmental science manager at the Houston Department of Health, said the city is ramping up resources and launching awareness campaigns whenever it sees a jump in a given area. The data is disaggregated by zip code, and the look sites target individual schools, communal residences and prisons.

Community organizations use the data to create vaccination pop-ups and launch door-to-door campaigns. Epidemiologists are watching the numbers to identify where they might need to increase nursing staff. Schools use it to launch testing initiatives. And the health department is reassigning staff members to COVID-19 work when the numbers rise.

The system was not cheap. The city has spent nearly $10 million since March 2020, including about $8.2 million from federal COVID-19 relief legislation. And the reliability of the data only came from a thorough analysis to assess its shortcomings and how it compares to individual test results.

“Now that the positivity rate isn’t there, we can rely on sewage more,” Hopkins said. “We think it’s representative.”

But using the data doesn’t have to be an expensive and complex undertaking, Bivins added. At least it could just be used as a type of pandemic weather forecast.

“When the numbers start to go up,” he said, “maybe you’re wearing a mask.”

Lauren Clason, CQ-Roll Call.

Michael J. Chiaramonte