The “novel” Coronavirus requires novel approaches, both analytical and remedial. Despite hearing repeatedly about “how much we don’t yet know” about Covid-19, from just about everyone in government, media, and medicine, we are regularly subjected to the same old, tired refrain:
“We are working to secure tests and PPE and will think about reopening the economy incrementally.” There’s nothing novel about our response to the Coronavirus.
When trying to disentangle what local political leaders actually know from their natural inclination to want to project a sense of competency and reassurance, a whole slew of questions come to mind. Why aren’t they talking more about the second and third spikes, which the CDC projects to be far more deadly? Why aren’t we hearing about serology testing? Is it really so dangerous that we need to destroy the economy? Is it really only affecting long term care facilities? Can I trust what I’m hearing?
Surely, for instance, we should expect that our government’s knowledge extends to the Stanford University study of Santa Clara County, CA, which found that actual infections (cumulative) are likely to be 50 to 85 times higher than the total confirmed cases.
Why aren’t we hearing about it? You would probably act differently if you thought that 1,670 people (0.12% of the State’s population) have contracted Coronavirus so far, then if you thought it has infected 141,950 of your fellow citizens or one in 10 of us.
With the way our leaders talk about Coronavirus here in New Hampshire, and how it is complacently regurgitated by media outlets, you might not take a precaution that you should have if only the true extent of the issue was made known to you, and not downplayed from the start to make you feel safe.
On the flip side of the coin, the notion that actual infections may be 50 to 85 times higher means that actual deaths, or the “infection fatality rate,” is likely 50 to 85 times lower than what is being reported. That seems relevant in the ongoing debate about whether and when to reopen the economy.
We might blithely accept our government’s account of what actions need to be taken to ensure the future safety of our citizenry, passively assuming that with all their doctors and consultants and bureaucrats, those in positions of authority must know best. But the truth is, they don’t.
If our leaders really knew anything, they would surely be talking about the possibility of wastewater testing for Covid-19, as an early warning system.
Applying the process to Covid-19 was first discussed in late March by a team out of Cranfield University, though the process itself has been around for some time and was previously used to combat other diseases. It was then studied by a Massachusetts company called Biobot, in cooperation with very credible names like Harvard, MIT and Brigham and Women’s, in an effort to determine the efficacy of the testing and develop a method for getting the materials and processes for wastewater testing for Coronavirus into the hands of cities and towns everywhere.
Since then, scientific teams across the globe, including Paris, Norway, England and Australia, and also domestically, including San Francisco and Tacoma, have either independently come up with processes for testing wastewater for Covid-19 or verified the legitimacy of the approach and the soundness of the science behind it. (See, e.g., “Testing Sewage for Coronavirus Could Help Predict Future Covid-19 Outbreaks.” Newsweek. Apr. 23, 2020.).
The benefits of wastewater testing have also been given some attention (though not nearly enough to get it on the radar screens of our State’s decision-makers) by reputable media outlets like Newsweek, WGBH, ABC News, The Boston Globe, Wired Magazine, Nature, The Tacoma News Tribune, Science, and others.
So far, at least one local government has contracted with Biobot and undertaken an analysis of the extent of Coronavirus infection in their area through wastewater testing. New Castle County, Delaware, was able to conclude that the actual level of infection was 15 times higher than the official case count.
It is immediately apparent from the consumption of those news accounts that:
- Testing wastewater for Covid-19 is effective: It can present a fairly accurate picture of not only whether a community contains infected people, but also approximately how many people are likely to be infected in that area.
- It’s cheap: Exact dollar estimates are hard to come by, presumably as private companies look to license their materials and technologies to governments and public utilities, but according to Dr. Zhugen Yang, of Cranfield University, it may be as simple and inexpensive as a single paper collection device costing 1 pound (approximately $1.24).
- Wastewater testing can save lives: Since this process can give governments a snapshot of how many people are likely to be infected in an area at any one time, the various snapshots we glean from wastewater testing for Covid-19 can be compared to each other to reveal trends. And trends are a crucial part of the equation for saving lives. If we know where the virus is likely to spike, because we have an “early warning system,” as the process has ubiquitously been dubbed, we can quarantine in a targeted way and direct resources to problem areas, but otherwise and elsewhere reopen economies and start to return to something resembling normalcy.
With all that said, would you like to have an “early warning system” for Covid-19 in your community? Yeah, me too. So why haven’t we heard more about wastewater testing in our public discourse? Quite simply, what it probably amounts to is pure ignorance.
In a recent discussion with The State Epidemiologist, Dr. Benjamin Chan, whom we’ve all come to regard (deservedly or not) as an authority on the subject of how to test for Covid-19 infection in New Hampshire, it became apparent pretty quickly that Dr. Chan knew really nothing at all about wastewater testing. (“The Exchange.” NHPR. Apr. 21, 2020).
Listeners can judge for themselves (starting at 46:30), but when Dr. Chan says, “If we were to go out and test wastewater, we would expect Covid-19 to be detected… but it wouldn’t necessarily change what we do,” it directly contradicts the growing body of media on the subject that had been accumulating over the previous 3 weeks.
Those accounts make clear that wastewater testing is a powerful analytical tool in the fight against Covid-19. And the insights gleaned from wastewater testing are not simply as binary as whether there is or is not Coronavirus somewhere in the area. We can test and compare communities to see how the virus spreads. And then we can retest, to see how the spread has changed, and forecast how it is likely to change in the future.
Upon surveying the news landscape, one finds that there is not a single New Hampshire publication covering wastewater testing. The closest media market giving the issue any attention is Boston. Laura Knoy, the host of The Exchange, confessed to not having heard of wastewater testing for Covid-19 when the topic was called in, though WGBH (NHPR’s de facto “sister station”), The Boston Globe and Boston Herald have all covered it thoroughly. One can only come to the conclusion that our shot-callers aren’t punching the ticket for wastewater testing because they just don’t know about it.
Whatever the reason, be it obstinacy or ignorance, if you want a cheap and effective early warning system for Covid-19 in your community, one that can be implemented alongside swab testing, serology testing, an eventual vaccine, and anything else the scientists think up, please call or write your elected officials, from the Governor and Congressional delegation on down to school board. If ignorance truly is the only thing standing in the way of adopting an approach that could help reopen the economy in a sustainable way, and save lives that would otherwise be lost, then that knowledge and awareness gap can be closed simply by speaking up!
To effectively combat the Coronavirus pandemic, we can’t abdicate our individual and collective responsibility. We can and should demand that our government be knowledgeable and well informed about what measures exist to keep us safe. If they truly don’t know, we need to tell them, because we must approach the novel Coronavirus in a novel way.
by Chris Buck, Esq.( web developer, recovering attorney, and guest blogger here and there. You can follow him @ChrisBuck)
