Systemic inequities in our healthcare system have led Covid-19 to take a disproportionate toll on different groups of Americans, notably different races and ethnicities. Can wastewater-based monitoring of Covid-19 help promote health equity?

Wastewater-based monitoring serves everyone connected to a sewer system. This means that, if a wastewater monitoring program includes wastewater treatment plants that serve a representative population, then the monitoring program automatically serves a representative population.

In contrast, an equitable monitoring system based on clinical testing requires not only placing testing sites in the right places, but also that a representative population seeks testing. In other words, even if a testing site is located near a group of people, there is no guarantee those people will be served by that site. …

Biobot was selected by the US Department of Health and Human Services, the parent department of the CDC, to execute a national COVID-19 wastewater monitoring project. We’re incredibly excited about this project, and we’ll be sharing stories about its progress in a series of posts, starting with this one.

Why we need wastewater-based monitoring now, more than ever

Now that about half of all Americans have received safe and highly effective vaccines against COVID-19, and with summer approaching, case rates are falling. This is great news, but it does not mean the pandemic is over. The virus that causes COVID-19 has spread over the entire world and continues to mutate. And while the virus may feel like a familiar threat, COVID-19 is still a very new disease. There are known unknowns, like which new variants will arise and what effect they will have on disease transmission and mortality. But we should also expect unknown unknowns as well. …

Rollins College, Winter Park, Florida

Rollins College Campus in Winter Park, Florida

“With Biobot’s data, we can identify the embers of what could become a forest fire.” — Susan Rundell Singer, Vice President for Academic Affairs and Provost, Rollins College.

A Unique Challenge and Opportunity for Higher Education

Across the country, colleges and universities were forced to make difficult decisions about the Fall 2020 semester as a result of the ongoing COVID-19 pandemic. Rollins College was no exception. However, early in their planning, administrators saw a unique opportunity to preserve some of the traditional college experience by utilizing new, innovative public health tools.

Rollins College is a private liberal arts college in Winter Park, Florida- just outside downtown Orlando. The…

South Platte Renew Wastewater Treatment Plant, Colorado

South Platte Renew Wastewater Treatment Facility

“Wastewater epidemiology is one key piece of the puzzle for decision makers” — Blair Corning, Deputy Director of Environmental Programs, South Platte Renew.

Turning Serendipity into Opportunity

Just a few days into the pandemic, Pieter Van Ry happened to see a story about Biobot Analytics’ COVID-19 work, which focuses on detecting and quantifying indicators of COVID-19 in sewage samples.

Van Ry, the Director of South Platte Renew (SPR) in Colorado, immediately saw the value of wastewater analytics. “It was an effort to determine if there was a way that we could gain more information or have another tool early on in the pandemic to…

The City of Harrisburg, Pennsylvania

The City of Harrisburg, Pennsylvania

I would recommend Biobot Analytics for any municipality that has a wastewater system.”— Mayor Eric Papenfuse, City of Harrisburg

Analytics that Inform and Empower

Before the COVID-19 pandemic hit Pennsylvania, the state capital normally swelled with commuters during the day. Once COVID-19 hit and remote work took over, the local economy was devastated due to the loss of its usual customer base.

Mayor Eric Papenfuse knew that he had to respond to the dual health and economic crises in a comprehensive and informed way. …

We know that COVID-19 testing still matters. But which is better: Wastewater-based or clinical COVID-19 test data? The answer is easy — Both.

To understand why, it’s important to first understand differences in how samples are collected for each type of test.

Wastewater testing collects information from groups of people. Virus is shed in the stool of infected individuals among thousands of other stool samples that are flushed down the toilet daily, mixed together in the sewer system, and collected downstream in a vial in aggregate.

Source: Biobot Analytics, Inc.

Clinical testing collects information from individuals. …

As vaccination expands across the US, the ability to monitor the virus concentration in sewage in parallel with vaccine rollout and reported Covid-19 cases can provide real-world evidence for, and improve our understanding of, the impact of vaccination on reducing the spread of Covid-19.

Monitoring wastewater data provides invaluable insight. The SARS-CoV-2 virus is shed in the stool of infected individuals and aggregated in public sewers, where it can be detected and quantified to provide information on population-level Covid-19 incidence. …

Read about our method to estimate the number of COVID19 cases from wastewater viral titers without assuming a viral shedding parameter from clinical studies

Why it matters

The presence of SARS-CoV-2 in the feces of COVID-19 patients and in wastewater has drawn attention to the use of wastewater surveillance as an epidemiological tool. Communities are looking at SARS-CoV-2 viral titers to understand trends over time, and further inform reopening plans for states and school systems. However, we believe that there’s much more that can be learned from wastewater data. For example, at Biobot we have been pioneering the development of models to estimate the number of COVID-19 cases from viral titers. …

Viral concentrations of SARS-CoV-2 in wastewater are a predictive indicator of the number of COVID-19 cases within a community, demonstrating how Wastewater-Based Epidemiology can serve as a crucial early-warning system in the fight against coronavirus and future pandemics.

As the U.S. continues to grapple with a rise in COVID-19 cases across the country, public health officials have an incredibly difficult job determining when to reopen communities and businesses, as well as when to issue stay-at-home orders in response to new outbreaks. Now, more than ever, officials need smarter data to help them make these tough decisions.

Unfortunately, current testing and hospitalization data present a narrow and delayed snapshot into the spread of the virus within a community. This data also does not account for asymptomatic cases, which constitute a high proportion of any given infected population.

For the…

“I’ve been dealing with viral outbreaks for the last 40 years. I’ve never seen a single virus — that is, one pathogen — have a range where 20 percent to 40 percent of the people have no symptoms.” That’s what Dr. Anthony Fauci recently told the House Committee on Energy and Commerce.

For those concerned with public health, Dr. Fauci’s comment highlights an alarming fact about the coronavirus that presents a unique challenge. If people are asymptomatic, then they don’t know they have the virus — so they don’t get tested.

Accordingly, basing measures of prevalence on hospitalizations or deaths…

Biobot Analytics

We analyze sewage for viruses, bacteria and chemical metabolites excreted in urine and stool. We map this data, enabling smarter public health decisions.

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