Colorado is moving toward statewide coverage of wastewater surveillance

Colorado is moving toward statewide coverage¹ of wastewater surveillance

Transcript²

After you take care of business and push the handle on your toilet, it's out of sight, out of mind, right?

But when the pandemic started, some folks, like Pieter Van Ry, realized there's actually gold in that stuff.

"How it began was I actually, on a Sunday morning, woke up and I read a Popular Mechanics article," he said. This was early on, March 2020, when the first wave of COVID-19 infections hit. "At the end of that article, it said, 'If you have a wastewater facility and you're interested in participating in this study, please contact us.'"

As a matter of a fact, he did happen to have a wastewater facility.

Van Ry directs South Platte Renew. Its Englewood treatment plant serves 300,000 people southwest of Denver. That article Van Ry read had a catchy³ title: How Poop Offers Hints About The Spread of Coronavirus.

KHN logo

This story was produced in partnership⁴ with Kaiser Health News.

To see just how, I took a visit to the South Platte facility. On a snowy February afternoon, a hatch was opened down to a dark stream where the effluent flows into the plant.

"So this is essentially⁵ where it comes in," Van Ry said, motioning to where big pipes meet down more than dozen feet below.

Let's just say the odor did not carry the delightful⁶ fragrance⁷ of a dozen roses.

Van Ry's colleague, lead operator Brandon Hinkhouse, showed how a machine siphoned off fluid through piping into a white plastic container.

"It grabs a sample and then purges⁸ it again. Then it'll actually take a sample and that's what we collect," he said.

The South Platte team sends those wastewater samples to a Massachusetts company called Biobot Analytics. Its mission: "population health analytics powered by sewage."

How the testing works

From the start, lab results from the samples showed exactly what the virus was doing, Van Ry said. The team at South Platte Renew had stumbled onto a powerful new public health tool: testing wastewater to monitor, wave by wave, the spread of a virus.

"It was spreading rapidly through the community," Van Ry said.

In a conference room, he showed a slide of data from samples. All the surges were clear: alpha, delta⁹ and then a spectacular spike¹⁰ driven by a new variant¹¹ in early 2022.

The technique caught on around Colorado and the country. Colorado Mesa University's program, in collaboration¹² with the Broad Institute of M.I.T. and Harvard, generated national coverage via a story in the New York Times.

Now the federal Centers for Disease Control and Prevention is aiming to expand wastewater testing with the National Wastewater Surveillance System.

And Colorado is doing the same.

At the state lab in Denver, techs wearing masks and white lab coats draw out liquid with pipettes.

"The samples come in here and they start their initial processing," said lab director Emily Travanty. "They get concentrated and filtered, and then they go on to the detection and sequencing."

People infected with SARS-CoV-2, the virus that causes COVID-19, shed viral RNA, genetic¹³ material from the virus, in their feces. In wastewater tests, scientists use that RNA to tell what's there.

Travanty said the Colorado Department of Public Health & Environment (CDPHE) started doing this five years ago with routine testing of foodborne illnesses, like salmonella.

"So we were able to pivot¹⁴ that expertise¹⁵ toward COVID-19 as the pandemic emerged, and build upon that expertise within the laboratory," she said.

Effort could expand

The agency is now working with 47 wastewater utilities that currently serve about 60% of Colorado's population. Its goal is statewide coverage.

The state compiles the data from a variety of sites on a public dashboard. It also shares its numbers with the CDC. About $9.4 million in federal funds is paying for the state's wastewater testing project from January 2021 through at least July 2023. The total includes personnel, supplies, equipment and contracts.

Travanty's colleague, epidemiologist Rachel Jervis, noted¹⁶ that with clinical coronavirus tests, someone needs to seek medical care, get tested and then get results.

"Whereas with COVID wastewater, we found that up to 50 percent of people will shed COVID virus in their stool regardless of whether or not they have symptoms," she said. "So we're sort of removing the human behavior component¹⁷ of seeking medical care."

Along with normal testing, it gives an early warning sign about where COVID spread is highest.

"Essentially we're looking at trends. We rarely use a single sample to infer much about our COVID wastewater data," Jervis said. "We're looking at trends across several samples."

"It's a blunt instrument in some sense, right? You're able to say that, 'Yeah, there seems to be a lot of virus in this location at this time,'" said Jude Bayham, an assistant professor at Colorado State University and in the Colorado School of Public Health, who is also a member of the state's COVID-19 modeling team.

Bayham said as overall COVID-19 trends improve and Colorado pivots¹⁸ to the next phase — and maybe scales down other testing — still-evolving wastewater analysis promises to step up.

"Wastewater surveillance is a relatively¹⁹ cheap alternative that can provide a lot of information," he said.

That kind of information can guide coronavirus response.

Action at the University of Denver

At the University of Denver, outside a red-bricked dorm, some folks with the school's response team recently cracked open a heavy steel manhole lid.

Down below, a steady stream of wastewater flowed.

"That's sewage right now. Well, it's everything right now," said Keith Miller²⁰, an associate professor in chemistry and biochemistry at DU. "It's heavy load, right? They're taking showers right now. So there isn't a lot of solids."

In fall 2020, the first weeks of the in-person school year, DU's team started pulling samples from pipes like this.

Mechanical engineer Corinne Lengsfeld oversees²¹ the campus's saliva²² testing lab. She said a wastewater sample taken on one Friday early that semester was off the charts. "It was a million virus units per one liter," she said. "Holy Toledo!"

That information convinced school officials to have everyone in the dorm do rapid nasal testing. "That's what wastewater testing is — it's the one that's gonna give you the biggest picture first," Miller said.

Using the wastewater data, plus following up with quick testing, allowed them to quickly identify 10 infectious students and move them to an isolation²³ dorm. Lengsfeld said that without that, perhaps 100 more students in the dorm of 300 might have caught it.

"It works. I mean, it definitely is a case study, I think, of exactly how to control spread," she said.

How testing wastewater will help in the future

Back at Platte Valley, Pieter Van Ry also takes pride in his team's work. Treatment plants like this have generally been unheralded, doing a key job no one wants to think about, and is often the butt²⁴ of wisecracks.

"Yeah, your number two is our number one," he said. "There's a lot of good ones out there."

But now there's a new lofty priority: to be a sentinel of coming contagion²⁵. And not just for COVID-19. Eventually, it could be used to spot other diseases too.

"It could be one of those things that does become somewhat of a game changer in terms of understanding community health," Van Ry said.

"We are really excited about this new tool," said state epidemiologist Dr. Rachel Herlihy. "It will help us understand regional differences. It's also been incredibly useful for us in understanding the emergence²⁶ of new variants²⁷."

"We're still really figuring out how to best put it to use," Herlihy added.

A top official with the CDC sees it that way too, telling reporters in a recent conference call that the agency anticipates using the system for infectious diseases and other things.

"One of the strengths of wastewater surveillance is that it is very flexible," said CDC microbiologist Dr. Amy Kirby, team lead for the National Wastewater Surveillance System. "So once we have built this infrastructure²⁸ to collect the samples, get them to a laboratory, get the data to CDC, we can add tests for new pathogens fairly quickly."

Should a new pathogen of interest pop up, she said, they could ramp²⁹ up this system within a few weeks to start gathering³⁰ community level data on it.

The agency expects to be able to use the system to target other pathogens, such as antibiotic³¹ resistance, foodborne infections, and an emerging fungal organism called Candida auris.

There is also interest, down the road, in using it for noninfectious diseases, like tracking substance abuse, Kirby said.

While the approach is groundbreaking in the U.S., it's been used for years elsewhere.

"Wastewater surveillance has been used for many decades to track polio in communities, not in the U.S., but definitely overseas as part of polio eradication³² efforts," Kirby said. "And they use it essentially the same way we do – to look for communities where polio is circulating and then use that as a trigger for additional clinical surveillance in those communities."

TSR: John Daley / Wastewater Surveillance in the Nationl Covid Plan : The federal Centers for Disease Control and Prevention is aiming to expand wastewater testing with the National Wastewater Surveillance System. And it's all part of the Biden plan to track and contain covid going forward. Colorado is doing this to such an extent that much of its population is "covered" — but nationally only a quarter of the population is covered. John Daley, CPR.

1 coverage   

n.报导，保险范围，保险额，范围，覆盖

参考例句：

• There's little coverage of foreign news in the newspaper.报纸上几乎没有国外新闻报道。
• This is an insurance policy with extensive coverage.这是一项承保范围广泛的保险。

2 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

3 catchy   

adj.易记住的，诡诈的，易使人上当的

参考例句：

• We need a new slogan.The old one's not catchy enough.我们需要新的口号，旧的不够吸引人。
• The chorus is very catchy to say the least.副歌部分很容易上口。

4 partnership   

n.合作关系，伙伴关系

参考例句：

• The company has gone into partnership with Swiss Bank Corporation.这家公司已经和瑞士银行公司建立合作关系。
• Martin has taken him into general partnership in his company.马丁已让他成为公司的普通合伙人。

5 essentially   

adv.本质上，实质上，基本上

参考例句：

• Really great men are essentially modest.真正的伟人大都很谦虚。
• She is an essentially selfish person.她本质上是个自私自利的人。

6 delightful   

adj.令人高兴的，使人快乐的

参考例句：

• We had a delightful time by the seashore last Sunday.上星期天我们在海滨玩得真痛快。
• Peter played a delightful melody on his flute.彼得用笛子吹奏了一支欢快的曲子。

7 fragrance   

n.芬芳，香味，香气

参考例句：

• The apple blossoms filled the air with their fragrance.苹果花使空气充满香味。
• The fragrance of lavender filled the room.房间里充满了薰衣草的香味。

8 purges   

清除异己( purge的名词复数 )； 整肃（行动）； 清洗； 泻药

参考例句：

• Mandelshtam perished in the purges of the 1930s, Akhmatova remained silent. 曼杰利什坦姆在30年代的清洗中死去，阿赫玛托娃也销声匿迹。
• He purges his subconscious and meditates only on God. 他净化他的潜意识且只思念上帝。

9 delta   

n.（流的）角洲

参考例句：

• He has been to the delta of the Nile.他曾去过尼罗河三角洲。
• The Nile divides at its mouth and forms a delta.尼罗河在河口分岔，形成了一个三角洲。

10 spike   

n.长钉，钉鞋；v.以大钉钉牢，使...失效

参考例句：

• The spike pierced the receipts and held them in order.那个钉子穿过那些收据并使之按顺序排列。
• They'll do anything to spike the guns of the opposition.他们会使出各种手段来挫败对手。

11 variant   

adj.不同的，变异的；n.变体，异体

参考例句：

• We give professional suggestions according to variant tanning stages for each customer.我们针对每位顾客不同的日晒阶段，提供强度适合的晒黑建议。
• In a variant of this approach,the tests are data- driven.这个方法的一个变种，是数据驱动的测试。

12 collaboration   

n.合作，协作；勾结

参考例句：

• The two companies are working in close collaboration each other.这两家公司密切合作。
• He was shot for collaboration with the enemy.他因通敌而被枪毙了。

13 genetic   

adj.遗传的，遗传学的

参考例句：

• It's very difficult to treat genetic diseases.遗传性疾病治疗起来很困难。
• Each daughter cell can receive a full complement of the genetic information.每个子细胞可以收到遗传信息的一个完全补偿物。

14 pivot   

v.在枢轴上转动；装枢轴，枢轴；adj.枢轴的

参考例句：

• She is the central pivot of creation and represents the feminine aspect in all things.她是创造的中心枢轴，表现出万物的女性面貌。
• If a spring is present,the hand wheel will pivot on the spring.如果有弹簧，手轮的枢轴会装在弹簧上。

15 expertise   

n.专门知识(或技能等)，专长

参考例句：

• We were amazed at his expertise on the ski slopes.他斜坡滑雪的技能使我们赞叹不已。
• You really have the technical expertise in a new breakthrough.让你真正在专业技术上有一个全新的突破。

16 noted   

adj.著名的，知名的

参考例句：

• The local hotel is noted for its good table.当地的那家酒店以餐食精美而著称。
• Jim is noted for arriving late for work.吉姆上班迟到出了名。

17 component   

n.组成部分，成分，元件；adj.组成的，合成的

参考例句：

• Each component is carefully checked before assembly.每个零件在装配前都经过仔细检查。
• Blade and handle are the component parts of a knife.刀身和刀柄是一把刀的组成部分。

18 pivots   

n.枢( pivot的名词复数 )；最重要的人（或事物）；中心；核心v.（似）在枢轴上转动( pivot的第三人称单数 )；把…放在枢轴上；以…为核心，围绕（主旨）展开

参考例句：

• The success of the project pivots on investment from abroad. 这个工程的成功主要依靠外来投资。 来自《简明英汉词典》
• The novel pivots around a long conversation between two characters. 这部小说是以两个人物的对话为中心展开的。 来自《简明英汉词典》

19 relatively   

adv.比较...地，相对地

参考例句：

• The rabbit is a relatively recent introduction in Australia.兔子是相对较新引入澳大利亚的物种。
• The operation was relatively painless.手术相对来说不痛。

20 miller   

n.磨坊主

参考例句：

• Every miller draws water to his own mill.磨坊主都往自己磨里注水。
• The skilful miller killed millions of lions with his ski.技术娴熟的磨坊主用雪橇杀死了上百万头狮子。

21 oversees   

v.监督，监视( oversee的第三人称单数 )

参考例句：

• She oversees both the research and the manufacturing departments. 她既监督研究部门又监督生产部门。 来自《简明英汉词典》
• The Department of Education oversees the federal programs dealing with education. 教育部监管处理教育的联邦程序。 来自互联网

22 saliva   

n.唾液，口水

参考例句：

• He wiped a dribble of saliva from his chin.他擦掉了下巴上的几滴口水。
• Saliva dribbled from the baby's mouth.唾液从婴儿的嘴里流了出来。

23 isolation   

n.隔离，孤立，分解，分离

参考例句：

• The millionaire lived in complete isolation from the outside world.这位富翁过着与世隔绝的生活。
• He retired and lived in relative isolation.他退休后，生活比较孤寂。

24 butt   

n.笑柄；烟蒂；枪托；臀部；v.用头撞或顶

参考例句：

• The water butt catches the overflow from this pipe.大水桶盛接管子里流出的东西。
• He was the butt of their jokes.他是他们的笑柄。

25 contagion   

n.(通过接触的疾病)传染；蔓延

参考例句：

• A contagion of fear swept through the crowd.一种恐惧感在人群中迅速蔓延开。
• The product contagion effect has numerous implications for marketing managers and retailers.产品传染效应对市场营销管理者和零售商都有很多的启示。

26 emergence   

n.浮现，显现，出现，（植物）突出体

参考例句：

• The last decade saw the emergence of a dynamic economy.最近10年见证了经济增长的姿态。
• Language emerges and develops with the emergence and development of society.语言是随着社会的产生而产生，随着社会的发展而发展的。

27 variants   

n.变体( variant的名词复数 )；变种；变型；（词等的）变体

参考例句：

• Those variants will be preserved in the'struggle for existence". 这些变异将在“生存竞争”中被保留下来。 来自辞典例句
• Like organisms, viruses have variants, generally called strains. 与其他生物一样，病毒也有变种，一般称之为株系。 来自辞典例句

28 infrastructure   

n.下部构造，下部组织，基础结构，基础设施

参考例句：

• We should step up the development of infrastructure for research.加强科学基础设施建设。
• We should strengthen cultural infrastructure and boost various types of popular culture.加强文化基础设施建设，发展各类群众文化。

29 ramp   

n.暴怒，斜坡，坡道；vi.作恐吓姿势，暴怒，加速；vt.加速

参考例句：

• That driver drove the car up the ramp.那司机将车开上了斜坡。
• The factory don't have that capacity to ramp up.这家工厂没有能力加速生产。

30 gathering   

n.集会，聚会，聚集

参考例句：

• He called on Mr. White to speak at the gathering.他请怀特先生在集会上讲话。
• He is on the wing gathering material for his novels.他正忙于为他的小说收集资料。

31 antibiotic   

adj.抗菌的；n.抗生素

参考例句：

• The doctor said that I should take some antibiotic.医生说我应该服些用抗生素。
• Antibiotic can be used against infection.抗菌素可以用来防止感染。

32 eradication   

n.根除

参考例句：

• The eradication of an established infestation is not easy. 根除昆虫蔓延是不容易的。
• This is often required for intelligent control and eradication. 这经常需要灵巧的控制与消除。