Everyone poops —and that universality means sewage can potentially provide a lot of information about a community’s health.
To that end, Biobot Analytics, a wastewater epidemiology company based in Cambridge, Massachusetts, has recruited 350 wastewater plants across the country to participate in a nine-month analysis program that includes the City and Borough of Juneau.
The Mendenhall Wastewater Facility along with the Juneau Wastewater Utility Division have just begun shipping off samples collected from the city’s wastewater to Biobot for the specific purpose of testing and quantifying the presence of the SARS-CoV-2 virus, which causes COVID-19. That data is then submitted by Biobot to the Centers for Disease Control and Prevention where it’s made accessible to state and local health departments so decisions can then be made from a community
Biobot’s strategic account specialist Cameron Colby said that while the program is currently set to strictly monitor for COVID-19 variants for the length of nine months, the company has intentions of expanding not only the timeline for testing but the extend of what is tested for.
“This phase of the contract that we’re in is just intended to be a nine-month period and focused on COVID, however, the intention of having a national wastewater surveillance system, a network of wastewater treatment plants across the country that are submitting samples to be analyzed for a plethora of diseases, so that we’re not just responding to a public health crisis once we know that it’s a problem, we’re able to be more proactive about it,” Colby said. “Currently, we are in the research and development phase, and we’ll launch monkeypox analyses in early fall of 2022.”
Colby added that Biobot wants to be in a position to pivot quickly to analyze wastewater for other emerging health concerns.
Biobot’s testing can be used to test wastewater for high-risk substances such as fentanyl, opioids, methamphetamine and cocaine and determine what kind of activity might be happening within a community, according to Colby.
How does it work?
According to Chad Gubala, product and treatment manager for the Mendenhall Wastewater Facility, wastewater surveillance isn’t exactly a new concept, but with the emergence of Biobot, the process has become much more sophisticated in terms of not only what can be tested for but also how narrow of a scope the testing can be.
“When I went through to enter us into the Biobot system, they were all game for actually having us sample as many points as we wanted to within Juneau, so there’s actually not only the opportunity to do sort of a communitywide integrative look at the health, but you can also now narrow things down by neighborhood if you wanted to, so it’s rather fascinating,” Gubala said.
The way in which wastewater gets tested is relatively standard from state to state; a stream of sewage water flows into the plant and while in addition to trash being filtered out, there are two separate samples that are taken from the stream: the influent and effluent channels. According to Gubala, the influent sample is used for COVID due to the fact that the treatment process degrades the remnant virus significantly, while the effluent sample is a mandatory part of treatment facility’s regulatory compliance.
In order to regulatory compliance to occur, treatment plants rely on a device known as ISCO composite samplers. The ISCO composite samplers pull a sample once an hour and those samples are then composited and sent out for regulatory compliance monitoring two to three times a week in compliance with the U.S. Environmental Protection Agency and the Alaska Department of Environmental Conservation.
“We’re obliged by the state and the feds through the EPA and through our permitting process to make sure that we discharge under permitted limits for things like biochemical oxygen demand (BOD), we have to stay within certain PH levels, we need to basically be absent of any E. coli, so our waste stream is heavily monitored by us three times a week and that gets reported into the state as part of our regulatory compliance,” Gubala said.
Breaking new ground
Gubala said that by participating in Biobot’s program, nothing changes within the city’s regulatory compliance testing, but rather a larger sample is pulled from the stream than is typically required and is then split and divided according to what Biobot wants. “We’re looking forward to this, our deputy city manager and our deputy public works director are the two COVID coordinators for the city, so we’re working in a bit of a vacuum without having as much as direct testing or surveillance as there was before, so everyone is looking forward to actually getting some indication as to how our community is doing on this,” said Gubala. “We’re keen to participate in the program largely so we can see how Juneau is tracking in time and what’s happening in our community in an aggregate manner, but then also Biobot is publishing information from all of the testing facilities that they’re engaged with, so we’ll be able to see how we’re fairing with the COVID pandemic nationwide, as well. Those are the key things for us, we’re looking at the results on this as being a very instructive and useful tracking parameter for us.”
Biobot is the first in the country to bring to market the quantification of Sars-coV-2 in a commercial product, Colby said, in addition to providing such a short turnaround to then share the results of the data.
Colby also explained that Juneau was selected to participate in the program based on a list of treatment plants from the CDC, which were selected by each individual state.
The program officially began in April of 2022 and is scheduled to end in January of 2023, however, Juneau facilities just started sending out samples at the end of August. Colby said many state departments of health worked directly with the Centers for Disease Control and Prevention to provide a list of priority wastewater treatment plants for Biobot to assume outreach to.
“Each state department of public health got together and they selected wastewater treatment plants specifically in areas that may not have constant access to testing and also areas that may have traditionally been more underserved,” Colby said. “So, the public health departments gathered up that list of wastewater treatment plants, they submitted that to the CDC, the CDC gave that list to Biobot and we then reached out directly to those wastewater treatment plants to recruit them to join in this program and start submitting samples.”
Biobot worked closely with Water Environment Federation to enroll two utilities in Alaska, Juneau being the most recent to enroll in mid-August after a few months of conversation about program logistics, hence the reason for Juneau’s slight delay in sending out samples.
When wastewater samples are sent to be analyzed for the presence of COVID-19, the virus is no longer able to infect anyone and is in an inactive state, Colby said. People who are positive for the virus then shed RNA of the virus in their fecal matter whether they’re asymptomatic, have heavy symptoms or no symptoms at all.
Also, Colby said the Biobot testing is useful in understanding the severity of COVID-19 variants when not everyone can be tested individually due to not having health insurance, testing for variants through wastewater becomes a much more reliable and cost-effective measure.
“Community officials can make decisions on masking requirements potentially. We’ve had instances in states where hospitals have made decisions to halt electric surgeries until virus levels start to come down again, and then also people can individually make those decisions; if you see there’s a trend of over a period of time of increasing presence of the virus in the community you’re in, you may make decisions to wear a mask out; let’s say if you’re immunosuppressed or you have elderly people that you interact with on a frequent basis, it also helps people at that personal level make decisions about their own personal health.”
Colby said the operators at the Juneau wastewater treatment plant are collecting samples two times per week and they’re sent to Biobot’s lab in Cambridge, Massachusetts to be analyzed. The shipping time from sample collection to when they arrive in our lab will be about one to two days and then they have results turned around within 24-hours. While the program currently is set to last for nine months, Colby said there are hopes of eventually expanding the use of Biobots testing for longer periods of time, as well as an extension of what specifically is tested for.
“This phase of the contract that we’re in is just intended to be a nine-month period and focused on COVID, however, the intention of having a national wastewater surveillance system, a network of wastewater treatment plants across the country that are submitting samples to be analyzed for a plethora of diseases, that’s the idea,” Colby said. “A sustainable and ongoing network of these plants that are constantly sending samples to be analyzed so that we’re not just responding to a public health crisis once we know that it’s a problem, we’re able to be more proactive about it. So, while the contract is finite, and it ends in January of 2023, the idea or the intention for us is that this becomes a more permanent fixture in public health surveillance across the country.”
Biobot data visualization (which CDC participants have the choice to opt into) can be found at https://biobot.io/data/, as well as the link to the CDC COVID-19 Tracker Wastewater Surveillance page at https://covid.cdc.gov/covid-data-tracker/#wastewater-surveillance.