Tracking viruses might be tricky.
Sewage provides an answer.
(All you’ve gotten to do is flush.)
Here’s how a scrappy team of scientists, public health experts and plumbers is embracing wastewater surveillance as the long run of disease tracking.
Aug. 17, 2022
The Covid-19 pandemic has turned sewage into gold.
People who find themselves infected with the coronavirus shed the pathogen of their stool. By measuring and sequencing the viral material present in sewage, scientists can determine whether cases are rising in a specific area and which variants are circulating.
People excrete the virus even in the event that they never seek testing or treatment. So wastewater surveillance has develop into a critical tool for keeping tabs on the virus, especially as Covid-19 testing has increasingly shifted to the house.
The institutions and localities that invested in wastewater surveillance during the last two years are discovering that it may be used to trace other health threats, too. The Sewer Coronavirus Alert Network has already begun tracking the monkeypox virus in wastewater. And last week, Recent York City officials announced that polio had been detected in town’s sewage.
Six months ago, NYC Health + Hospitals, a big, local health care system, began piloting its own wastewater surveillance system to trace the coronavirus and the flu. Monkeypox and polio monitoring will start as soon as next week. There are a selection of approaches to wastewater surveillance. Here’s a visible guide to how the coronavirus tracking process works in a single Recent York hospital.
Part 1: Within the Hospital Basement
Through which the toilets are flushed, sewage flows through a basement pipe and two intrepid scientists come to gather it.
Recent York City was the epicenter of the nation’s first Covid wave, and its hospitals were hit hard by several surges within the pandemic. In late 2021, Health + Hospitals decided to construct a sustainable, long-term pathogen surveillance system to get ahead of future outbreaks, said Leopolda Silvera, the worldwide health deputy at Elmhurst Hospital Center in Queens, which is a component of the health care network.
The wastewater surveillance initiative is now running at 10 hospitals, however it began, in February, at Elmhurst.
Coronavirus fragments deposited into hospital toilets travel through the plumbing system and enter a sewage pipe within the basement.
“That is our baby,” John Reilly, the supervisor plumber at Elmhurst, said, banging on the surface of the pipe. Every Monday, a member of the wastewater team drops a group device, which the team calls the Contraption, into a gap within the pipe.
Over the following 24 hours, the wastewater will rush over, around and thru the device.
The subsequent day, two researchers arrive to envision on the Contraption. “I need to warn you that it’s going to be gross,” said Sherin Kannoly, who was on collection duty with Justin Silbiger.
Wearing masks and gloves, they fastidiously remove the device from the pipe after which use tweezers to extract a tampon — yes, a tampon — from the mesh tube.
The researchers have experimented with different designs for the Contraption; someday this spring they were using a porous metal cylinder that contained a tampon to soak up the wastewater. Their current design uses charcoal water filters as an alternative.
The technicians double-bag the waterlogged tampon to make sure it doesn’t leak on the 15-minute drive across Queens.
Then they put the sample on ice and click on the cooler shut. The dirty work is finished.
Part 2: Within the Queens College Lab
Through which the degrees of the virus are measured.
Before the pandemic hit, John Dennehy spent his time studying bacteriophages, or viruses that infect bacteria, often isolating them from wastewater. “When the pandemic got here, I felt like I had an obligation as a virologist to contribute my skills,” Dr. Dennehy said.
In 2020, Dr. Dennehy, with colleagues including Monica Trujillo, a microbiologist at Queensborough Community College, began testing samples of town’s wastewater for the coronavirus. Once they heard that the hospitals desired to create their very own surveillance system, they were wanting to help. Dr. Dennehy’s lab at Queens College is the primary stop for the hospital samples.
The sample is pasteurized in a hot water bath, making it protected for scientists to handle. Then, the water is filtered to remove solids and debris.
The scientists add two compounds, polyethylene glycol and sodium chloride, to assist the virus form a solid precipitate.
The sample incubates within the fridge overnight after which spins in a centrifuge. When the method is complete, the researchers are left with a tiny pellet of virus.
They add a vibrant pink chemical called TRIzol to extract the RNA from the viral pellet. (In real life, science rarely looks the way in which it does in the flicks — the shockingly pink concoction is an exception, the researchers noted with enthusiasm.)
To find out how much virus is present within the sample, the researchers use P.C.R., the identical method used to check people for the virus. They put the RNA they’ve extracted into the tiny wells of a P.C.R. plate after which slide the plate right into a machine often called a thermal cycler.
The machine will amplify — make copies of — the viral RNA and measure how much is present. The more RNA there’s, the more virus presumably is present within the wastewater and, by extension, within the hospital community.
The researchers share the outcomes with hospital officials. This system has already proven promising.
Dr. Dennehy, Dr. Trujillo and their colleagues have found that the quantity of coronavirus and influenza within the hospital’s wastewater often began rising 10 to 14 days before the hospital saw a rise in Covid and flu patients.
“If you find yourself testing all the things and everybody, the wastewater doesn’t provide you with such an enormous lead,” Dr. Trujillo said. But once coronavirus testing in town dropped off, the wastewater data became especially worthwhile. “It’s really something that we hope that will likely be incorporated as one other tool for public health,” she said.
Ms. Silvera, the worldwide health deputy at Elmhurst, ferries the Queens College samples, and a few additional bottles of wastewater, to a business laboratory …
…and deposits them within the fridge…
…to maintain them cool until they’re able to be processed.
Part 3: Within the Pandemic Response Lab
Through which variants are identified.
Opentrons Labworks Inc., a laboratory robotics company, created the Pandemic Response Lab in 2020 to offer high-volume, high-speed coronavirus testing and, later, coronavirus sequencing of patient samples. The seek for viral variants in wastewater involves essentially the identical process.
“It just so happens that that sample will not be coming from an individual but from wastewater, which, you understand, has some elements that got here from people,” said Jonathan Brennan-Badal, the chief executive of Opentrons.
The Queens College laboratory isolated the virus’s RNA. To sequence the genetic material, the Pandemic Response Lab first converts the RNA into DNA, a process often called reverse transcription.
A pipetting robot adds the crucial chemicals and enzymes to a plate containing small amounts of the viral RNA. The plate is then placed right into a thermal cycler — every one emblazoned with a Snow White-inspired name — and the enzymes convert the RNA into DNA.
The scientists shuttle the sample backwards and forwards between a small army of laboratory robots.
The robots add chemicals and enzymes, and the samples are manipulated in quite a lot of ways. The viral DNA is amplified after which chopped up into fragments which are short enough to be read by the sequencer.
These fragments are then amplified and marked with molecular barcodes, which permit the scientists to later distinguish individual samples from a pool of them. Finally, the samples are cleaned after which combined, sometimes by hand.
In spite of everything the humans and robots have accomplished their respective tasks, the pooled samples are loaded into the sequencer, which determines the genetic sequence of every fragment, allowing scientists to find out what mutations and variants are present.
The outcomes are mechanically uploaded to a server and processed. The findings are reported to the hospitals weekly.
The sequencing results “reflect what has been seen with clinical data,” Ms. Silvera said. Because the BA.4 and BA.5 variants of the coronavirus spread, as an example, they began to “dominate” the wastewater samples, she added.
The hospital project is just one in every of many bobbing up across the country and around the globe. Recent York City has its own city-wide wastewater surveillance system, which involves collecting sewage samples from municipal wastewater facilities, including the Newtown Creek Wastewater Treatment Plant.
And the hospital team is already looking toward the long run, considering how the identical system could be harnessed to observe quite a lot of potential health threats. “The data is invaluable, truthfully,” Ms. Silvera said.
And all it takes is a flush.
Tracking viruses might be tricky.
Sewage provides an answer.
(All you’ve gotten to do is flush.)
Here’s how a scrappy team of scientists, public health experts and plumbers is embracing wastewater surveillance as the long run of disease tracking.
Aug. 17, 2022
The Covid-19 pandemic has turned sewage into gold.
People who find themselves infected with the coronavirus shed the pathogen of their stool. By measuring and sequencing the viral material present in sewage, scientists can determine whether cases are rising in a specific area and which variants are circulating.
People excrete the virus even in the event that they never seek testing or treatment. So wastewater surveillance has develop into a critical tool for keeping tabs on the virus, especially as Covid-19 testing has increasingly shifted to the house.
The institutions and localities that invested in wastewater surveillance during the last two years are discovering that it may be used to trace other health threats, too. The Sewer Coronavirus Alert Network has already begun tracking the monkeypox virus in wastewater. And last week, Recent York City officials announced that polio had been detected in town’s sewage.
Six months ago, NYC Health + Hospitals, a big, local health care system, began piloting its own wastewater surveillance system to trace the coronavirus and the flu. Monkeypox and polio monitoring will start as soon as next week. There are a selection of approaches to wastewater surveillance. Here’s a visible guide to how the coronavirus tracking process works in a single Recent York hospital.
Part 1: Within the Hospital Basement
Through which the toilets are flushed, sewage flows through a basement pipe and two intrepid scientists come to gather it.
Recent York City was the epicenter of the nation’s first Covid wave, and its hospitals were hit hard by several surges within the pandemic. In late 2021, Health + Hospitals decided to construct a sustainable, long-term pathogen surveillance system to get ahead of future outbreaks, said Leopolda Silvera, the worldwide health deputy at Elmhurst Hospital Center in Queens, which is a component of the health care network.
The wastewater surveillance initiative is now running at 10 hospitals, however it began, in February, at Elmhurst.
Coronavirus fragments deposited into hospital toilets travel through the plumbing system and enter a sewage pipe within the basement.
“That is our baby,” John Reilly, the supervisor plumber at Elmhurst, said, banging on the surface of the pipe. Every Monday, a member of the wastewater team drops a group device, which the team calls the Contraption, into a gap within the pipe.
Over the following 24 hours, the wastewater will rush over, around and thru the device.
The subsequent day, two researchers arrive to envision on the Contraption. “I need to warn you that it’s going to be gross,” said Sherin Kannoly, who was on collection duty with Justin Silbiger.
Wearing masks and gloves, they fastidiously remove the device from the pipe after which use tweezers to extract a tampon — yes, a tampon — from the mesh tube.
The researchers have experimented with different designs for the Contraption; someday this spring they were using a porous metal cylinder that contained a tampon to soak up the wastewater. Their current design uses charcoal water filters as an alternative.
The technicians double-bag the waterlogged tampon to make sure it doesn’t leak on the 15-minute drive across Queens.
Then they put the sample on ice and click on the cooler shut. The dirty work is finished.
Part 2: Within the Queens College Lab
Through which the degrees of the virus are measured.
Before the pandemic hit, John Dennehy spent his time studying bacteriophages, or viruses that infect bacteria, often isolating them from wastewater. “When the pandemic got here, I felt like I had an obligation as a virologist to contribute my skills,” Dr. Dennehy said.
In 2020, Dr. Dennehy, with colleagues including Monica Trujillo, a microbiologist at Queensborough Community College, began testing samples of town’s wastewater for the coronavirus. Once they heard that the hospitals desired to create their very own surveillance system, they were wanting to help. Dr. Dennehy’s lab at Queens College is the primary stop for the hospital samples.
The sample is pasteurized in a hot water bath, making it protected for scientists to handle. Then, the water is filtered to remove solids and debris.
The scientists add two compounds, polyethylene glycol and sodium chloride, to assist the virus form a solid precipitate.
The sample incubates within the fridge overnight after which spins in a centrifuge. When the method is complete, the researchers are left with a tiny pellet of virus.
They add a vibrant pink chemical called TRIzol to extract the RNA from the viral pellet. (In real life, science rarely looks the way in which it does in the flicks — the shockingly pink concoction is an exception, the researchers noted with enthusiasm.)
To find out how much virus is present within the sample, the researchers use P.C.R., the identical method used to check people for the virus. They put the RNA they’ve extracted into the tiny wells of a P.C.R. plate after which slide the plate right into a machine often called a thermal cycler.
The machine will amplify — make copies of — the viral RNA and measure how much is present. The more RNA there’s, the more virus presumably is present within the wastewater and, by extension, within the hospital community.
The researchers share the outcomes with hospital officials. This system has already proven promising.
Dr. Dennehy, Dr. Trujillo and their colleagues have found that the quantity of coronavirus and influenza within the hospital’s wastewater often began rising 10 to 14 days before the hospital saw a rise in Covid and flu patients.
“If you find yourself testing all the things and everybody, the wastewater doesn’t provide you with such an enormous lead,” Dr. Trujillo said. But once coronavirus testing in town dropped off, the wastewater data became especially worthwhile. “It’s really something that we hope that will likely be incorporated as one other tool for public health,” she said.
Ms. Silvera, the worldwide health deputy at Elmhurst, ferries the Queens College samples, and a few additional bottles of wastewater, to a business laboratory …
…and deposits them within the fridge…
…to maintain them cool until they’re able to be processed.
Part 3: Within the Pandemic Response Lab
Through which variants are identified.
Opentrons Labworks Inc., a laboratory robotics company, created the Pandemic Response Lab in 2020 to offer high-volume, high-speed coronavirus testing and, later, coronavirus sequencing of patient samples. The seek for viral variants in wastewater involves essentially the identical process.
“It just so happens that that sample will not be coming from an individual but from wastewater, which, you understand, has some elements that got here from people,” said Jonathan Brennan-Badal, the chief executive of Opentrons.
The Queens College laboratory isolated the virus’s RNA. To sequence the genetic material, the Pandemic Response Lab first converts the RNA into DNA, a process often called reverse transcription.
A pipetting robot adds the crucial chemicals and enzymes to a plate containing small amounts of the viral RNA. The plate is then placed right into a thermal cycler — every one emblazoned with a Snow White-inspired name — and the enzymes convert the RNA into DNA.
The scientists shuttle the sample backwards and forwards between a small army of laboratory robots.
The robots add chemicals and enzymes, and the samples are manipulated in quite a lot of ways. The viral DNA is amplified after which chopped up into fragments which are short enough to be read by the sequencer.
These fragments are then amplified and marked with molecular barcodes, which permit the scientists to later distinguish individual samples from a pool of them. Finally, the samples are cleaned after which combined, sometimes by hand.
In spite of everything the humans and robots have accomplished their respective tasks, the pooled samples are loaded into the sequencer, which determines the genetic sequence of every fragment, allowing scientists to find out what mutations and variants are present.
The outcomes are mechanically uploaded to a server and processed. The findings are reported to the hospitals weekly.
The sequencing results “reflect what has been seen with clinical data,” Ms. Silvera said. Because the BA.4 and BA.5 variants of the coronavirus spread, as an example, they began to “dominate” the wastewater samples, she added.
The hospital project is just one in every of many bobbing up across the country and around the globe. Recent York City has its own city-wide wastewater surveillance system, which involves collecting sewage samples from municipal wastewater facilities, including the Newtown Creek Wastewater Treatment Plant.
And the hospital team is already looking toward the long run, considering how the identical system could be harnessed to observe quite a lot of potential health threats. “The data is invaluable, truthfully,” Ms. Silvera said.
And all it takes is a flush.
