One Test to Rule them All! Tracking COVID-19 in our Sewers

Welcome to the first episode of the Water We Doing Podcast! 

The COVID-19 pandemic has impacted everyone across this planet, has tested our ability to adapt, develop and role out vaccines and figure out efficient ways to test and monitor our entire population.

When testing is limited, what is the best way to understand the spread of a virus in a large population? In this episode we learn about Wastewater Surveillance and how you can test samples from our sewers to understand where the virus has spread. We get insight from Dr. Steve Hrudey the Chair of the COVID-19 Wastewater Coalition from the Canadian Water Network. Dr. Hrudey helps us understand how this technology works, where it's been used before, and how it can be used in the future.

You don't have to be a math whiz to know that being able to test an entire population with one sample versus testing everyone individually means a lot less work. This technology is becoming even more important as we begin tracking new variants within our communities and begin planning to protect ourselves for any potential future pandemics.

To find out more about the wastewater surveillance for COVID-19 in Canada and the  Canadian Water Network COVID-19 Wastewater Coalition Click Here.

To find out more about the Aquatic Biosphere Project Click Here.

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Transcript

David Evans: 0:19

Hi, and welcome to the first episode of the Water We Doing? podcast. My name is David Evans, and I'm the host and producer, and I'm so excited to go on this journey with you as we talk to experts about global issues. And we ask, what are we doing? And how can we do better. This is the official podcast of the Aquatic Biosphere Project out of Edmonton, Alberta, where we are planning to bring a water education and conservation facility to the province. I started this podcast as a way of talking about water issues and being able to learn from experts directly. And to be able to share that knowledge with anyone who might be interested. I've always been interested in environmental issues, I've been lucky enough to work with a number of different environmental organizations. And for the past five years, I've worked as a terrestrial field coordinator, conducting biodiversity monitoring for the Alberta Biodiversity Monitoring Institute, and InnoTech, Alberta. It's afforded me a really unique view of environmental issues right here in Alberta. And I'm so excited about this project to build on that knowledge and learn more about what are the issues that face Canada, and other countries around the world. When I'm not stomping around in the field collecting data on biodiversity, I volunteer my time as the director of conservation for the Aquatic Biosphere Project, and also as the host and producer of this podcast. Alright, that's enough about me. Let's dive into the show. Here is the first episode of the what are we doing podcast? You have no idea how excited I am to talk to you today. I am currently on the last night of my quarantine. Yes, my partner unfortunately tested positive for COVID we have been quarantining together. And then once her isolation ended, mine began. So I just completed a 10 days with her and 14 days on my own. And tomorrow is the first time I get to leave my house in 24 days, we've been super fortunate. And we haven't had any really rough symptoms, I haven't actually had any symptoms at all. So I don't even know if I actually even have had the virus. And that's where the danger of COVID-19 really lies. Because the symptoms present in so many different ways. It's really hard to know if you should get tested or if you shouldn't. But what if I told you that there was a way where we could test everyone without actually having to test people individually? In this episode, you'll hear from the chair of the COVID-19 wastewater coalition from the Canadian water network and University of Alberta, Dr. Steve Hrudey get ready because today we're all going to become spies as we learn the tips and tricks of wastewater surveillance for COVID-19. Water we doing? And how can we do better? your one stop shop for everything water related from discussing water to use and the organisms that depend on it. For all the global issues that you really never knew all had to do with water. I'm your host, David Evans from the Aquatic Biosphere Project. And I just want to ask you something. What are we doing? How can we do better? Our bodies have viral receptors that line our respiratory system. When you're initially getting infected with COVID-19, It's through these viral receptors along our respiratory route, that we actually get infected. During the process of getting infected and being infected. Anytime that we cough or we sneeze or we just laugh or anything like that these viral receptors actually begin to shed the virus and what that means is any droplets that come out of our mouth or nose, they actually may have the virus attached to them. And this is how we could potentially infect Others. That's why mask wearing is so important. Currently, most of the testing for COVID-19 is through nasal pharyngeal swabs chasing that 10 times fast. I'm sure many people listening have already experienced this. But for those who haven't, I can definitely attest, it isn't the most pleasant thing to have that long swab coming at you. And it just goes straight up your nose, and it feels like a tickling the bottom of your brain. So after receiving my test and testing negative, by the way, I was so curious to find out more about what's being done for testing, to see if there was other ways that we are actually testing for COVID-19 in the community without destroying everyone's noses. And this is when I discovered the interesting world of wastewater surveillance. I know it sounds gross. But as it turns out, we actually shed the virus COVID-19. Or as it's also called, SARS-Cov-2. To in our feces, yes, we're talking about sewage or wastewater today, and how we can use wastewater to track where COVID-19 has spread within our communities. The idea behind wastewater surveillance is that you could take a sample of any wastewater, and then be able to test for a pathogen, or an illicit drug or anything that the human body would excrete, to see if it's present in that sample. And that can tell you a lot about the people that are using that system. So let's say we're worried about a new virus that's coming into town, it might take a while before we start to see people report to hospitals saying that they have symptoms and they should be tested. But we may be able to detect it even earlier. If we're testing the wastewater from the city, and we detect the virus within that sample, then we know that the virus is in the community that people are shedding it, and we can take action before people might even realize that they are even sick. Now I needed to call in the big guns for this episode, just to make sure we got the facts completely straight. I reached out to the Canadian Water Network, which hosts the National Research advisory group on wastewater surveillance in Canada for COVID-19. I spoke with their chair.

Dr. Steve Hrudey, Canadian Water Network: 7:44

My name is Steve Hrudey. I'm a retired professor from the Faculty of Medicine and Dentistry at the University of Alberta. I have about 50 years of experience in both applications and research in Environmental Health Sciences.

David Evans: 7:59

You may be more familiar with Steve Hrudey's work, then you might think he actually sat on the advisory panel for the walkerton water crisis. The crisis began in May 2000. And it's one of Canada's most recent public health emergencies. a five day rainstorm ended up washing cow manure into one of the town's wells, which happened to have a crack in it. And they didn't treat the water properly, so that it would get rid of the E. coli bacteria. And this infected the entire town's drinking water with E. coli 2000 people got sick. And sadly, six people died because of improper drinking water. Dr. Hrudey was involved in the inquiry where they were trying to figure out what happened and how they could prevent this from happening again. And it led to a lot of water reforms across Canada about how we can protect our water supply from bacteria and pathogens such as E. coli. Sorry, got a little sidetracked with the walkerton story there. Dr. Hrudey. Is there a long history of using wastewater surveillance? I mean, it's something I've never heard about before. What are the uses for this technology? And how widespread is it? There is a fairly long history, probably the most effective use has been in monitoring the efforts to eradicate polio by use of the polio vaccine communities have been tracked for the prevalence of polio virus in wastewater as a means of judging how well vaccination programs have been effective. There's been examples in Canada for the North battleford outbreak that happened in 2001. After walkerton they were able to detect the Cryptosporidium pathogen in wastewater from the community before during and after the the outbreak. Okay, so this is something that we have experienced with, but maybe we haven't been using it to its full potential always. As soon as we had the genetic code for SARS. covi, two or COVID-19 researchers in the Netherlands began to use this technology to see if they could detect COVID in wastewater before they had any clinical tests that came back positive. Back when COVID-19 was initially spreading and there was global closures and lockdowns. One of the initial questions was, are we dealing with the live virus can be

Dr. Steve Hrudey, Canadian Water Network: 10:19

They be infected through wastewater. This was an important early question. As it turns out, the evidence appears to be that source COVID is not particularly stable in sewage systems. And certainly it poses much less of a risk of infection for for wastewater workers than the plethora of pathogens. Yeah, the genes that are already in there. So

David Evans: 10:43

Alright, so step one, we know it's safe, well, at least relatively safe, we're not likely to become infected with COVID-19 from wastewater. But there's other challenges. Step two, to get the samples ready for testing, we need to actually prepare them. So this is a little bit different than clinical testing, where they shove that swab straight up your nose, the wastewater samples are prepared. And then we go to Step three, the same process is used to test the wastewater samples as the swabs that go up your nose. It's a process called PCR or polymerase chain reaction, it's a way of amplifying the viral RNA that's in that sample, imagine trying to find a needle in the haystack. But if you could make that needle reproduce 100, a few 1000 times, you're going to be able to find one of those needles a lot easier. And that's the basic process of a PCR test. So this was first tested in the Netherlands to understand if there was spread in the community. And if they could test for COVID-19 in wastewater, and they were the first ones to actually detect it. And since then, it's gone around the world, many, many countries and jurisdictions are testing wastewater to understand where COVID-19 has spread within their communities.

Dr. Steve Hrudey, Canadian Water Network: 12:01

You know, we've recently had a situation developed in Yellowknife where they believe that they've got cases in the community that they didn't know about from clinical testing. And so that's caused them to implement more restrictive measures and require people who have been under quarantine to get tested, they could give an early warning of the arrival of COVID in the community, the reality is that a lot of things have to be right for that to work. I have to say that the expectations that this technique would automatically provide warnings wherever it's used, probably won't apply in all cases, because it depends on how frequently you test how quickly you can turn around the results and how quickly you can communicate those results to the public health authorities. And a lot of places are only sampling once a week. So how much warning Can you give, you have a two or three day turnaround time in your lab and then take another day or two to get the results to public health authorities. You might be able to say retrospectively, that you had an early warning, but

David Evans: 13:05

that's out of the bag at that point.

Dr. Steve Hrudey, Canadian Water Network: 13:07

Right, exactly. So the idea of using it for Sentinel sites like with the owner case where they don't have community spread at the moment, they pretty much knew where they had cases and had people quarantined, but they couldn't explain what they saw on the wastewater from, from what they had known about. So you know, that's an intriguing thing.

David Evans: 13:29

So there's definitely some kinks to work out. But we can work through this. And it does have used for specific situations. If we have an area that we think is free from COVID, we don't have any active cases in the community, we can test that by looking at the wastewater, we can also test to see if new variants are present in our community. I feel like I'm hearing about a new variant from a different country almost every single day now, keeping track of the spread of these new variants is going to be essential in our fight against the spread of covid 19. I think one of the biggest benefits to this type of testing that we really haven't touched on at all, is the topic of asymptomatic carriers, you might actually be infected with SARS, cov two, and you wouldn't even know it, you might not even have any outward symptoms. So there's no reason why you would ever think to go get tested. But wastewater surveillance gets past all the individual testing and just looks at where we are as a population. It's able to detect the virus regardless of any symptoms that you actually might have.

Dr. Steve Hrudey, Canadian Water Network: 14:37

The other major application, which is only in the formative stages here is to focus on high risk facilities. There is a large new research project being launched in evidence and to look at long term care facilities to go into the sewer network and collect the wastewater directly from a long term care facility. It sounds good in theory, there's a lot of challenges to overcome to actually make it valuable. There's the reality COVID patients in the hospital, certainly in intensive care, our two wheeled to be self toileting, so their waste won't show up in the sewage system from the hospital. So when they pick things up, it's probably more in They could have visitors and staff.

David Evans: 15:24

These special use case scenarios are really important. Because I can see this as being the main focus moving forward, individual hospitals, prisons, long term care facilities having a monitoring process in place where they may not test everyone individually. But they can test the wastewater to get a picture of what's going on on the inside of the building. This could give them the ability to see the spread of a virus, the flu or any type of pathogen moving forward. The issue around residents being self toileting or not, does raise concerns, though, because maybe that's not a big deal in a hospital, we probably already know who has been infected. But in a long term care facility, you want to know as soon as people are infected, and if they're not self toileting, those people aren't going to be part of these samples. That being said, this information is still very valuable. If we know about visitors and staff that are infected going into these facilities. If there's a tool that we can use to get a good idea of what's going on, we need to take that, unfortunately, there have been a lot of supply chain issues, especially with the reagents that are used for the tests. Because these reagents are being used for all of the COVID-19 testing, that's done, there's a lot of demand for all of these reagents, because everyone wants to get a test. But hopefully moving forward, we can get enough reagents to do all of the testing that we need to do.

Dr. Steve Hrudey, Canadian Water Network: 16:54

The idea of being able to collect a single sample for an entire community that might tell you something useful, compared with having to try and sample everybody clinically in that community. You know, you don't need to be a mathematician to figure out that there's a lot fewer analyses involved. The good news is with these molecular biology techniques is that, you know, once you've proven that they can work and get the experience and the equipment necessary to do it. All you need is the genetic code to tackle a different pathogen. You mean, if you think about it, there's been a lot of concern about lack of testing. And a lot of that criticism is valid, typically self support or failing to harness the techniques that they could have done. But the idea that as soon as you got the genetic code, people were working on it the next day, that's kind of stunning terms of scientific progress, if you have these techniques in place, and someone just has to give you the blueprint, away you go. The fact that we've conducted millions of tests now and clinically in less than a year, it's hard to imagine anything else in previous history where we could have scaled up that quickly. The reality is, it's not if but when we'll have another one, hopefully, it'll be more like 100 years instead of another year. But clearly having these capabilities in the future is going to be important.

David Evans: 18:23

Just like Dr. Hrudey said, this will happen again, we're not even out of this pandemic. But we have to start thinking about what we would do differently to prevent another pandemic from happening. And wastewater surveillance will likely play a large role in future early detection systems. So hopefully we can isolate and prevent the next pathogen that comes knocking before it takes hold. I'd like to thank Dr. Hrudey for being a part of this podcast. And I'm so excited to see the future uses of this technology, even though it's kind of gross. Thanks for listening to this episode. If you enjoyed this episode, please hit the subscribe button, so you don't miss any of our future episodes coming out sometime soon. Later this week, we'll be releasing our deep dive episode, which is our full interview with Dr. Hrudey where you can learn so much more about wastewater surveillance and what we're doing right now in Canada. Be sure to check it out. Can't get enough but wastewater surveillance in Canada, check out the Canadian water networks website, cwn-rce.ca. I'm the host and producer David Evans. And I've just like to thank the rest of the team from the aquatic biosphere project specifically to Paula Polman, Sophie Cervera and Anna Bettini Thanks for all of your help. T learn more about the aquati biosphere project and what we'r doing here in Alberta tellin the story of water. Check us ou at AquaticBiosphere.ca. And i you have any questions o comments about the show, we' love to hear them. Email us a conservation@aquaticbiosphere.or at please don't forget to lik subscribe and leave us a review It really helps us out. In th next episode we'll be talkin about ghost fishing. What eve is ghost fishing? How did al this abandoned, lost damage fishing gear get tossed out int the ocean and what we're doin to clean it up. We'll be talkin to the Global Ghost Gea Initiative on how they ar banding together governments i large companies to be able t stop this from happening. An we'll be talking to the Emeral Sea Protection Society who ar actively cleaning up the coas around Vancouver Island. Sta tuned, make sure you'r subscribed because you won' want to miss it. Thanks and it' been a splash