What Wastewater Might Tell Us
By Albert B. Kelly
Beginning early last year and continuing for several months, there was great debate and heated discussion when some members of the CCUA proposed “monetizing” the sewer utility, an arrangement that would have resulted in a private equity firm laying claim to future revenues of the utility in exchange for a large upfront payment in the tens of millions of dollars.
That proposal did not come to pass, but the rationale at the time was that monetizing was a good thing because this chunk of money could be used for a variety of things including economic development, revitalization, and expansion of broadband to name a few.
I’m against monetizing the CCUA and while there are several reasons why I oppose such efforts, one of the foundational reasons is that a sewerage authority has a narrowly defined mission which basically consists of acquiring, constructing, maintaining, operating, or improving works for the collection, treatment, transport, and disposal of sewage. While it doesn’t sound like there would be much room for innovation here, you might be surprised.
Recently I came across various articles suggesting that wastewater might be one of the better ways to track and assess public health and stay a step ahead of viruses, pandemics, mutations, and whatever else threatens the public’s health at a community level or even a neighborhood level.
An article by Matt Stieb for the “Intelligencer” made the point that while not everyone is willing or able to get tested, in this case for Covid-19, most everyone does deposit their bodily waste into the sewer system and because they do, scientists can now undertake what is known as “wastewater epidemiology”.
Epidemiology is that part of medicine that deals with public health issues at both an individual level and a community level. In this case, the focus would be on whole segments of the population. The article went on to say that the Covid-19 virus is detectable in stool samples even when people are without symptoms of any kind. The idea is that by testing wastewater, scientists would be able to make predictions about where the next big surge might break out before it gets bad so that hospitals, officials, and others can prepare.
While the prospect of testing sewage is flat-out gross, what is appealing is the idea that scientists and public health officials don’t have to rely on people’s willingness to cooperate, whether that involves self-reporting of symptoms, stepping up to get tested, or providing information about the status of their sickness and recovery to public health workers.
I say that because in today’s world, everything from vaccines and boosters to wearing masks and getting tested has become some type of political statement with overtones about individual freedom and patriotism and various conspiracy theories ad nauseam. Being able to bypass all of this and separate the signal from the noise has huge implications.
Today we’re talking about Covid-19, but in the future it will be some other pandemic-level stuff and when the first news reports about sick people start filtering out of Southeast Asia or Latin America we won’t necessarily have to wait until the thing reaches a critical mass of symptomatic cases before we act, we’ll know we’ve got a problem much sooner.
According to biostatistician Aparna Keshaviah, testing of sewage can pick-up exactly when dangerous new viral variants start circulating in a community providing early warnings to public health officials and this type of “sewage surveillance” as she calls it, can predict new outbreaks with a lead time of one to two weeks.
But the benefits of testing wastewater go beyond just tracking Covid-19. Sewage surveillance can provide invaluable community-level and neighborhood-level information about rates of vaccination, use of medications, antibiotic resistance, levels of illegal drug use, and the presence of pathogens in the food supply. In a county that ranks last or next-to-last when it comes to health and wellness, early detection is no small thing.
Among the several reasons I opposed the CCUA’s push to monetize its assets was the prospect that those resources would be used for things far outside their mandate as a sewerage authority. That said, using some of their existing resources to undertake a program of “sewage surveillance” for all the reasons listed above, perhaps in conjunction with partners such as the county health department, Inspira, Rutgers University, Stockton University, or the Robert Wood Johnson Foundation, would be timely and innovative and something I could support.