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Detecting COVID Community Spread
As scientists, we see that COVID-19 will not be controlled unless we test more because that's the only way to know where it is and how bad it is. But truly effective surveillance could mean doing thirty million tests a day at a cost of more than one trillion dollars a year, which is unrealistic. But there's another way and it's already being used to monitor community outbreaks: Testing wastewater.
Infected people shed the virus in their stool and usually early in the infection before symptoms begin, so testing wastewater is an ideal early indicator of usually one to two weeks.Some US states have already started wastewater surveillance programs. So have countries such as Finland, the Netherlands and Australia. Pakistan is using its polio surveillance program to also track the coronavirus. The cost of wastewater surveillance is modest compared to widespread individual testing.
We don't yet have a protocol for determining where and when to collect samples. We'd also need a national database to collect the data and share it publicly. How we would coordinate this nationally will be a challenge. But these are minor barriers given the payoff.
People in a hotspot would know to take precautions. Plus, it's something we can do whereas the effort to test individuals has so far failed. Even if a vaccine arrived early, thousands of people are expected to die in the months ahead. Anything we can do slow that down is worthy.
More Information
As the Covid-19 pandemic marches across America, causing record-breaking numbers of cases, almost every solution for controlling the disease includes more testing, especially as cities and states try to reopen. But with states hitting their limits on testing, we need new tools for understanding Covid-19 transmission. A national wastewater surveillance program offers a cost-effective approach to track Covid-19 across the majority of the U.S. population and provide early warnings of resurgence.
