Wastewater Surveillance

UP NEXT ON "CYCLE OF HEALTH."

>> IN HONOR OF NATIONAL PUBLIC HEALTH WEEK, TONIGHT'S TOPIC IS WASTE WATER SURVEILLANCE AND MAPPING.

IT MAY NOT COME TO MIND FOR MOST FOLKS WHEN THEY THINK OF PUBLIC HEALTH, BUT COLLECTING AND ANALYZING WASTEWATER CAN DETECT TRENDS IN DISEASE IN COMMUNITIES ACROSS THE ENTIRE STATE.

TONIGHT WE ARE SCWOINED BY THREE EXPERTS IN THE FIELD WHO WILL HELP US UNDERSTAND HOW THIS ALL WORKS.

HELLO AND WELCOME TO CYCLE OF HEALTH.

I'M DR. RICH O'NEILL.

IN HONOR OF NATIONAL PUBLIC HEALTH WEEK, TONIGHT'S TOPIC IS WASTEWATER SURVEILLANCE AND MAPPING.

IT MAY NOT COME TO MIND FOR MOST FOLKS WHEN THEY THINK OF PUBLIC HEALTH, BUT COLLECTING AND ANALYZING WASTEWATER CAN DETECT TRENDS IN DISEASE IN COMMUNITIES ACROSS THE ENTIRE STATE-- ESPECIALLY WITH UPDATING MAPPING.

TONIGHT WE'RE JOINED BY THREE EXPERTS IN THE FIELD WHO CAN HELP US UNDERSTAND HOW THIS PROCESS WORKS.

LET'S MEET OUR GUESTS: DR. DAVID LARSEN: GRADUATE DIRECTOR AND ASSOCIATE PROFESSOR OF PUBLIC HEALTH AT SYRACUSE UNIVERSITY DR. DUSTIN HILL: POSTDOCTORAL RESEARCHER AT SYRACUSE UNIVERSITY, AND MR. BRYAN GREENE, CO-CEO OF QUADRANT LABORATORIES.

THANK YOU ALL FOR BEING HERE.

SO LET'S TALK ABOUT WASTE WATER SURVEILLANCE.

WHAT IS THIS PROGRAM?

>> WASTE WATER SURVEILLANCE IS AN INITIATIVE BY THE DEPARTMENT OF HEALTH TESTING A COMMUNITY'S WASTE WATER FOR INFECTIOUS DISEASE OR A TYPE OF EXPOSURE OR CHEMICAL.

AROSE OUT OF COVID IN RESPONSE TO THE PANDEMIC AND HAS EXPANDED ACROSS THE STATE AND ACROSS THE COUNTRY, MEANT TO KEEP US SAFE AND MORE HEALTH SECURE.

>> WHAT IS YOUR ROLE IN THIS, DAVE.

>> I'M AN EPIDEMIOLOGIST, AND I'VE BUILT INFECTIOUS DISEASE SURVEILLANCE SYSTEMS FOR A LONG TIME.

MARCH OF 2020, BACK IN THE EARLY DAYS OF THE PANDEMIC, WE HAD AN INFORMATION VOID.

WE DIDN'T KNOW HOW FAR COVID HAD SPREAD GEOGRAPHICALLY.

WE KNEW THERE WERE HOSPITALLATIONS IN NEW YORK CITY AND WUHAN AND ACROSS THE COUNTRY BUT THERE WAS NOT CERTAIN INFORMATION.

AT THAT POINT I SAW ON TWITTER, THEY PULLED THE SARS 2 VIRUS OUT OF WASTE WATER.

HISTORICALLY WE HAVE USED WASTE WATER SURVEILLANCE FOR OTHER INFECTIOUS DISEASES LIKE POLIO, CHOLERA AND THINKING, WILL LET'S DO THE THIS FOR SARS 2 AND THAT KICK STARTED OR WORK IN CENTRAL NEW YORK AND EXPANDED TO BUFFALO AND STONY BROOK AND WITH THE STATE DEPARTMENT OF HEALTH.

>> SO MAPPING WASTE WATER, YOU ARE CONNECTED TO Dr. LARSON'S WORK.

DUSTIN, HOW DOES YOUR WORK FIT IN?

>> WASTE WATER SAMPLES ARE A COMMUNITY METRIC.

WHEN YOU THINK ABOUT TESTING FOR COVID-19, YOU TEST INDIVIDUALS OR IN THE SCHOOLS, FOR EXAMPLE.

>> AND MY NASAL SWAB.

>> EXACTLY.

>> BUT WASTE WATER SAMPLES IS REPRESENTATIVE OF A COMMUNITY.

SO IF YOU IMAGINE A NEIGHBORHOOD, YOU TAKE A SAMPLE OF THE NEIGHBORHOOD, YOU NEED TO KNOW WHAT PARTS OF THE NEIGHBORHOOD CONTRIBUTE TO THE WASTE WATER SYSTEM BECAUSE THE SAMPLES ARE REPRESENTATIVE OF THAT COMMUNITY AND SO THEN BEFORE COVID, WASTE WATER SYSTEMS WERE MAPPED ACROSS THE STATE, IT WAS NOT A CENTRALIZED SYSTEM AND THE INFORMATION WAS NOT DOUBLING TAL OR ACCESSIBLE TO OUR TEAM ESPECIALLY COLLECTING DATA BUT THEN NEEDED TO KNOW WHAT COMMUNITIES WERE LINKED WITH THE SAMPLES TO KNOW HOW TO INTERPRET THE DATA.

AND AS THAT STARTED A PROJECT OF MAPPING OUT THE SYSTEMS ACROSS NEW YORK STATE, WHICH TOOK SELF-MONTHS TO COMPLETE AND WE ENDED UP MAPPING OUT 596, ALL OF THE MUNICIPAL TREATMENT PLANTS ACROSS NEW YORK STATE AND SO THAT EFFORT LED TO THE NEXT STAGE WHICH WAS SCALING UP WASTE WATER SURVEILLANCE ACROSS NEW YORK STATE TO DO THE TESTING AT.

>> YOU HAVE DEVELOPED A MAPPING OF ALL OF THE WASTE WATER TREATMENT, THE SEWAGE TREATMENT PLANTS IN THE STATE.

>> IN THE STATE,UP.

>> ENTIRE STATE IS MAPPED.

>> YEP.

>> AND YOU ARE TAKING SAMPLES FROM ACROSS THE STATE AND SOMEHOW FEEDING THEM SOME PLACE TO...?

>> THE SAMPLES ARE COLLECTED AND SENT FOR ANALYSIS.

>> WAS WE DO IS WE TAKE THE SAMPLE, WE SPIN IT DOWN AND CONCENTRATE THE RNA IN THE SAMPLE.

SO FROM THE RNA, WE CAN REHYDRATE, REFORM A PELLET IN THAT SAMPLE, AND WE REHYDRATE THAT PELLET AND MEASURE THE RNA LEVELS OF DIFFERENT VIRUSES INCLUDING COVID-19, NORA VIRUS, HEPATITIS A AND WE USE THAT AGAINST THE HUMAN LOAD IN THE SAMPLE.

>> THERE IS A WHOLE ARRAY OF DIFFERENT DISEASES THAT YOU CAN LOOK FOR.

>> YES, WE CAN LOOK FOR ANY DISEASE THAT IS VIRAL BY USING RNA.

>> THAT'S AMAZING.

SO KEEP GOING.

I DIDN'T MEAN TO INTERRUPT YOU.

>> SO WE MEASURE OUT THE VIRUSES OF INTEREST IN THAT SAMPLE.

WE ALSO MEASURE OUT WHAT IS CALLED THE CRASS PHASE THAT WILL CALIBRATE THAT TO-- WHAT DOES THAT MEAN.

>> IT HELPS DETERMINE HOW MANY PEOPLE ARE SERVICED BY THAT WATER SAMPLE.

SO IF YOU THINK OF IT, WE'VE TESTED COMMUNITIES, WE'VE TESTED DORMS, HOSPITALS, SO IF YOUR DORM ONLY HAS 100 PEOPLE, YOU ARE GOING TO HAVE A LOWER LEVEL OF THE VIRUS.

SO BY DETECTING, WE KNOW THE POPULATION SERVED BY THE SAMPLE SO WE CAN SAY THIS VIRUS IS PRESENT IN ROUGHLY THIS MUCH PERCENTAGE.

>> IN THE SAMPLE OF THE WASTE WATER TREATMENT.

>> CORRECT.

>> HOW SENSITIVE IS THIS?

HOW LITTLE BIT OF VIRUS CAN YOU DETECT USING THIS RNA PROCESS?

>> WE HAVE BEEN ABLE TO DETECT ONE ACTIVE INFECTION IN A POPULATION OF 10,000 PEOPLE.

>> WAIT A MINUTE.

SAY THAT AGAIN.

ONE PERSON IN 10,000, YOU CAN DETECT.

IN ONE PERSON HAS IT... >> CORRECT.

>> THAT'S AMAZING.

>> MOST OF THE SAMPLING IS MORE TARGETED WITH SOME OF THE SAMPLING WE'VE DONE ON S.U.

AND OTHER COLLEGES IN NEW YORK, WHERE THE SAMPLING TARGET IS ROUGHLY ONLY 2 TO 300 PEOPLE.

BUT IN THESE LARGE COMMUNITIES, WE ARE ABLE TO DETECT ONE ACTIVE CASE IN A POPULATION OF 10,000.

>> SO REALLY, YOU ARE LOOKING AT THE ENTIRE POPULATION OF NEW YORK?

>> YEAH.

>> YOU ARE DETECTING THE VIRUS COVID AND OTHER THINGS THROUGHOUT THE ENTIRE STATE.

>> YES, WE HAVE ABOUT 200 TREATMENT PLANTS IN THE STATE NETWORK.

AND THEY SEND THEIR WASTE WATER, THE MAJORITY SEND THEIR WASTE WATER TO QUADRANT AND WE HAVE PARTNERS WITH SUNY BUFFALO AND SUNY STONY BROOK THAT DO THEIR LOCAL COUNTIES.

>> MY ALMA MATER, SUNY BUFFALO, THANK YOU.

>> THEN ALL THAT DATA COMES THROUGH TO SYRACUSE UNIVERSITY.

WE START TO ANALYZE IT.

DUSTIN HERE HAS DEVELOPED A MODEL THAT PREDICTS HOSPITALIZATIONS 10 DAYS OUT AND WE ARE GETTING READY TO ROLL THAT OUT TO LOCAL HEALTH DEPARTMENTS THAT WILL HELP WITH RESOURCE PLANNING, WITH GUIDING.

WE CAN KNOW WHEN SURGES ARE GOING TO HAPPEN.

WE ARE DEVELOPING A MODEL NOW THAT'S 30 DAYS EARLY WARNING OF SURGES.

>> WOW.

>> THAT'S JUST FOR SARS COV 2, COVID AND WE WANT TO REPLICATE THAT FOR DIFFERENT PATHOGENS OF PUBLIC HEALTH CONCERN SO THAT WORK WILL BE ONGOING OVER THE NEXT FEW YEARS.

>> YOU ARE DEVELOPING A WAY TO KNOW HOW MANY PEOPLE ARE GOING TO GO INTO THE HOSPITALS 10 DAYS AND MAYBE 30 DAYS IN ADVANCE JUST BASED ON WHAT YOU ARE SAMPLING AND BRIAN SAYS, YEAH, WE ARE GETTING THIS KIND OF SAMPLE AND THEN YOU ARE TAKING THAT AND BEING ABLE TO PREDICT.

BOY, THAT WILL BE A GAME CHANGER.

>> IT IS DEFINITELY A GAME CHANGER.

THIS WASTE WATER SURVEILLANCE IS GOING TO MAKE NEW YORK STATE HEALTHIER, SAFER AND EMPOWER US, NOT ONLY AGAINST WHAT CIRCULATES NOW LIKE COVID AND INFLUENZA AND RSV.

EPIDEMIOLOGISTS WE HAVE THE TERM CALLED DISEASE X.

WHATEVER IS NEXT.

AVIAN INFLUENZA HAS BEEN IN THE NEWS.

WE ARE MORE PREPARED FOR THAT THAN BEFORE COVID.

IF THERE IS ANOTHER CORONAVIRUS THAT EMERGES, WE ARE PREPARED FOR THAT.

IT IS MEANT TO IMPROVE OUR RESPONSE TO INFECTIOUS DISEASES.

>> TERRIFIC.

WE'VE LEARNED A LOT ABOUT WASTE WATER SURVEILLANCE ALREADY.

LET'S SEE A LITTLE ABOUT HOW IT ALL HAPPENS.

OUR CYCLE OF HEALTH TEAM TRAVELED DOWN TO THE CORTLAND WASTEWATER TREATMENT FACILITY TO SEE HOW SAMPLES ARE COLLECTED, THE PROCESS IT TAKES FOR THE SAMPLES TO BE PROCESSED INTO DATA, AND HOW THAT DATA CAN BE USED BY HEALTH OFFICIALS.

LET'S TAKE A LOOK.

>> WASTE WATER SURVEILLANCE IS IMPORTANT FOR PUBLIC HEALTH BECAUSE IT CAN BE USED AS WARNING TOOL.

IT CAN BE USED FOR PREVENTION EFFORTS ESPECIALLY RIGHT NOW CONCERNING COVID-19.

WE CAN LOOK AT TRENDS, SEE IF THERE ARE INCREASES IN INFECTION RATES AND PUT OUT A PREVENT TIFF WARNING GETTING PEOPLE TO ACTIVELY TAKE A ROLE IN THEIR PREVENTION EFFORTS.

SO IF SOMEBODY KNOWS THERE IS AN INCREASE IN COVID, THEY KNOW THAT WE HAVE HAD MITIGATION EFFORTS THAT WE'VE USED FOR THE LAST THREE YEARS THAT THEY SHOULD BE PUTTING THOSE INTO PLACE.

RIGHT NOW IN CORTLAND WE ARE JUST DETECTING FOR COVID IN THE WASTE WATER BUT THERE IS TONS OF PILOT PROJECTS GOING ON IN THE STATE AND ACROSS THE COUNTRY FOR OTHER DISEASES, FOODBORNE ILLNESS, OPIOIDS, ANTI-BACK TER DWRAL RESISTANCE.

SO IT'S DEFINITELY OPENED A WORLD OF OPPORTUNITY FOR PUBLIC HEALTH BUT THE NICE THINGS ABOUT WASTE WATER SURVEILLANCE IS IT DOESN'T RELY ON PEOPLE GOING AND GETTING TESTED SO IT DOESN'T RELY ON AN INDIVIDUAL'S HEALTHCARE SEEKING BEHAVIOR; WHICH IS SOMETHING THAT KIND OF OUR OTHER DATA INDICATORS IT RELIES ON PEOPLE GOING TO GET TESTED OR RELIES ON PEOPLE BEING SICK ENOUGH TO GO TO THE HOSPITAL AND BE ENCOUNTERED IN THOSE HOSPITALIZATION OR CASE RATES.

SO IT'S KIND OF FILLING THAT NICHE OF GIVING US SOME INFORMATION ABOUT GENERAL POPULATION SPREAD WITHIN THE AREAS THAT THE CITY OF CORTLAND WASTE WATER TREATMENT FACILITY SERVICES.

>> I'M BRUCE ADAMS, THE SUPERINTENDENT OF WASTE WATER FOR THE CITY OF CORTLAND.

I MANAGE THE WASTE WATER DEPARTMENT FOR THE CITY.

WE ARE A NINE MILLION GALLON PER DAY DESIGNED PLANT, AVERAGE YEAR ROUND FLOW ABOUT 5.2 MGD.

WE SERVE THE CITY OF CORTLAND AS WELL AS THE VILLAGES OF MAGRAW AND HOMER AND THE TOWN OF CORTLANDVILLE.

THE SAMPLING PROCESS FOR PRODUCING THE MATERIALS THAT ARE TESTED INVOLVES US DOING A 24-HOUR COMPOSITE SAMPLE, WHICH WE DO EVERY DAY ANYWAY AND THIS IS A SAMPLE THAT IS DRAWN OVER THE COURSE OF A DAY AND THE INDIVIDUAL SAMPLES ARE ANALOGOUS TO THE FLOW AT THE TIME AND IT'S REFERRED TO AS A FLOW WEIGHTED COMPOSITE AND UPON GETTING THE COMPOSSIBLE-- COMPOSITE, WE PUT IT IN A SMALLER BOTTLE, SUITABLE FOR SHIPPING.

WE PACKAGE IT UP IN MATERIALS THAT THE PROGRAM IS NOW PROVIDING US TO UNDER STATE FUNDING AND THAT INVOLVES SECONDARY CONTAINMENT, MATERIALS, COOLER, ICE PACK, A SHIPPING BOX AND THEN IT SHIPS THROUGH UPS.

THE SAMPLE IS TESTED WITH THE METHODOLOGY THAT THEY DEVELOPED BACK IN 2020 INVOLVING ULTRA ENTRY-- ULTRACENTRIFUGE AND ANALYSIS AND COMPILE THE DATA AND SEND IT TO US AT THE SAME TIME JOE MORAN WITH THE CDC FOUNDATION ANALYZES THE DATA, PUTS IT IN CONTEXT BY DEVELOPING TRENDS AS THE DATA POINTS MOVE OVER TIME.

>> TYPICALLY WE GET THE REPORT FROM THE EPIDEMIOLOGIST WHO WORKS WITH SYRACUSE UNIVERSITY AND THE NEW YORK STATE DEPARTMENT OF HEALTH.

SO HE GIVES US A REPORT AND THEN BRUCE ALSO KIND OF GIVES US A REPORT THAT HAS A LITTLE BIT MORE OF A DETAILED BREAKDOWN AND ANALYSIS.

WE KIND OF USE THAT DATA TO LOOK AT IT IN A COMPLEMENTARY WAY TO OTHER DATA THAT WE'VE ALWAYS BEEN USING.

>> FERVENTLY HOPEFUL THAT ONCE WE ARE PAST THE CURRENT PANDEMIC, THAT IT WON'T FALL BY THE WAYSIDE, THAT THE DEPARTMENT OF HEALTH WILL CONTINUE TO SEE THE VALUE OF THIS AS A GENERAL PURPOSE TOOL THAT CANNOT ONLY ASSESS CURRENT AND ONGOING RISKS BUT ALSO GIVE A FRAMEWORK THAT CAN BE USED TO INTERCEPT NEW UNEFFECT SHUS DISEASES-- NEW INFECTIOUS DISEASES THAT MIGHT COME INTO THE COUNTRY.

>> WE HAVE A HUGE OPPORTUNITY WITH WASTE WATER SURVEILLANCE, ESPECIALLY WITH THE PARTNERSHIP WITH THE CORTLAND WASTE WATER TREATMENT PLANT BECAUSE THEIR BUY IN HELPS US BUY IN THAT WILL HOPEFULLY HELP THE COMMUNITY BUY IN TO USING THIS AS A TOOL, NOT TO SCARE PEOPLE INTO WHAT'S HAPPENING, BUT JUST MAKE THEM MORE AWARE AND MAKE THEM MORE SELF AWARE WHAT THEY CAN DO TO CHANGE THINGS AND HOPEFULLY IMPROVE THE HEALTH OF THE COMMUNITY AS WE GO AS WELL.

>> SO WE'VE SEEN HOW THIS PROCESS WORKS FOR COVID.

I'M JUST WONDERING, CAN THIS BE USED FOR OTHER DISEASES?

YOU MENTIONED THAT, DAVE, EARLIER?

HOW ABOUT POLIO, WHICH WAS, IN MY CHILDHOOD, POLIO WAS JUST THIS TREMENDOUSLY SCARY THING WITH PEOPLE, KIDS ENDING UP IN IRON LUNGS.

IT WAS UNBELIEVABLE.

SO TELL US ABOUT THAT.

>> SO WASTE WATER SURVEILLANCE CAN BE USED FOR POLIO.

IT'S ONE OF THE DISEASES THAT HAS BEEN HISTORICALLY MONITORED THROUGH WASTE WATER SURVEILLANCE, ONE OF THE WAYS THAT COUNTRIES WHERE IT IS ACTIVELY CIRCULATING USE IT TO KEEP TRACK OF WHAT IS GOING ON THERE.

UNFORTUNATELY IN 2022, POLIO WAS REINTRODUCED TO THE UNITED STATES.

WE HAD THE FIRST PARALYTIC CASE OF AN INDIVIDUAL ACTUALLY RECEIVED-- THEY WERE INFECTED WITH POLIO IN THE UNITED STATES.

SOMEONE BROUGHT IT IN.

IT WAS BELIEVED FROM SOMEONE WHO WAS UNVACCINATED OR RECEIVED AN ORAL POLIO VACCINE.

POLIO CAME BACK TO NEW YORK AFTER DECADES OF IT THOUGHT TO BE ELIMINATED.

AND INITIALLY WAS THOUGHT TO JUST BE IN ONE REGION, ONE COUNTY IN NEW YORK STATE.

BUT WITH THE WASTE WATER SURVEILLANCE EFFORT, THE STATE WAS ABLE TO IDENTIFY AREAS THAT THE CASE MAY HAVE BEEN IN CONTACT WITH AND THEY SCALED UP TO INVESTIGATE THOSE OTHER LOCATIONS AND IT WAS FOUND THAT THERE WAS ACTUALLY WIDESPREAD TRANSMISSION ACROSS THE STATE.

AND THAT WAS INFORMED BY WASTE WATER SURVEILLANCE.

IF WE HADN'T HAD THE SCALE OF THE VIRUS WOULD NOT HAVE BEEN KNOWN WITHOUT THAT SYSTEM AND QUADRANT WAS REALLY IMPORTANT IN SUPPORTING THAT AND IDENTIFYING COLLECTING THE SAMPLES AND HELPING GET THEM TO WHERE THEY NEEDED TO GO TO BE ANALYZED.

>> SO WE WERE ABLE TO GO BACK, SO THE FIRST ACTIVE CASE WHEN THE GOVERNOR DECLARED THE STATE OF EMERGENCY SEPTEMBER OF 2020, WE WERE ABLE TO GO BACK IN WASTE WATER SAMPLES THAT HAD BEEN COLLECTED, PRIMARILY FOR DETECTION IN COVID AND USE THOSE TO DETECT THAT THOSE POLIO CASES HAD BEEN PRESENT IN DIFFERENT AREAS OF SOUTHERN NEW YORK SINCE APRIL OF 2020.

WE CONTINUE TO TAKE SAMPLES AND FACILITATE THE SAMPLE COLLECTION WITH THE LOCAL TREATMENT PLANTS.

AND BRING THOSE SAMPLES BACK TO QUADRANT WHERE THE RNA IS ISOLATED DOWN, REHYDRATED AND THEN WE'VE WORKED WITH THE CDC TO FACILITATE TESTING OF POLIO CONTINUOUSLY IN THOSE SAMPLES.

>> AND IT WAS APRIL OF 2022.

SO THERE WERE SAMPLES GOING BACK THAT HAD BEEN STORED AS BRIAN MENTIONED.

AND WITH THAT, WE KNEW WHERE POLIO MAY HAVE BEEN FIRST INTRODUCED IN THE STATE.

AND COULD YOU KIND OF TRACK THROUGH THE MAPS HOW IT KIND OF MOVED THROUGHOUT THE SYSTEM AND IT CONNECTED, ESSENTIALLY, STARTED IN ONE PLACE AND MOVED AND EVENTUALLY SPREAD OUT FROM THERE LIKE A RIPPLE EFFECT THROUGHOUT THE REGION.

>> THAT REALLY IS AMAZING BECAUSE, YOU KNOW IS WRISH INSTEAD OF HAVING PEOPLE CALL OTHER PEOPLE THAT WERE IN CONTACT, YOU CAN GO IN THE WASTE WATER AND FIGURE IT OUT AND TRACK IT ALL.

YOU MUST HAVE ONE GIANT SPREAD SHEET, RIGHTED?

>> A LITTLE MORE SOPHISTICATED.

>> SPREAD SHEETS ARE THE LIMIT OF MY TECHNOLOGICAL SOPHISTICATION.

AND I IMAGINE, IF I'M THINKING ABOUT THIS, THE ECONOMICS OF THIS MUST BE AMAZINGLY EFFICIENT COMPARED TO, YOU KNOW, ALL THE MILLIONS OF SWABS AND ET CETERA.

>> SO FOR ABOUT THE SAME COST TO PROCESS AN INDIVIDUAL 15 VY SALIVA SAMPLE, WE CAN DO THE WASTE WATER AND THE POPULATION CAN BE AS MANY AS 10,000.

SO WAS WE ARE ABLE TO DO IS EFFICIENTLY MONITOR AREAS AND TARGETEDLY ROLL OUT INDIVIDUAL TESTING.

SO RATHER THAN HAVING THE ENTIRE POPULATION GO AND DO INDIVIDUAL TESTING ALWAYS, WE CAN IDENTIFY THE AREAS THE RISK THROUGH WASTE WATER AND THEN HAVE SMALLER PORTIONS OF THOSE PEOPLE DOING INDIVIDUAL TESTING IN ISOLATE OUT THE INFECTED INDIVIDUALS THAT WAY.

>> I UNDERSTAND THAT THIS IS THE PROCESS THAT WAS USED AT SYRACUSE UNIVERSITY IN THE DORMS.

>> VERY MUCH SO.

SO WE HAD WASTE WATER TESTING AS PART OF OUR OPENING PLAN IN MAY OF 2020 TO REOPEN FOR SMALL SEMESTER.

SYRACUSE UNIVERSITY SHUT DOWN MARCH OF 2020 WITH SPRING BREAK AND COVID AND IN MAY OF 2020, WE WERE LIKE, ALL RIGHT, IF IT'S GOING TO REOPEN, WE BETTER DO IT WELL.

WE PUT IN WASTE WATER SURVEILLANCE IN AS MANY DORMS AS WE COULD.

WE HAD MASS TESTING THROUGH SALIVA TEST WITH QAWND RESISTANT AND THEN MOVING FORWARD OR, I GUESS WE HAD-- IT'S KIND OF FUNNY.

WE TESTED ALL THESE DORMS.

OUR VERY FIRST POSITIVE TEST, ERNIE DAVIS HALL, WE TESTED EVERYONE WITHIN 90 MINUTES.

NOT A SINGLE POSITIVE.

I CALLED IT A RANDOM POOPER EFFECT.

SOMEBODY IN THE BUILDING USED THE TOILET THAT DOESN'T LIVE THERE AND THAT PUT A DAMPER ON THE PROGRAM.

WE ANALYZED THE DATA AFTER THAT.

THAT WAS THE ONLY SINGLE TIME WHERE WE TESTED THE WASTE WATER OF A DORM AND COULDN'T FIND AN INFECTION, SO WE WERE LOOKING AT 95% SENSITIVITY AND 99% SPECIFICITY, THE WASTE WATER SURVEILLANCE IS AMAZING.

>> SENSITIVITY AND SPECIFICITY.

HELP US UNDERSTAND THOSE.

>> THOSE ARE TWO EPIDEMIOLOGY TERMS.

SENSITIVITY IS THE PROBABILITIES OF FINDING SOMEONE WITH AN INFECTION.

AND SPECIFICITY IS THE CONFIDENCE THAT YOU FOUND THE RIGHT PEOPLE WITHOUT AN INFECTION.

THAT'S, WHEN YOU ARE THINKING ABOUT ISOLATING PEOPLE FOR COVID, THAT SPECIFICITY IS EVEN MORE IMPORTANT THAN SENSITIVITY BECAUSE THEN YOU ARE NOT ISOLATING PEOPLE OR FORCING THEM TO CHANGE.

>> SO YOU WERE ABLE TO DETECT THAT IN THAT DORM AND THEN FIGURE OUT-- IT WASN'T ANYBODY IN THE DORM.

>> IT WASN'T ANYBODY IN THE DORM.

THAT'S THE ONLY TIME I.

WAS THE FIRST TIME SO IT STANDS OUT IN MEMORY.

BUT EVERY OTHER TIME, WE DETECT IN THE WASTE WATER, WE WOULD ASK THE STUDENTS TO GO TEST AND THEN WE WOULD FIND POSITIVES AND DO THE CONTACT TRACING AND IT REALLY ENHANCES THE UNIVERSITY'S ABILITY TO RESPOND TO COVID, TO STAY OPEN AND TO NOT HAVE A HUGE PUBLIC HEALTH CRISIS AND PUT EVERYBODY AT RISK.

>> DISRUPTION OF EVERYBODY'S LIVES, YEAH AND DAVE, YOU AND I WERE TALKING BEFORE ABOUT HOW THE SCIENCE FOR THIS IS ACTUALLY FAIRLY OLD.

TELL US ABOUT THAT.

>> SO IT IS OLD.

WE ARE TALKING BACK TO THE 19 40S AND 50s WHEN PEOPLE WERE TESTING WASTE WATER FOR PATHOGENS LIKE POLIO AND TYPHOID AND CHOLERA.

THESE ARE ALL TRANSMITTED FECAL ORALLY, ALL WATER BORN PATHOGENS.

AND IN OUR MINDS, EPIDEMIOLOGISTS KEY COMPARTMENTALIZE WASTE WATER SURVEYANCE IS FOR WATER BORN PATHOGENS SO COVID-19 COMES IN, SPREADS THROUGH THE AIR AND A COMPLETE PARADIGM SHIFT AND WE REALIZE THAT WASTE WATER IS NOT JUST A TO FIND PATHOGENS INFECTIOUS IN THE WASTE WATER.

IT'S REPRESENTATIVE OF WHATEVER COMES THROUGH THE HUMAN POPULATION SO THAT'S INFECTIOUS DISEASE, CHRONIC DISEASE, DRUG USE, EXPOSURES LIKE EAST PALESTINE AND THE TRAIN DERAILMENT, TOXIC EXPOSURES.

>> CHEMICALS INGESTED.

ALL THAT CAN BE FOUND IN WASTE WATER AND THAT'S WHERE THE SCIENCE NEEDS TO GO, WE NEED TO UNDERSTAND BETTER WHAT CHEMICALS SHOULD WE TEST FOR, WHAT MARKERS SHOULD WE TEST FOR AND HOW DOES IT RELATE TO PUBLIC HEALTH RISK.

KEEP THE RISK FROM THE PUBLIC AND IMPROVE OUR LIVES AND HAVE HEALTHIER LIVES.

>> I THINK THE MOST AMAZING THING, SOME PEOPLE ARE AVOIDING GETTING THEIR POLIO VACCINE.

WHEN I THINK OF THAT AS A PARENT, I THINK OH MY GOODNESS, DO THEY HAVE ANY IDEA THE DISASTER THAT WOULD BE IF THEIR CHILD GOT POLIO AND WAS PARALYZED?

OR, YOU KNOW, IN SOME WAY IMPAIRED FROM THAT.

SO I THINK THAT THAT-- I WOULD ASSUME THAT'S GOING TO BE PART OF WHAT THIS SCIENCE AND THIS PROGRAM WILL BE DOING IN THE FUTURE TO TRY AND PREVENT THOSE KINDS OF OUTBREAKS.

>> YEAH, SO WE'VE SEEN IN PLACES WITH MUCH HIGHER POLIO TRANSMISSIONS THAN THE UNITED STATES, ISRAEL, P PARTICULARLY, THEY HAVE A LARGER POLIO TRANSMISSION PROBLEM WITH THE CONFLICT IN THE SURROUNDING AREAS.

THE WASTE WATER SIGNAL WILL HIT BEFORE THEY HAVE PARALYTIC CASES SO THEY CAN SEE-- WATCH THE WASTE WATER AND THEN RUSH IN, VACCINE AND THEN THEY CAN PREVENT PARALYTIC CASES.

>> THAT'S AMAZING.

SO FOR THOSE PARENTS WHO ARE A LITTLE BIT VACCINE HESITANT, YOU KNOW, YOU GET THE MESSAGE THAT HEY, THERE IS POLIO IN OUR COMMUNITY.

>> DANGER.

>> DANGER.

>> IF YOU HAVE BEEN ON THE FENCE, NOW IS THE TIME TO GO AND GET THE VACCINES.

>> WE CAN PREVENT PARALYSIS BECAUSE IT'S HEART BREAKING TO GET POLIO PARALYSIS.

>> SO THAT IS PUBLIC HEALTH IN ACTION.

RIGHT THERE.

THAT'S ALL THE TIME WE HAVE, I WANT TO THANK OUR GUESTS... DR. DAVID LARSEN: GRADUATE DIRECTOR AND ASSOCIATE PROFESSOR OF PUBLIC HEALTH AT SYRACUSE UNIVERSITY DR. DUSTIN HILL: POSTDOCTORAL RESEARCHER AT SYRACUSE UNIVERSITY, AND MR. BRYAN GREENE, CO-CEO OF QUADRANT LABORATORIES.

IF YOU'D LIKE TO SEE MORE OF OUR PROGRAM AND EXTRAS, VISIT OUR WEBSITE, WCNY.ORG/CYCLEOFHEALTH.

TO HEAR OUR NEW COMPANION COMMUNITY FM RADIO SHOW, CHECK UP FROM THE NECK UP, VISIT WCNY.ORG/COMMUNITYFM.

FOR CYCLE OF HEALTH, I'M PSYCHOLOGIST DR. RICH O'NEILL.

THANKS FOR CHECKING IN.

ON THE NEXT "CYCLE OF HEALTH," SUICIDE PREVENTION.

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