Wastewater surveillance continues to inform COVID-19 surges in Kansas

Two years ago, scientists in Kansas and around the world found an interesting way to track the novel coronavirus: sewage water. By measuring the concentration of virus particles in flushed bowel movements, they are able to estimate how much of the virus was generally present in any given area.

People infected with the coronavirus shed it through breathing, sneezing, coughing and in their stool. By measuring viral particles in the sewer system, known as wastewater surveillance, scientists can capture the total amount of virus present in large groups of people regardless of whether they had been tested.

Justin Hutchison, an assistant professor at the University of Kansas, and fellow KU professor Belinda Sturm led this wastewater surveillance project in Kansas in partnership with the Kansas Department of Health and Environment back in 2020.

Hutchison says the most interesting aspect of their wastewater surveillance project is that it can predict COVID-19 case surges around 5 days before they show up through clinical testing, and “that 5 days is a lot of lead time for people to prepare.”

That’s because viral shedding in bowel movements can precede individuals’ symptoms.

“One wastewater sample is giving us the same kind of community-level information that thousands of tests can give.”

In the present stage of the pandemic, the use of more at-home tests that aren’t necessarily reported to the state makes this wastewater surveillance more useful, too.

Not everyone gets tested for COVID-19, but everybody goes to the bathroom.

HOW WASTEWATER SURVEILLANCE WORKS

The process of collecting wastewater samples to quantify COVID-19 levels in a community involves partnerships with sewage facilities across the state that send samples to labs that can then analyze them for the genetic material of the coronavirus, SARS-CoV-2.

KDHE Director of Genomic Epidemiology John Anderson has worked closely with Hutchison and Sturm in the management of the wastewater surveillance project in Kansas, whose ownership has now been transferred from KU to KDHE. He says this ability of wastewater surveillance to anticipate COVID-19 spikes is something the state is interested in exploring further.

This year’s KU championship game provided one such opportunity for KDHE to understand whether this large event would result in a high number of future cases.

“We did see an increase in [virus concentrations in] Lawrence’s wastewater, which was then followed by an increase in cases,” Anderson said. This informed KDHE’s focus on monitoring the area for a spike in positive COVID-19 test results.

Recently, Hutchison and Sturm were also able to observe changes in different variants that emerge in a community. Hutchison said recent surges of the Omicron variant were apparent in genomic sequencing of wastewater samples. This information could help the state prepare for future surges of more infectious COVID-19 variants.

FUTURE OF WASTEWATER SURVEILLANCE IN KANSAS

Logistically, KDHE plans to enroll about 30 cities with populations of at least 3,000 or more across Kansas that can provide sewage water samples from water facilities multiple times a week. This will better inform COVID-19 trends in the state beyond KDHE’s current weekly updates on case counts.

While wastewater surveillance data aren’t currently trackable on the internet, Anderson said KDHE plans to make the data gathered from wastewater tracking publicly available in the form of dashboards, much like Missouri’s COVID-19 wastewater tracking tool.

In the future, Anderson says wastewater tracking will be an important part of public health prevention for COVID-19, but also with other viruses, such as monkeypox and the flu. “Having the infrastructure set up and available to quickly react to what the public needs is very important.”