New Zealand Lavatory Detective Agency

• submitted 2022-10-21 (Popular Science/National Museum of Natural Science Foundation) as “Chronicles of New Zealand Lavatory Detective Agency for SARS-CoV-2 Footprints”, accepted 2023-04-10,
• published 2023-05-06 [中文] @ https://foundation.nmns.edu.tw/writing/
• URI:  https://details-or-fragments.blogspot.com/2023/05/NZwws.html
• DOIs:  https://doi.org/10.6084/m9.figshare.23541075 ; https://doi.org/10.5281/zenodo.8054748
  

On Friday, October 21, 2022, the weather in Auckland, New Zealand (NZ) was cloudy and the temperature was 16 degrees C. Since this winter (June-August) was the peak of the COVID-19 pandemic in NZ, Ania and her family have not traveled for a while, so Ania was planning a weekend family trip, watching the weather report: sunny and fine weather with a temperature of 20 degrees. 

Fig 1: ESR COVID-19 Wastewater Surveillance Dashboard

Ania used to like to visit Lake Taupo the most, but at this moment she had to change her plan, even the pandemic in Auckland has generally slowed down. This time, Ania consulted the Environmental Research and Science (ESR)'s COVID-19 Wastewater Surveillance Dashboard, and she changed plans for her family.

Friday, October 21, 2022, the weather in Auckland, New Zealand (NZ) was cloudy and the temperature was 16 degrees C. Since this winter (June-August) was the peak of the COVID-19 pandemic in NZ, Ania and her family have not traveled for a while, so Ania was planning a weekend family trip, watching the weather report: sunny and fine weather with a temperature of 20 degrees. 

Ania used to like to visit Lake Taupo the most, but at this moment she had to change her plan, even the pandemic in Auckland has generally slowed down. This time, Ania consulted the Environmental Research and Science (ESR)'s COVID-19 Wastewater Surveillance Dashboard, and she changed plans for her family. 

Ania, who lives in Auckland (yellow circle area in Figure 1), learned from the website that the recent pandemic has slowed down (upper right in Figure 1), but many areas are still unstable (red triangle area in Figure 1). When checking the situation in Lake Taupo, the map showed a red triangle. Ania took a closer look at the trend chart and found that although the number of confirmed cases decreased, the wastewater data showed an increase. Therefore, she changed the location and decided to go to Kawakawa Bay, where the overall pandemic situation has declined. (Figure 1 map, blue triangle area). 

Fig 2:  Wastewater Variant Analysis

Not only that, but Ania had older and younger members in her family, so she further checked the situation of SARS-CoV-2 variants across the country and east of Auckland (Figure 2). 

Since NZ was in a state of competition for multiple variants of the COVID-19 , the scientific uncertainty at the time was high. Therefore, it was changed to an outdoor picnic to avoid indoor dining and group gatherings, in order to reducing the unknown risks of family travel. 

However, these data about COVID-19 are different from the confirmed clinical data familiar to the public (i.e. confirmed cases, hospitalization, moderate to severe disease, death, etc. in the blue curve in Figure 1), and what is this kind of "additional" environmental data? 

The green curve in Figure 1 covers 73% of the NZ population, and the average number of SARS-CoV-2 genomes detected in wastewater per person per day. This is from the surveillance results of wastewater samples from lavatory, sinks and drains in households in the community. Most of these shit & poops samples are regularly collected by an automatic sampler within 24 to 25 hours for testing. After estimating the number of viruses and analyzing the variants, a weekly wastewater surveillance report is provided, and finally published on the dashboard to inform the public of potential local COVID-19 risks. Wellington Laboratory's NZ National Wastewater Surveillance for COVID-19 footprint work is like the work of a Lavatory Detective Agency. 

Taking a closer look at the work of the "Lavatory Detective Agency" in NZ, it can be roughly divided into three stages (Figure 3): 

Fig 3: Chronicles of New Zealand Lavatory Detective Agency for SARS-CoV-2 Footprints

The first stage of establishment & testing: 

In 2020, when the pandemic broke out in the early stage, the COVID-19 wastewater surveillance project began to be established in April. 

After the alert level was raised to level 4 in May, ESR and the National Health Coordination Center (NHCC) coordinated the prevention strategy and established a national clinical data repository (Clinical Data Repository, CDR) for all COVID-19 test reports in laboratories across the country. 

From July to November, closed sampling research was carried out. On the one hand, it provided a "time snapshot" of wastewater viruses, and on the other hand, it provided the theoretical basis for NZ's wastewater surveillance task. 

The second phase of verification & expansion:  

During the "Zero COVID" in 2021, in areas with zero confirmed cases, the evidence of the SARS-CoV-2 footprints has been detected in wastewater. In Stratford, a small town in the Taranaki (where wastewater services cover 97%) since July 2021, it has joined the COVID-19 wastewater surveillance task. For the first time, virus fragments shed after infection with SARS-CoV-2 (or SARS-CoV-2 RNA fragments) were detected in the wastewater samples. 

After the wastewater "disease detective" solved the case based on the above-mentioned closed sampling research, the Detective Agency continued to strengthen public health measures, such as community testing and vaccination, canceling some community activities, and increasing wastewater sampling and testing. 

Subsequently, it was found in Stratford that 6 confirmed cases were all from the same family, and the pandemic was quickly brought under control. It was not until 3 months later that further community cases were found in the wastewater, so the results of the COVID-19 wastewater surveillance tasks were verified and has been reported in the World Health Organization as a case report.  

The third stage of daily wastewater surveillance:  

After NZ gave up Zero COVID, it provided new digital tools for the public to "living with the COVID", allowing the exploration of the COVID-19 wastewater surveillance report to be like checking the weather report, helping the public to manage their own safety. 

“NZ’s move to self-reporting has made our official case numbers less reliable than ever before – and that’s where wastewater testing comes in”, microbiologist Siouxsie Wiles and ESR geneticist Mike Bunce, the ESR scientists explained. 

July 2022, NZ launched an interactive COVID-19 wastewater dashboard, using new tools to track the COVID-19 footprints, assisting the public to be ware of national and regional pandemic trends, and providing temporal and spatial visual assistance, such as map area options and searches. It also supports the comparison of trends in different time periods as shown in Figure 1 and Figure 2. 

So how does NZ's "Lavatory Detective Agency" establish the relationship between wastewater data and clinical data? 

It was hard to detect SARS-CoV-2 cases during the time of Zero COVID in NZ. How could NZ solve the problem of wastewater sensitivity when the virus in wastewater was extremely low? Figure 4 illustrates the overall research landscape. 

Fig 4: Relations between COVID19 clinical and wastewater data

In July 2020, ESR selected a community with a population of about 120,000 to sample wastewater daily in two areas. They are the Managed Isolation and Quarantine Facility (MIQF) and the wastewater treatment plant (WWTP). 

The left side of Figure 4 is the clinical analysis of COVID-19 that is familiar to the general public, and the right side is to illustrate the analysis process of COVID-19 wastewater-based epidemiology (WBE). 

The main difference between the two methods lies 

in the source of samples and sampling methods. 

The follow-up quality control is based on the purpose of the researcher, and different viruses are used as the control group. For example, this study chose to use Feline Infectious Peritonitis Virus (FIPV) and Murine Norovirus Virus (MNV) as external process controls to monitor viral copies and evaluate inhibition by quantitative RT-qPCR. 

Subsequent processes such as virus concentration, RNA extraction, use of PCR to test whether the sample is positive or negative, or further sequencing are the same as the process of people testing the virus from nasal swabs. 

Finally, using the clinical data in the EpiSurv surveillance database of the Ministry of Health, four infectious models (Total Cases, Infectious Cases: reported symptomatic cases or imputed asymptomatic cases, Relative Infectious Cases, New Daily Cases), compared with the wastewater data for statistical analysis to confirm the relationship between clinical cases and wastewater data, and verified that in a low-infection environment, wastewater data can still help to detect about 10 positive cases in an area of 100,000 people. 

Fig 5: COVIDPoops19 snapshot (20230507)

Of course, "Lavatory Detective Agency" is not limited to NZ. At present, there are more than 4,100 surveillancesites in nearly 300 universities in at least 70 countries around the world, all of which have similar research surveillance works. For example, scientists in many wastewater research laboratories in the United States, called them "sewer sleuths" in the journal Nature, these scientific detectives found that the virus lineages in recent wastewater are closely related to the lineages of global databases containing millions of sequences. The mismatch, called "cryptic lineages", finally traced the source of the SARS-CoV-2 to an office with less than 30 people. 

"Lavatory Detective Agency" detects SARS-CoV-2 footprints in the environment. In the near future, regardless of whether the next super variant is discovered, this kind of work to track the source of potential variants will help researchers understand the biological factors that lead to the mutation, or help ordinary people like Ania and her family: checking the COVID-19 wastewater data is like checking the weather data, thus self-risk prevention has become a simple daily routine. And if scientists or digital engineers want to further use the source data of the NZ "Lavatory Detective Agency", the "Open Lavatory" provided by ESR is available in the open database.

 

Reference:

[1] https://www.health.govt.nz/covid-19-novel-coronavirus/covid-19-health-advice-public/covid-19-wastewater-testing
[2] ESR News: https://www.esr.cri.nz/home/about-esr/media-releases/streamlining-covid-19-laboratory-data-to-ministry-of-health/ ; https://www.scoop.co.nz/stories/SC2005/S00024/sysmex-and-esr-collaborate-on-national-covid-19-results-cdr.htm. 2020/5/12
[3] Hewitt, Joanne, et al. "Sensitivity of wastewater-based epidemiology for detection of SARS-CoV-2 RNA in a low prevalence setting." Water Research 211 (2022): 118032.
[4] Harvey, Helen, "The riddle in the wastewater: Taranaki 'disease detectives' solved a Covid-19 mystery", https://www.stuff.co.nz/national/health/128983961/the-riddle-in-the-wastewater-taranaki-disease-detectives-solved-a-covid19-mystery. 2022/6/18
[5] Siouxsie Wiles and Mike Bunce, "As Covid case counts become less accurate, wastewater testing is riding to the rescue", https://thespinoff.co.nz/science/13-06-2022/as-covid-case-counts-rapidly-lose-accuracy-wastewater-testing-is-riding-to-the-rescue
[6] "ESR launches interactive COVID-19 wastewater dashboard to better track the virus's progress", https://thespinoff.co.nz/science/13-06-2022/as-covid-case-counts-rapidly-lose-accuracy-wastewater-testing-is-riding-to-the-rescue
[7] COVIDPoops19: Summary of Global SARS-CoV-2 Wastewater Monitoring Efforts by UC Merced Researchers Details: https://ucmerced.maps.arcgis.com/apps/dashboards/c778145ea5bb4daeb58d31afee389082
[8] Callaway, Ewen. "These scientists traced a new coronavirus lineage to one office-through sewage." Nature News. https://www.nature.com/articles/d41586-022-02996-y. 2022/9/26
[9] ESR Open Data: https://github.com/ESR-NZ/covid_in_wastewater

 

medium URI: https://medium.com/@andreahuang2019/new-zealand-lavatory-detective-agency-e5d4783c249b

 

 

紐西蘭馬桶偵探事務所

 English Version: New Zealand Lavatory Detective Agency

• submitted 2022-10-21 (第一版: "馬桶偵探事務所-SARS-CoV-2的足跡: 紐西蘭事件簿”, 
• accepted  2023-04-10 (第二版: 紐西蘭馬桶偵探事務所)
• published 2023-05-06 [中文] @ 科普寫作網路平台, 國立自然科學博物館文教基金會

財團法人國立自然科學博物館文教基金會科普寫作網路平台”審稿通過

Reference:

[1] https://www.health.govt.nz/covid-19-novel-coronavirus/covid-19-health-advice-public/covid-19-wastewater-testing
[2] ESR News: https://www.esr.cri.nz/home/about-esr/media-releases/streamlining-covid-19-laboratory-data-to-ministry-of-health/ ; https://www.scoop.co.nz/stories/SC2005/S00024/sysmex-and-esr-collaborate-on-national-covid-19-results-cdr.htm. 2020/5/12
[3] Hewitt, Joanne, et al. "Sensitivity of wastewater-based epidemiology for detection of SARS-CoV-2 RNA in a low prevalence setting." Water Research 211 (2022): 118032.
[4] Harvey, Helen, "The riddle in the wastewater: Taranaki 'disease detectives' solved a Covid-19 mystery", https://www.stuff.co.nz/national/health/128983961/the-riddle-in-the-wastewater-taranaki-disease-detectives-solved-a-covid19-mystery. 2022/6/18
[5] Siouxsie Wiles and Mike Bunce, "As Covid case counts become less accurate, wastewater testing is riding to the rescue", https://thespinoff.co.nz/science/13-06-2022/as-covid-case-counts-rapidly-lose-accuracy-wastewater-testing-is-riding-to-the-rescue
[6] "ESR launches interactive COVID-19 wastewater dashboard to better track the virus's progress", https://thespinoff.co.nz/science/13-06-2022/as-covid-case-counts-rapidly-lose-accuracy-wastewater-testing-is-riding-to-the-rescue
[7] COVIDPoops19: Summary of Global SARS-CoV-2 Wastewater Monitoring Efforts by UC Merced Researchers Details: https://ucmerced.maps.arcgis.com/apps/dashboards/c778145ea5bb4daeb58d31afee389082
[8] Callaway, Ewen. "These scientists traced a new coronavirus lineage to one office-through sewage." Nature News. https://www.nature.com/articles/d41586-022-02996-y. 2022/9/26
[9] ESR Open Data: https://github.com/ESR-NZ/covid_in_wastewater

 

 

medium URI: https://medium.com/@andreahuang2019/紐西蘭馬桶偵探事務所-3a14e17ba86f

Whispers of Viruses and Bacteria in Wastewater

• submitted 2022-11-15 (Science Monthly), accepted 2022-12-02,
• published as "Use wastewater to monitor viruses and bacteria! Wastewater Epidemiology" , Science Monthly, No. 640. pp.60-63, 2023-04-01 
•  DOIs: https://doi.org/10.6084/m9.figshare.23540997 ; https://doi.org/10.5281/zenodo.8054581

Professor Marlene Wolfe, one of the leaders of the US Sewer Coronavirus Alert Network (SCAN) team, said in an interview with the British Medical Journal: “We can take that sample, which is less than a gram of wastewater solids, from communities all across the country: that small sample can represent up to 4 million people in some cases.”.

The whisper of SARS-CoV-2 was loud in less than a gram of wastewater sample. At the end of 2022, more than 3,800 monitoring stations in at least 70 countries around the world are watching the wind and listening to the whisper of SARS-CoV-2 in the water.

Figure 1: History of Wastewater Science Terminology

History of Wastewater Science Terminology

The origin of the detected wastewater can be traced back to the Broad Street cholera outbreak in Soho, London in 1854. At that time, in a public well and cesspool near a house where many people died of cholera, feces were found to leak bacteria and contaminate the water supply system of the pump, causing an epidemic. 

• In the mid-1950s, "Wastewater Tracing or Tracking" appeared successively after the research on the wastewater infected by snail schistosomiasis in South Africa. 
• Around 1970s, "wastewater monitoring" and "wastewater surveillance, "WWS)" or "Wastewater-Based Surveillance (WBS)" are commonly used in industrial wastewater detection research.
• In the 2000s, issues such as tracking heroin and other illicit drugs emerged as "sewage epidemiology" and "wastewater-based epidemiology (WBE)". The mixed use of subject terms mainly describes the scientific based on the premise that the substances excreted by humans in wastewater can be used to calculate the initial concentration.
  

However, by 2014, the term "wastewater epidemiology" gradually replaced the term "sewage epidemiology". Although the terms sewage and wastewater are still commonly used interchangeably, the recent official documents of the World Health Organization (WHO) mainly use the term "wastewater surveillance". Scholars also suggested the standardization of related science and technology, and supported the use of "wastewater surveillance (WWS)" and "wastewater epidemiology (WBE)" as common terms.

If we examine the differences in definitions, we can distinguish them from the perspective of public health (Figure 1):

• wastewater tracing or tracking is mainly to identify the source of pathogens or toxins;
• wastewater monitoring is an action to ensure that waste water discharge does not cause public health risks ;
• wastewater surveillance emphasizes systematic, continuous testing of wastewater for the benefit of public health and may be relevant for public health policy;
• wastewater epidemiology (WBE) is the scientific field that links pathogens and chemicals found in wastewater to population health.

Which infectious human pathogens were studied in wastewater before COVID-19?

Wastewater surveillance (WWS) has been used to assess waterborne and fecal-oral pathogens that cause diarrhea-related diseases. The well-studied pathogens of human infectious diseases include picornaviridae, caliciviridae and reoviridae, etc. (indicated by * in Fig. 2). Epidemics of international concern such as coronavirus, Ebola virus, Zika fever, and polio/poliomyelitis virus (indicated by *** in Figure 2) have provided information on public health actions or policies, but influenza is rare founded in WWS literature.

Figure 2: Wastewater Surveillance (WWS) of known infectious diseases before the COVID-19 pandemic: virus classification by family/genus

 

 

 

 

 

 

 

 

 

 

 

 

If the coronavirus is the subject, the early coronavirus wastewater monitoring is in view of the emergence of new viruses with high epidemic potential, which usually involves complex dynamic effects on animals, humans and the environment. Therefore, since the 1970s, environmental monitoring has been implemented by monitoring surface water, mud and biosolids to understand the status of such viruses in the water cycle, ex. human coronavirus (HCoV), human coronavirus 229E (CoV-229E), HKU1 and severe acute respiratory syndrome coronavirus (SARS-CoV); zoonotic coronaviruses such as Middle East respiratory syndrome coronavirus (MERS-CoV) and animal coronaviruses: such as bovine coronavirus (BCoV), mouse hepatitis virus (MHV), etc. This stage focuses on coronavirus, the survival status of viruses in wastewater and the efficiency of virus recovery, etc., but the overall knowledge is still very scarce and fragmented.

After the COVID-19 pandemic

Figure 3: Overview of Wastewater Surveillance (WWS) after COVID-19

The COVID-19 pandemic has seen extensive adaptation of global wastewater surveillance (WWS), and wastewater can also be an effective potential application for surveillance of respiratory-transmitted pathogens. Technologies for detecting SARS-CoV-2 and new variants through wastewater are becoming more sophisticated. 

Figure 3 generally illustrates the current WWS in addition to early development of chemicals such as drugs, cleaning agents, industrial pollutants or pathogens like antibiotic-resistant bacteria, etc., as well as human infectious disease pathogens (described in Figure 2).

After COVID-19, in addition to the new monitoring of SARS-CoV-2, monkeypox and influenza RSV have recently become emergencies of international concern, and such pathogens have also become the focus of WWS, especially when most people cannot receive RSV clinical test, wastewater data can fill the gaps. 

Meanwhile, the progress in wastewater genome monitoring technology has solved the problem of multiple virus strains in wastewater. As shown in Figure 3, according to the WHO classification of coronavirus variant strains, new variants can be found in wastewater samples 14 days in advance, and clinical monitoring can be determined instances of virus transmission that cannot be captured, for high-risk groups such as student dormitories, airports, hospitals, nursing homes and other long-term care facilities. In addition to providing early warnings, it can also help contain and mitigate virus outbreaks. In the long run, WWS is more an important tool for tracking the dynamics of viral lineages in combination with dominance.

Further analysis from the perspective of wastewater epidemiology (WBE), in resource-rich countries is mainly assessed in sewers and sewage systems, but in resource-poor environments, most residents are not connected to centralized wastewater treatment plants, using pit toilets, septic or open defecation, so the WWS process varies depending on the wastewater system.

Overall, as shown in Figure 4, WBE includes the process of sampling, sampling methods, virus concentration and concentration techniques, use of control viruses in the control process, virus isolation, RNA extraction, virus detection and quantitative sequencing, and finally completes epidemiological modeling to analyze epidemic trends.

However, WBE still faces many challenges, such as sampling control: daily changes in water flow, differences in wastewater systems, weather factors, temperature, sedimentation rate, and virus shedding and other factors. In terms of virus recovery and concentration: concentration method efficiency, RNA extraction, purification efficiency and storage of RNA, etc. Plus virus detection and/or quantification. Challenges such as RNA quality, RNA quantity, PCR inhibitors, and normalization of data will all affect COVID-19 wastewater surveillance, which faces shortcomings such as low recovery rate and long processing time.

Figure 4: Analysis Process of COVID-19 Wastewater Epidemiology (WBE)

WWS is intended to complement, not replace clinical tests

SARS-CoV-2 wastewater surveillance differs from clinical diagnostic testing in the design and interpretation of community-scale sampling programs, as well as in the different assays which attempted to concentrate and extract RNA from wastewater and environmental water samples.

Because viral RNA can be discharged into wastewater before symptoms and diagnostic testing, SARS-CoV-2 wastewater surveillance can help document trends in high-prevalence cases of COVID-19, and in cases of low prevalence or lack of clinical testing evidence.

Early warning can be provided, while wastewater viral load can be used to monitor the impact of public health social measures, including increased or relaxed restrictions, as well as enhanced risk communication, warning the community about the (re)emergence of the virus, and advising the community about testing, quarantine, isolation, as well as suggest actions such as vaccinations and seeking health care.

In sum, WWS advantages include providing objective metrics that are less susceptible to biases inherent in clinical testings, such as 

• health-seeking behaviour, 
• disease severity (including symptomatic and asymptomatic), 
• healthcare and testing accessibility, 
• physician and individual response to testing propensity, 
• cost and reporting constraints, etc.
  

We take the interactive COVID-19 WWS of the New Zealand Institute of Environmental Research and Science as an example (Figure 5). This dashboard has been launched in July 2022 to allow the public to track the footprints of SARS-CoV-2 and view national and regional epidemics, etc. latest trends.

It provides a spatial-temporal visual map; it presents wastewater statistics and provides functions such as regional options, search, and comparison of trends in different periods. 

• From Figure 5(a), we can observe that Wellington shows that the wastewater data and the corresponding spikes of confirmed cases are different in three time periods (green dotted circles): during the peak period of the epidemic, due to sufficient clinical testing, the confirmed cases and wastewater data are about the same.
• In the low epidemic period, the peak of wastewater data far exceeds the confirmed status due to factors such as people feeling tired (or thinking it is unnecessary) to rub their noses, the overall detection capacity slows down, or the willingness to report decreases. 
• The public can also check the latest SARS-CoV-2 variant virus. Figure 5 (b) and (c) show the ratio and trend information respectively.
  

In general, the wastewater data not only supplements clinical monitoring, but also provides background information on the public’s epidemic prevention environment base. The dashboard shows that wastewater data covers 73% of the population in New Zealand. A small sample of less than one gram only needs a few expensive PCRs.

Compared with the costs of tests and costs for clinical PCR, yes, using WWS to listen to the muttering sounds from all directions in the wastewater is cheaper and wider. Plus, virus and bacteria of various kinds can be identified, warned and tracked broadly. It can also assist the public in preventing and managing risks by them selves, easily in their daily life and sustainably for the whole country health.

Figure 5:SARS-CoV-2 wastewater monitoring network of the Institute of Environmental Science and Research (ESR) in New Zealand
COVID-19 Wastewater Surveillance Dashboard: https://esr-cri.shinyapps.io/wastewater

Reference

[1] Nelson, Bryn. What poo tells us: wastewater surveillance comes of age amid covid, monkeypox, and polio. BMJ 378 (2022).

[2] COVIDPoops19: https://ucmerced.maps.arcgis.com/apps/dashboards/c778145ea5bb4daeb58d31afee389082

[3] Kilaru P, Hill D, Anderson K, Collins MB, Green H, Kmush BL, Larsen DA. Wastewater Surveillance for Infectious Disease: A Systematic Review. Am J Epidemiol. (2022) Oct 13.

[4] Larsen, David A., et al. Wastewater monitoring, surveillance and epidemiology: a review of terminology for a common understanding. FEMS microbes 2 (2022). 2021-08-19

[5] Gonçalves, José, et al. Centralized and decentralized wastewater-based epidemiology to infer COVID-19 transmission–A brief review. One Health (2022): 100405.

[6] World Health Organization. Environmental surveillance for SARS-COV-2 to complement public health surveillance: interim guidance, 14 April 2022. No. WHO/HEP/ECH/WSH/2022.1. WHO (2022).

[7] [3]

[8] Carducci, Annalaura, et al. Making waves: coronavirus detection, presence and persistence in the water environment: state of the art and knowledge needs for public health. Water Research 179 (2020): 115907.

[9] McPhillips, D and Howard,J (CNN), The RSV surge didnt come out of nowhere, but gaps in data made it tougher to predict, October 27, 2022. https://edition.cnn.com/2022/10/27/health/virus-surveillance-data-gaps/index.html

[10] Karthikeyan, Smruthi, et al. Wastewater sequencing reveals early cryptic SARS-CoV-2 variant transmission. Nature 609.7925 (2022): 101-108.

[11] Aguiar-Oliveira, Maria de Lourdes, et al. Wastewater-based epidemiology (WBE) and viral detection in polluted surface water: A valuable tool for COVID-19 surveillance—A brief review. International journal of environmental research and public health 17.24 (2020): 9251.

[12] [6] 

medium URI: https://medium.com/@andreahuang2019/whispers-of-viruses-and-bacteria-in-wastewater-95a7776a31b3

 

metaRead: How to Solve the Covid Testing Data Problem | 如何解決新冠檢測資料問題

How to Solve the Covid Testing Data Problem By Faye Flam at  
https://www.bloomberg.com/opinion/articles/2022-10-29/covid-wastewater-data-is-the-best-way-to-track-the-virus-this-winter | 彭博社論 (2022-10-29)

• Many people are no longer taking PCR or rapid tests — even when they have symptoms. Better wastewater data can help.
• 許多人不再接受 PCR 或 快篩——即使他們有症狀。更好的廢水資料可以提供幫助。

 Opinions include | 引用觀點來源包括:

• People | 人: Mariana Matus,Newsha Ghaeli,Sam Scarpino, Faye Flam
• Organization | 組織 : Bloomberg, Harvard Medical School, New York Times, Biobot, Rockefeller Foundation, Axios-Ipsos

Key points | 重要觀點:

•  " ... as testing dropped off, the wastewater measurements separated — showing new hills that weren’t visible from official testing data" | 隨著新冠檢測的減少，廢水測量結果——顯示了官方檢測資料中看不到的新山丘。
• "... biologists tracking the Covid pandemic forecast a long purgatory..." | 追踪新冠大流行的生物學家預測，一場漫長的煉獄將到來。
• "It would also be a public health service to make sure that the data is presented simply and clearly, so that people can check it as effortlessly as they do the weather forecast. And just as with the weather, regular “Covid forecasts” should be featured on the local news — especially when a disaster is on the way." | 這也將是一項公共衛生服務，以確保資料的呈現簡單明了，以便人們可以像查看天氣預報一樣輕鬆查看資料。就像天氣一樣，定期的“新冠病毒預報”應該出現在當地新聞中——尤其是在災難即將來臨的時候。

 

COVID-19 rapid antigen test	COVID-19抗原快篩	http://www.wikidata.org/entity/Q106915773
Covid-19 Testing	新冠檢測	http://www.wikidata.org/entity/Q86901049
pandemic	大流行	http://www.wikidata.org/entity/Q12184
PCR Test	PCR 檢測	http://www.wikidata.org/entity/Q176996
public health	公共衛生	http://www.wikidata.org/entity/Q189603
sewage	污水	http://www.wikidata.org/entity/Q10966166
wastewater	廢水	http://www.wikidata.org/entity/Q336191
wastewater monitoring	廢水偵測	http://www.wikidata.org/entity/Q95586549
wastewater surveillance	廢水監測	http://www.wikidata.org/entity/Q98073976