Water-Based Epidemiology – finding a needle in a very dirty haystack
Aligned with our mission to advance the understanding and impact of microbiology, the Society reached out to our community of microbiologists to share their experiences in responding to SARS-CoV-2. We aim to showcase the perspective of scientists during the COVID-19 pandemic and the variety of roles adopted to mitigate the global crisis.
This case study comes from a research group led by David Graham, a Professor of Ecosystems Engineering at Newcastle University, UK. The account explains how the group developed an array of methods for quantifying viral load in sewage, creating the new science of 'water-based epidemiology', and how they employed their knowledge across various projects.
The COVID-19 pandemic has changed the world. From its onset, partnerships were essential, and completely new methods were developed to combat its global spread. Early in 2020, SARS-CoV-2 RNA fragments (the COVID-19 virus) were detected in wastewater from human faecal matter. Measuring RNA viruses in sewage is very tricky, but the Graham Group at Newcastle University developed an array of new methods for quantifying the virus in sewage; i.e., accurately finding a needle in a very dirty haystack. Discoveries led to rapid and inexpensive ways of identifying COVID-19 infections across whole communities, including symptomatic and asymptomatic cases.
Our work with UK-based and international colleagues has radiated around the world, creating the new science of 'wastewater-based epidemiology' (WBE). Newcastle University’s scientific contributions are significant, though our engagement and our impact on policy may be greater. The UK Scientific Advisory Group for Emergencies (SAGE) invited Graham to join the expert Transmission in the Wider Environment Group (TWEG) to advise on exposure risks of SARS-CoV-2 via water and wastewater. This has led to new research and layers of more engagement. We co-developed the National Wastewater Epidemiology Programme for WBE research. We also work as experts in the Environmental Monitoring for Health Protection (EMHP) wastewater surveillance programme, Environment Agency, and Department for Environment, Food and Rural Affairs (DEFRA), providing science-informed guidance on health protection on mass scales.
We started developing SARS-CoV-2 quantification methods in March 2020 before the first UK community-spread COVID-19 case, which translated into action with Northumbrian Water Limited and Labaqua (a Spanish water company), where we compared SARS-CoV-2 levels in wastewater between Durham, UK and Santiago de Compostela, Spain. This work was prescient because Spain was already deep into the pandemic, whereas the first peak had not yet appeared in the UK. We accelerated COVID-19 knowledge in the UK, based on Spanish experience, by simultaneously quantifying the virus before and within national peaks.
Our greatest engagement work, however, has been translating WBE into practice. Graham’s work on TWEG and EMHP has placed our group at the centre of national guidance. Graham co-authored reports to SAGE on exposure risk of COVID-19 from aquatic environments and methods of detecting SARS-CoV-2 now used in national WBE surveillance. Our PhD student, Amelie Ott, authored the Parliamentary Office of Science and Technology report to Parliament on WBE for COVID-19. We co-wrote two highly regarded reviews, which have been cited over 100 times since July 2020.
Our work addresses the biggest problem of our day – the global COVID-19 pandemic. Everything was conceived and grew during the lockdown, demanding huge dedication from our whole team. This work would have been difficult under normal circumstances, but almost impossible under pandemic conditions. Our WBE efforts helped shape the UK response to this global threat, but our work goes much further.
Our team are co-leading the development of an integrated WBE network for Latin America with the Pan-American Health Organisation, and also working with the United Nations Environment Programme to provide science-informed guidance for reducing the global spread of antimicrobial resistance (AMR) – considered by many as the "next pandemic”. Led by Newcastle University in collaboration with Karolinska Institute in Sweden, the University of Santiago de Compostela in Spain and MGI-tech which operates globally, the project co-creates a Pan-American network for Environmental Epidemiology (PANACEA).
The Newcastle University team, with partners from 14 countries, are using previous samples and coordinating a campaign that is assessing the real-time prevalence and genomic variants of the virus in the major cities of the continent. The team is quantifying SARS-CoV-2, AMR and other infectious agents, and is performing microbiome analysis using the Rocket High-Performance Computing Service at Newcastle University.
Our WBE shows the diversity of ways that Newcastle works with its external partners; we were recently recognised with an Engagement and Place Award by the University.
References
1. Parliamentary Office of Science and Technology (POST). Monitoring wastewater for COVID-19, 2020. https://post.parliament.uk/monitoring-wastewater-for-covid-19/ [Accessed 14/02/2022]
About the authors
Professor David Graham is a Professor of Ecosystems Engineering at Newcastle University. His group uses methods from engineering, microbiology, ecology, mathematics, biochemistry and molecular biology to solve problems in environmental engineering in a holistic manner.