Instant Alert + Wastewater COVID19

More and more it is becoming clear (when you take away the excitement of PhD and Post-Grad students jumping down a manhole to collect samples and run back to the lab to shout eureka "we found SARS-CoV-2 in the sewage") that the use of this method of detection is only a precursor for the inevitable community spread in the local area.

There is a complete lack of acknowledgement that detection in wastewater does not prevent the virus from spreading, it merely confirms the existence of the virus in the community or facility.

Clearly the objective has to be early detection and reducing/lowering the spread in the community. This requires early detection in the population when those who have it are infective (i.e. can spread it).

The virus is an RNA virus and has been confirmed that it exists in the sewage, hours after a person is infected, right up to 3- 4 weeks afterwards. There are also incidences where it lasts for much longer. This does not mean that the person is infectious for 4 weeks or more. On the contrary, there are studies indicating that period of being infectious is in the first 8 days, a period when the infected person has a high viral load.

It is virtually impossible (right now) to identify if a person has it in the first few hours. But as the hours slip by to within 24 hours they already have reached a point of a high viral load and rising all the way up, on average, until day 4/5 when it tends to peak and drop back over the next 3-4 days. By day 9 the viral load is so low the risk (albeit a small one) of infection is negligible.

So the time of the greatest risk of being infective (passing it on) is generally within the first 8 days. By the time it is noticeable in sewage, it is already in circulation at risk of community transmission. Detecting it at this early stage can lower community spread if a hotspot is located and lockdown (or mitigating steps are taken) to lower the spread. However, this allows the community hospitals to be on a higher alert ahead of any expected upsurge of local infections.

The chronology of current testing methods is such that if you feel unwell, generally after a day or two from having symptoms, you seek to have a test. Sadly, the current timeline to get results is not less than 3-4 days. So by the time a person feels a need to get a test and receive the results, you are likely to be 5/6 days into the infectious period.

As the viral load gets lower to 8 days when you are not infective, it leaves only 2 days when you confirm you are infective before you have a low viral load and not spreading the virus.

The solution is an instant daily low-cost test that can be done as an entry/exit to ships/aeroplanes/offices/hospitals/countries/arenas. The combination of an instant alert, with an early warning system for the community, in wastewater, is the only way that the economy is going to be opened up. 

However, the biggest hurdle right now is the reliance on rtPCR which has two restrictions. First, even the shortest PCR test (90 minutes) will not stop it getting onto a plane/into an airport/or a train station/office building. Second, the test uses a process that detects fragments of RNA, not the virus itself. Which means that it can detect that the virus exists, but cannot tell if the person(s) is in the high-risk high viral load infectious stage. Just that the person has it, or had it, even long after they are infective.

As for the reason for lock-downs. It has become clear that elderly, infirm, at-risk people are "collateral damage" to this disease. They are the innocent civilians in the COVID19 war. The question becomes, can we live with the collateral damage not mitigating if that risk passes it on to those unable to avoid contact with the healthy?

Gerard Brandon is CEO of Integumen plc a company specialising in life and environmental science with two subsidiaries specialising in bacteria, virus and toxins hosted on laboratory-grown and detection of bacteria, virus and toxins in water for human consumption.