With Britain in the grip of the Covid-19 pandemic during the summer of 2020, scientists were frantically looking for ways to get ahead of the virus as it swept through the country, mutating at an alarming rate.
And one of the best methods they found was to regularly test raw sewage.
Because it turned out that sewage from tens of thousands of homes across the country contained vital clues as to where the virus was spreading, even before GPs and hospital doctors picked it up.
Anyone infected with Covid sheds tiny bits of the virus’s DNA in their poop, even if they don’t have symptoms.
Crucially, this DNA can be detected in wastewater several weeks before infection rates rise indicating a local outbreak.
This branch of science, called wastewater-based epidemiology, proved to be the breakthrough that was needed in the fight against covid and, as of summer 2020, the UK Health Security Agency (UKHSA), which oversees initiatives of such important public health, launched a large-scale scheme.
In the picture: a particle of Covid-19, any infected person sheds small fragments of the DNA of the virus in their poop, even if they have no symptoms.
Environmental Monitoring for Health Protection, as it was called, was a program to test, three times a week, raw sewage samples from more than 300 treatment plants across England, covering about 70 percent of the population. the population.
The data collected by the program played a key role in mapping Covid infection rates and informing policies, such as local lockdowns, to contain the spread of the virus.
Such was the success of the sewage testing scheme that almost 60 other countries have since set up similar testing programs and some, including the US and India, are now expanding their use to check for future variants of Covid.
However, Good Health may reveal that rather than build on the success of the scheme, the UKHSA quietly removed Covid surveillance from sewage in England several months ago.
This came to light when former Downing Street consultant Dominic Cummings said in a recent online blog that he had been told by government insiders that the program had been abandoned to save money.
He wrote: ‘The officials told me they were going to close it down, for savings. valance [Sir Patrick Vallance, the government’s chief scientific adviser] and other officials objected, but were rebuffed.
“However, it worked well and was copied all over the world. Obviously it can be used not only for Covid but as part of an early warning system for other potential diseases.
“It is a tragic example of the refusal to learn from Covid.”
The value of sewage-based epidemiology was again evident recently when traces of polio in sewage prompted London health chiefs to offer nearly a million children under the age of ten an urgent booster vaccination to protect them. against a virus that can cause paralysis.
Live poliovirus has been detected in sewage in at least eight districts in the north and northeast of the city.
It was first collected at a sewage plant in London in February, when the sewage monitoring program was still in full swing.
Young children are thought to be most at risk, with uptake of the polio vaccine in some parts of London being as low as 55 per cent.
The UKHSA website acknowledges that sewage surveillance “has played a key role in detecting mutations of the Covid virus”.
However, in a statement to Good Health, it confirmed that it is no longer monitoring the spread of the Covid virus through sewage surveillance.
The statement said: “As with all surveillance programs at UKHSA, we have the ability to extend this backup if the need arises.”
However, the decision has been met with dismay among experts, who say they hoped the UK would build on the success of the program and expand it to tackle other emerging health risks.
“Scientists involved in the monitoring program in England are disappointed that it is over,” says Dr Andrew Singer, senior scientist at the UK Center for Ecology and Hydrology near Oxford, which was awarded a grant from the government of £900,000 in July 2020 to develop tests. Procedures to monitor wastewater for coronavirus.
In the image: a particle of the polio virus. Live poliovirus has been detected in sewage in at least eight districts in the north and northeast of the city.
‘This technology has the potential to help us address existing and emerging health risks such as polio, influenza, monkeypox and antibiotic resistance.
“It is a low-cost, accurate, and anonymous method of detecting disease outbreaks several days before a surge in hospital cases and can alert authorities to take action to reduce the spread of infection.”
Another wastewater monitoring expert, who did not want to be named, said: ‘I would love to know what the thought process was behind a program that was so useful, that it was removed at such an early stage in its development. We had just started to get a good handle on coronavirus surveillance.
Critics of the decision fear the move could jeopardize England’s ability to respond to future viral threats.
Meanwhile, other governments appear to be building their coronavirus surveillance systems around sewage monitoring, without turning their backs on it.
In March, US President Joe Biden’s administration said it would become a key part of its future virus detection systems, while India is expanding sewage controls on Covid to half a dozen new cities after a pilot scheme in the city of Bangalore proved successful.
Closer to home, Wales has set aside £4m to fund a six-month pilot project covering sewage checks at 50 wastewater treatments. (While UKHSA covers the whole of the UK, home nations can do their own if they see fit.)
The Welsh scheme will involve taking wastewater samples at least five days a week across the network, looking for signs of emerging infections and reporting to Welsh government advisers on a regular basis.
The monitors will also look for early warning signs of other infections, such as the flu, polio and norovirus, as well as signs of increasing antibiotic resistance, by looking for minute amounts of the drugs that are dumped into the sewer system.
Scientists were frantically looking for ways to get ahead of the virus as it swept across the country, mutating at an alarming rate.
And the wording of the tender to run the trial contract makes it clear that the powers that be in Wales see wastewater controls as playing a central role in protecting the population against another pandemic.
He states: ‘Wastewater-based epidemiology is a rapidly developing science. New technology developed and implemented during the Covid-19 pandemic has the potential to support more sustainable services in Wales.
“This program has the potential to shift the balance of our health and care system toward earlier detection and intervention, helping to prevent disease.”
Dr Singer says: ‘Wales is showing what other countries could and should be doing. The epidemiology of wastewater has clearly demonstrated its value.’
Meanwhile, Northern Ireland has set aside £3.8m to cover wastewater monitoring at 30 sites and has pledged to continue to support the project in the long term.
Northern Ireland health minister Robin Swann said in March: ‘There is no question that Covid-19 remains a health risk.
“This program will play a key role in helping protect the public by identifying areas where cases have increased.”
In Scotland, the Scottish Environment Protection Agency received funding for its own Covid surveillance programme, which involves frequent checks at around 100 sewage treatment plants, until the spring of this year.
The beauty of sewage as a public health resource is that it is estimated that a person infected with Covid-19 sheds up to ten million particles of the virus’s genetic material in just one gram of fecal matter.
This means that it is possible for scientists to detect if only one person in 100,000 in the local population is carrying the virus.
Scientists in the UK and Europe began routinely checking wastewater about 20 years ago, mainly to track the use of illicit drugs such as cocaine.
But in recent years, studies have found that it can also be used to monitor everything from how much alcohol people actually drink (contrary to what surveys claim) to whether the use of asthma-relieving medications rises when levels of air pollution are high.
Although UKHSA has scaled back its sewage-based Covid checks, it says it is expanding surveillance for polio.
In a statement, it said: “We are conducting sewage polio surveillance in London and a further ten to 15 sites will be set up nationally to determine if the virus is spreading elsewhere.”
