COVID-19: Waste not, want not

The idiom "waste not, want not" can be interpreted as, if you use something wisely or completely, you will be less likely to find yourself in need of anything. I was accustomed to hearing this from my parents and grandparents. My parents were born during the Great Depression and my grandparents lived through these hard times. My maternal grandma truly wasted nothing, and she me taught how to get the most out of just about everything. So, you might wonder why I am writing about waste and want. Well, I learned something new about SARS-CoV-2 this week that has me intrigued. In September 2020, the Centers for Disease Control and Prevention starting tracking SARS-CoV-2 in wastewater and created the National Wastewater Surveillance System (NWSS). The virus sheds RNA, or genetic material, in the stool, which ends up in wastewater going to treatment plants. Eighty percent of U.S. households are served by municipal water collection systems. Individuals will shed the virus in the gastrointestinal tract whether they have symptoms of COVID-19 or not. Testing wastewater is a complement to other surveillance testing systems. However, no one needs to go to a testing center or seek health professional advice for this system to work; we just flush the toilet. Data from water treatment plants can serve as an early warning system that a new wave of COVID-19 is coming. As the viral shedding in wastewater increases, the transmission of SARS-CoV-2 increases in that area. This can alert public health officials to a new wave or surge in the infection. Water samples are collected as they flow into the treatment plants, and those samples are sent to a lab to detect virus concentrations. This data is reported to the CDC, which tracks the results on its website by state and county. It is important to note that only select sites that are willing to participate are used for reporting to the database. So, is another surge of COVID-19 coming, as has been seen in other countries around the world? Although there is a decline in cases, deaths and hospital admissions, our wastewater may be telling us a different story. According to the 15-day report from the CDC for March 2-16, 16% of sites showed a substantial increase in viral shedding in wastewater. Based on Ohio county reporting data, Allen and Union counties had over a 1,000% increase of the virus in samples collected. Hardin County had a 1-9% increase; while Hancock, Sandusky and Wood counties showed a 10-99% decrease. Marion and Auglaize counties had no recent data reported to the system. A Feb. 3, 2022, study published in Nature Communications evaluated wastewater from New York City. The researchers detected some novel variants or lineages in the genetics of viruses found in the wastewater that have not been reported to the Global Initiative on Sharing all Influenza Data's (GISAID) Epi CoV database. The GISAID was established in May 2008 to track the genetic data or variations for influenza virus. This information is what helps to inform what influenza strains should be in the flu shot. The Munich, Germany-based GISAID started tracking genetic data on SARS-CoV-2 with the COVID-19 pandemic. What is alarming about the novel variants in the New York City wastewater is they are new to the tracking system. Based on the genetics of the viruses discovered, the four novel mutations were from an omicron COVID-19 infection. Omicron and its mutations are the predominant strain in the U.S. right now, and the news has been covering the BA.2 mutation. The BA.2 mutation is even more transmissible than the BA.1 omicron virus. The question of severity has not been completely answered. A Japanese study in hamsters showed a higher severity of illness for the BA.2 strain over BA.1, but human data from Europe and South Africa does not seem to confirm the animal research. It is believed that exposure and infection with BA.1 omicron provides protection against the BA.2 virus. In light of the predominance of the omicron strain, both Moderna and Pfizer have made requests to the U.S. Food and Drug Administration to secure emergency use authorization for a second booster dose. This is based on study data indicating that higher antibody levels from the booster vaccine provides additional protection against the omicron strains. So, analyzing wastewater could help us track and predict future surges in SARS-CoV-2. Feel free to call the Ohio Northern University HealthWise Pharmacy at 419-772-3784 for more on the science on COVID-19. ONU HealthWise is offering COVID-19 and flu vaccines from 4-6 p.m. Mondays through Fridays; call the pharmacy for an appointment for other time slots. Kier is a pharmacist on behalf of the ONU HealthWise team.