15 ms·

SARS-CoV-2 titers in wastewater are higher than expected from confirmed cases

172 points by guscost 7y ago

Symmetry 7y ago
Well, yes. Even areas of the world with high levels of testing and low levels of infection are going to be missing some cases. Here in MA where a full 30% of tests are coming back positive[1] it would be surprising if actual infections weren't a multiple of confirmed cases. But things are probably much better than they were in February where estimates of the ration are that we were factor of 100 or more behind actual cases. [1]https://i.redd.it/ajxsj8jxyur41.png https://i.redd.it/ajxsj8jxyur41.png
- hprotagonist 7y ago
  19.9% per https://dashboard.cityofboston.gov/t/Guest_Access_Enabled/views/COVID-19/Dashboard1?%3AshowAppBanner=false&%3Adisplay_count=n&%3AshowVizHome=n&%3Aorigin=viz_share_link&%3AisGuestRedirectFromVizportal=y&%3Aembed=y https://dashboard.cityofboston.gov/t/Guest_Access_Enabled/vi... i wonder why the disparity?
  - lsllc 7y ago
    On the graphic it's "29% of todays tests were positive", not of overall tests which indeed stands at 19.94% positive (18941/94958). The graphic is incorrect with 16% of all tests positive. EDIT: Creator of the graphic is /u/oldgrimalkin who posts these each afternoon in /r/CoronavirusMa
- fulafel 7y ago
  The paper is comparing to "clinical estimates", probably those estimates already tried to take this into account?
kickscondor 7y ago
Finding out that we all have it already would be one of the more humorous endings to this story.
- whatshisface 7y ago
  There was some data from Iceland that showed about 50% of cases being asymptomatic. That's more optimistic than we saw originally, but not as optimistic as the most optimistic scenarios proposed.
  - monktastic1 7y ago
    There was also this report from northern Italy, where 40 of 60 asymptomatic blood donors were found to have antigens (incorrectly described as antibodies in the article, from what I've been told): https://it.finance.yahoo.com/notizie/coronavirus-castiglione-d-adda-il-065252105.html https://it.finance.yahoo.com/notizie/coronavirus-castiglione...
    - ZitchDog 7y ago
      Antigen is the actual virus.
      - monktastic1 7y ago
        I had understood it to mean viral proteins or RNA and not necessarily the full virus.
  - tonfa 7y ago
    And in a hard hit place in Germany it's 14% https://www.technologyreview.com/2020/04/09/999015/blood-tests-show-15-of-people-are-now-immune-to-covid-19-in-one-town-in-germany/ https://www.technologyreview.com/2020/04/09/999015/blood-tes... (which matches some of the estimates for Italy)
    - detaro 7y ago
      Please note that how useful the results of that study are is widely debated. Not much detail about the process has been published, it's unclear how reliable the tests used are (other experts say they will likely also trigger for other Corona-viruses) and how representative the sample is (e.g. they did look at individuals, not households).
lidlin 7y ago
The title of the article is deceiving as virus itself was never isolated from wastewater. The authors used RT-PCR to test for the presence of a 150bp segment of the SARS-CoV-2 genome. Although the presence of nucleic acid implies that virus is there, infectious virus was not isolated in this study.
- vikramkr 7y ago
  That is how you detect and characterize the biota of a water source quickly and efficiently- quantitative pcr or rtpcr to detect viral load levels. What would you expect they do instead?
whatshisface 7y ago
If the number of cases are really as high as this paper suggests (5% infected) then we are one or two weeks away from a death wave like nothing else. However let's pay attention to the many caveats the authors point out about their calculation, including the assumption that there are no particular individuals who are shedding especially large quantities of virus.
- martinko 7y ago
  Or the case fatality rate is a lot lower than we think it is.
  - mannykannot 7y ago
    Indeed - there is nothing here to indicate a sudden jump (faster than the already high rate of propagation), while there is good reason to believe that the incidence has been systematically undercounted, on account of the shortage of testing kits. The fatality rate is less likely to be under-counted, if we assume most fatalities are preceded by hospitalization (and often testing.)
  - grey-area 7y ago
    This seems increasingly likely.
  - whatshisface 7y ago
    That would be infection fatality rate, case fatality rate is what we think it is by definition. (A case is a known case, an infection is an infection.) Quibbles over wording aside, I think the Icelandic data showed us that the percent asymptomatic is about 50%, insufficient for boundless optimism.
    - Symmetry 7y ago
      And IIRC the Icelandic data doesn't tell us if those people were guaranteed to remain asymptomatic or were merely presymptomatic.
- 7y ago
owenmarshall 7y ago
This is the same approach used for global polio surveillance: http://polioeradication.org/polio-today/polio-now/surveillance-indicators/ http://polioeradication.org/polio-today/polio-now/surveillan...
fxj 7y ago
According to the Heinsberg Study in Germany, the infection rate was as high as 15% and the mortality rate in the town would be as low as 0.37 per cent. Germany launched the Heinsberg Protocol study to examine the rural town of Gangelt in the region of Heinsberg, where the first virus fatalities occurred. https://www.thenational.ae/world/germany-s-wuhan-has-15-per-cent-infection-rate-and-low-death-toll-1.1004050 https://www.thenational.ae/world/germany-s-wuhan-has-15-per-... During recent weeks, his team completed substantial research conducted through surveys and investigations in homes across the Heinsberg region - where more than 1,400 confirmed cases had been reported. Heinsberg has an approximate population of 250,000 inhabitants and has confirmed 46 coronavirus-related deaths. These research findings have already provided some indication on how the virus works, as Streeck clarified: “There is no significant risk of catching the disease when you go shopping. Severe outbreaks of the infection were always a result of people being closer together over a longer period of time, for example the après- ski parties in Ischgl, Austria.” He could also not find any evidence of ‘living’ viruses on surfaces. “When we took samples from door handles, phones or toilets it has not been possible to cultivate the virus in the laboratory on the basis of these swabs….” “To actually 'get' the virus it would be necessary that someone coughs into their hand, immediately touches a door knob and then straight after that another person grasps the handle and goes on to touches their face.” Streeck therefore believes that there is little chance of transmission through contact with so-called contaminated surfaces. https://today.rtl.lu/news/science-and-environment/a/1498185.html https://today.rtl.lu/news/science-and-environment/a/1498185....
- tosh 7y ago
  Just to add a bit more context regarding the now often cited study of Gangelt (some questions where raised re methodology and esp the policy conclusions): https://www.sueddeutsche.de/wissen/heinsberg-studie-herdenimmunitaet-kritik-1.4873480 https://www.sueddeutsche.de/wissen/heinsberg-studie-herdenim... it is a good start & germany is doing now many more serological studies (also to monitor over time) and hopefully we'll soon gain more confidence re status quo and what it means
  - bwb 7y ago
    Spain is doing one now with 30,000 families and Italy should have one finished soon.
dec0dedab0de 7y ago
This is neat, but a little scary. If I'm understanding it correctly, they are checking sewage for evidence of the virus, and estimating how many people have it based on that. This would be really cool if it were common place, and tested for all known viruses, drugs, fungus, bacteria, lead, whatever they can find. This could be used to track the health of the population over time and as it spreads. If it were publicly available this would be a great resource. The scary part is what if they start making the sewage sites smaller and smaller, or even just the collection locations to where its testing fewer people. Then use that information to enact quarantines or investigations.
- jimbokun 7y ago
  > Then use that information to enact quarantines or investigations. That's exactly what we want! Quarantine the specific areas where there is an outbreak, and relax the nation wide quarantines currently being enacted in many countries.
  - zepto 7y ago
    Only if you have an extraordinarily transparent process for determining when a quarantine is appropriate.
- zepto 7y ago
  That’s why you need a constitutional safeguard against depriving people of their freedoms.
- praptak 7y ago
  The scary part is already happening to drug users. The police in China are analyzing sewage to pinpoint who uses illegal drugs.
gwbas1c 7y ago
I live in MA and got very sick on Feb 26, then had a horrible cold. My wife is a doctor, and she thought I just had one of the many things going around. I asked her if it was COVID-19 and she looked at the CDC's web site and said she didn't think so. Then a week later she flew out of Logan to spend a weekend in LA. I also went skiing in New Hampshire twice, and went to two networking events! Throughout March I had symptoms that I never had in my life... I couldn't get a test! The symptoms went away after 4 weeks. Did I have it? I have no idea, but if I got it, it most likely came from her or my kids, who all felt kinda wonky in mid February. My wife had a very bad headache two weeks before I got sick.
- yters 7y ago
  My family lives in MD, and same thing happened to us in Feb. A child in our daughter's daycare came down with severe pneumonia and ended up in the hospital, our daughter was sick with diarrhea and fever for a week, and my wife caught a bad cough that lasted for weeks and had trouble breathing. Thing is, we cannot know at this point whether everyone already has covid-19, since there are no anti-body tests. It is a live possibility, but meanwhile we are shutting down the world's economy.
  - wbl 7y ago
    We know when Coronavirus entered the US and the serial interval, and can estimate via phylogeny how big the population of the virus is. The phylogenics+excess deaths are ruling out a mass infection that no one died from.
    - yters 7y ago
      How do we know when covid-19 entered the US? How do we know the R0? R0 is continually being estimated upward and death rate downward. We don't seem to have much clarity on any of this. Another problem is if covid-19 was already widespread, it would have been misclassified before the huge spotlight. So, increase in cases and deaths could be misattributed. If there is an overall increase in excess deaths, we still have a question of causality. Could the measures we are instituting themselves contribute to deaths? Just a lot of questions and lack of clarity in this matter.
yters 7y ago
If covid-19 is much less harmful than we originally thought, why were, and still are, medical experts proposing such draconian measures without a clear understanding of the true threat? Dr. Fauci, advisor to the president, proposed the other day that no one should ever shake hands again, in order to prevent spread. It is bizarre. Even when the disease first started to spread, there were people making these same points. In fact, most people thought the disease was no worse than a bad flu or cold, hence the difficulty to institute lockdown type measures in the first place. This is certainly not going to build trust in institutional expertise on these matters. So, once the medical experts are actually right, then they'll be ineffective at persuading people.
_wldu 7y ago
Researchers are finding that COVID-19 testing has roughly 33% false negatives: https://www.wsj.com/articles/questions-about-accuracy-of-coronavirus-tests-sow-worry-11585836001?mod=e2tw https://www.wsj.com/articles/questions-about-accuracy-of-cor... The LabCorp test is not FDA cleared or approved and is being used under an emergency act. "Testing was performed using the cobas(R) SARS-CoV-2 test. This test was developed and its performance characteristics determined by LabCorp Laboratories. This test has not been FDA cleared or approved. This test has been authorized by FDA under an Emergency Use Authorization (EUA). This test is only authorized for the duration of time the declaration that circumstances exist justifying the authorization of the emergency use of in vitro diagnostic tests for detection of SARS-CoV-2 virus and/or diagnosis of COVID-19 infection under section 564(b)(1) of the Act, 21 U.S.C. 360bbb-3(b)(1), unless the authorization is terminated or revoked sooner." The Quest test is not FDA approved either: https://www.questdiagnostics.com/dms/Documents/covid-19/SARSCoV-2_Patient_Fact_Sheet.pdf https://www.questdiagnostics.com/dms/Documents/covid-19/SARS... "It is possible for this test to give a negative result that is incorrect (false negative) in some people with COVID-19. This means that you could possibly still have COVID-19 even though the test is negative." "This test is not yet approved or cleared or authorized by the United States Food and Drug Administration (FDA)." Due to this, it's hard to trust test results. It's a best effort and not perfect.
- xenonite 7y ago
  Well, each test is different though. More so, testing wastewater is also a totally different story than testing humans. Although I find your comment interesting, I don't see how this relates to the topic of wastewater analysis.
epistasis 7y ago
I don't think that HN is a good venue for discussion of specialized preprints that have highly surprising results, in topics that are moving extremely quickly. Too few people in this community are able to evaluate the information contained, which leads to lots of pointless speculation, and lots of misinformation. Despite working in biology for 20 years, I would not trust any of my own interpretations of this pre-print. The only people who I would trust are named specialists in this field, that are willing to stake bits of their reputation on what they say. The only venue where that is happening in the public is on Twitter.
- ianai 7y ago
  I agree that HN is not capable of digesting this study reasonably not meaningfully. I question using Twitter for anything meaningful though.
  - epistasis 7y ago
    Twitter is often extremely useful for scientific fields, and in many ways is perfect for it. You can post a figure and legend, tag people that may find it interesting, and start threaded discussions. It's all in the public, with no invitations or closed doors, so it is open to discovery by that dozen or two dozen people in the world that may be interested. Science is the ultimate long-tail of super-specialized interests with extremely small audiences, and Twitter is perfect for connecting those people with extremely esoteric interests. There is a lot of crap, but science Twitter is also the only reason I'm on it. Sadly, my own biases against Twitter Kept me off it for 8+ years, but after I started finding the right people to follow, a whole new world opened up, and it is now a vital tool for me to navigate the literature and learn quickly which new tools are best.
    - ericd 7y ago
      >There is a lot of crap, but science Twitter is also the only reason I'm on it. Sadly, my own biases against Twitter Kept me off it for 8+ years, but after I started finding the right people to follow, a whole new world opened up, and it is now a vital tool for me to navigate the literature and learn quickly which new tools are best. That's really interesting, I've been avoiding Twitter for the same reason, but I can see how it'd help keep up with fast-moving niche fields. Maybe I'll give it a try, thanks!
Zenst 7y ago
The whole avenue of analysiing waste water when you have centeralised procesisng of the inhabitants as a finger in the air feel upon things is already used in some avenues and like this, many more avenues of potential. Sure it won't be exacting, but does give a feel for things in a way that is very cost effective over alternatives in so many area's. For example, drug usage - measuring the waste water for levels of cocaine, etc etc etc is already used to some degree and proven in many studies. Sure it won't say who, what or exactly were and with that, also anonymised and ticks a few privacy box's in that respect. Let alone the aspect that your fecies and urine and property that we all happily sign away to the water/waste company and even pay them. They can do with it what they like if it comes down to it, but in this approach, nobody is identified and it is more a finger in the air measure of things and a good indication of any shifts/change overall for the costs and speed of doing so. Though personal toilets that will do some serious analysis of your waste for health reasons may well be a big in japan joke phase, but certainly at some level they do have merit and whilst the waste treatments today may be a good overall feel, the market and technology will gradualy filter down into the homes for those that want to be ontop of their health or just want that extra level of safty. Certainly a good initiative and practical approach, though such an approach does depend upon a good waste/water infrastructure and that will be mostly modern area's, towns cities and the like and for some area's, may not have that high a percentage using such centralising waste management. Though when we start tracking area's health media wise like we do weather and get the poo forecast, that's when I know reality has caught up with my darkest of humour.
snovv_crash 7y ago
This reminds me strongly of the methods used in Neal Stephensons's novel Zodiac, where they follow sewerage pipes to determine where the source of an infection is.
floatingatoll 7y ago
The paper includes a disclaimer: > MM and NG are cofounders of Biobot Analytics. EJA is advisor to Biobot. NE and CD are employees at Biobot. All these authors hold shares in the company. Another comment suggests that Biobot is YC. As far as I can tell, Biobot has never posted a Launch HN, but they did post a Covid page 3 weeks ago: https://news.ycombinator.com/item?id=22627746 https://news.ycombinator.com/item?id=22627746 They were in the news in 2018 for testing wastewater to measure the opioid crisis, but I can't find any HN discussions about any link or story that I can find myself, or from their list of media posts. https://www.biobot.io/media https://www.biobot.io/media Among those links are a video interview / product demo (Cheddar) and a podcast interview (Latina Founders).
ping_pong 7y ago
A Danish study recently concluded that actual infection rates could be 30x-80x higher than what is shown by positive test results. This could easily explain the higher levels than expected and is potentially a good thing and bad thing. It means that mortality is much much lower that expected. https://www.reddit.com/r/COVID19/comments/fxk917/covid19_in_denmark_status_entering_week_6_of_the/fmuw8a8/ https://www.reddit.com/r/COVID19/comments/fxk917/covid19_in_... (Google translation) Google translate of section 4.1.2 (pg.27): 4.1.2. Revised planning basis Statens Serum Institut informs on the basis of antibody studies in 1,000 blood donors in the Capital Region, lost in the period 1-3. In April, 2.7% had been detected with antibodies, which, with a sensitivity of 70%, corresponds to 3.5% of those examined had already been infected with COVID-19. Statens Serum Institut states that if this figure is transmitted to the entire population of the Capital Region, it is equivalent to approx. 65,000 people may have been infected as early as 26 March. At this time, 917 confirmed cases of infection were found in the region. This means that there can be up to 70 times more infected in the community than confirmed cases. In the work of the State Serum Institute in modeling the development of the epidemic in Denmark, on the basis of studies in, among other things, Iceland and Germany, it has been decided to work with the real number of infected in Denmark being 30-80 times higher than the number that remains. ver proven. It is therefore estimated that the dark number is significantly higher than in the first planning scenario, and it is estimated from the State Serum Institute that for every detected infection case up to March 28, there may be 30-70, which are actually infected. This ratio will be affected by the number of people who will be infected in the future. Thus, there is probably much more widespread contagion in society than previously thought. This does not have a direct impact on the planning basis for the health care system, as the increased spread of infection is in a part of the population who do not need hospital treatment and probably only to a very limited extent have sought medical attention. It should also be noted that it also means that the mortality rate of infection with SARS-CoV-2 (infection fatality rate, IFR) is lower than the mortality rate of registered case fatality rate (CFR) and possibly lower than that of WHO have evaluated. The WHO has estimated that the IFR is between 0.3-1.0 with wide variation across age groups. With more precise knowledge of the dark figures, the IFR for the COVID-19 epidemic in Denmark can be clarified and the expected mortality will be accurately estimated. The State Serum Institute states that over the coming weeks they will be able to continuously monitor the development of immunity in the population through cooperation with the blood banks, focused sample studies and testing for the population's immune status in general. The above also means that the previous assessment of the mortality in connection with COVID-19 in Denmark is no longer true. When a more accurate assessment of the actual prevalence of infection is obtained on the basis of the epidemiologic surveillance and a precise IFR for the Danish epidemic is estimated, a new and true mortality prognosis can be estimated. The need for ordinary beds and intensive beds is evident from the modeling, which will be continuously qualified. TLDR: blood donor antibody testing indicates true infection rates are 30x-80x higher than confirmed cases in Denmark and that 1.5 weeks ago ~3.5% of Copenhagen’s population may have already been infected by Covid-19.

172 points by guscost 7y ago

Well, yes. Even areas of the world with high levels of testing and low levels of infection are going to be missing some cases. Here in MA where a full 30% of tests are coming back positive[1] it would be surprising if actual infections weren't a multiple of confirmed cases. But things are probably much better than they were in February where estimates of the ration are that we were factor of 100 or more behind actual cases. [1]https://i.redd.it/ajxsj8jxyur41.png https://i.redd.it/ajxsj8jxyur41.png

hprotagonist 7y ago
19.9% per https://dashboard.cityofboston.gov/t/Guest_Access_Enabled/views/COVID-19/Dashboard1?%3AshowAppBanner=false&%3Adisplay_count=n&%3AshowVizHome=n&%3Aorigin=viz_share_link&%3AisGuestRedirectFromVizportal=y&%3Aembed=y https://dashboard.cityofboston.gov/t/Guest_Access_Enabled/vi... i wonder why the disparity?
- lsllc 7y ago
  On the graphic it's "29% of todays tests were positive", not of overall tests which indeed stands at 19.94% positive (18941/94958). The graphic is incorrect with 16% of all tests positive. EDIT: Creator of the graphic is /u/oldgrimalkin who posts these each afternoon in /r/CoronavirusMa
fulafel 7y ago
The paper is comparing to "clinical estimates", probably those estimates already tried to take this into account?

kickscondor 7y ago

Finding out that we all have it already would be one of the more humorous endings to this story.

whatshisface 7y ago
There was some data from Iceland that showed about 50% of cases being asymptomatic. That's more optimistic than we saw originally, but not as optimistic as the most optimistic scenarios proposed.
- monktastic1 7y ago
  There was also this report from northern Italy, where 40 of 60 asymptomatic blood donors were found to have antigens (incorrectly described as antibodies in the article, from what I've been told): https://it.finance.yahoo.com/notizie/coronavirus-castiglione-d-adda-il-065252105.html https://it.finance.yahoo.com/notizie/coronavirus-castiglione...
  - ZitchDog 7y ago
    Antigen is the actual virus.
    - monktastic1 7y ago
      I had understood it to mean viral proteins or RNA and not necessarily the full virus.
- tonfa 7y ago
  And in a hard hit place in Germany it's 14% https://www.technologyreview.com/2020/04/09/999015/blood-tests-show-15-of-people-are-now-immune-to-covid-19-in-one-town-in-germany/ https://www.technologyreview.com/2020/04/09/999015/blood-tes... (which matches some of the estimates for Italy)
  - detaro 7y ago
    Please note that how useful the results of that study are is widely debated. Not much detail about the process has been published, it's unclear how reliable the tests used are (other experts say they will likely also trigger for other Corona-viruses) and how representative the sample is (e.g. they did look at individuals, not households).

lidlin 7y ago

The title of the article is deceiving as virus itself was never isolated from wastewater. The authors used RT-PCR to test for the presence of a 150bp segment of the SARS-CoV-2 genome. Although the presence of nucleic acid implies that virus is there, infectious virus was not isolated in this study.

vikramkr 7y ago
That is how you detect and characterize the biota of a water source quickly and efficiently- quantitative pcr or rtpcr to detect viral load levels. What would you expect they do instead?

whatshisface 7y ago

If the number of cases are really as high as this paper suggests (5% infected) then we are one or two weeks away from a death wave like nothing else. However let's pay attention to the many caveats the authors point out about their calculation, including the assumption that there are no particular individuals who are shedding especially large quantities of virus.

martinko 7y ago
Or the case fatality rate is a lot lower than we think it is.
- mannykannot 7y ago
  Indeed - there is nothing here to indicate a sudden jump (faster than the already high rate of propagation), while there is good reason to believe that the incidence has been systematically undercounted, on account of the shortage of testing kits. The fatality rate is less likely to be under-counted, if we assume most fatalities are preceded by hospitalization (and often testing.)
- grey-area 7y ago
  This seems increasingly likely.
- whatshisface 7y ago
  That would be infection fatality rate, case fatality rate is what we think it is by definition. (A case is a known case, an infection is an infection.) Quibbles over wording aside, I think the Icelandic data showed us that the percent asymptomatic is about 50%, insufficient for boundless optimism.
  - Symmetry 7y ago
    And IIRC the Icelandic data doesn't tell us if those people were guaranteed to remain asymptomatic or were merely presymptomatic.
7y ago

owenmarshall 7y ago

This is the same approach used for global polio surveillance: http://polioeradication.org/polio-today/polio-now/surveillance-indicators/ http://polioeradication.org/polio-today/polio-now/surveillan...

fxj 7y ago

According to the Heinsberg Study in Germany, the infection rate was as high as 15% and the mortality rate in the town would be as low as 0.37 per cent. Germany launched the Heinsberg Protocol study to examine the rural town of Gangelt in the region of Heinsberg, where the first virus fatalities occurred. https://www.thenational.ae/world/germany-s-wuhan-has-15-per-cent-infection-rate-and-low-death-toll-1.1004050 https://www.thenational.ae/world/germany-s-wuhan-has-15-per-... During recent weeks, his team completed substantial research conducted through surveys and investigations in homes across the Heinsberg region - where more than 1,400 confirmed cases had been reported. Heinsberg has an approximate population of 250,000 inhabitants and has confirmed 46 coronavirus-related deaths. These research findings have already provided some indication on how the virus works, as Streeck clarified: “There is no significant risk of catching the disease when you go shopping. Severe outbreaks of the infection were always a result of people being closer together over a longer period of time, for example the après- ski parties in Ischgl, Austria.” He could also not find any evidence of ‘living’ viruses on surfaces. “When we took samples from door handles, phones or toilets it has not been possible to cultivate the virus in the laboratory on the basis of these swabs….” “To actually 'get' the virus it would be necessary that someone coughs into their hand, immediately touches a door knob and then straight after that another person grasps the handle and goes on to touches their face.” Streeck therefore believes that there is little chance of transmission through contact with so-called contaminated surfaces. https://today.rtl.lu/news/science-and-environment/a/1498185.html https://today.rtl.lu/news/science-and-environment/a/1498185....

tosh 7y ago
Just to add a bit more context regarding the now often cited study of Gangelt (some questions where raised re methodology and esp the policy conclusions): https://www.sueddeutsche.de/wissen/heinsberg-studie-herdenimmunitaet-kritik-1.4873480 https://www.sueddeutsche.de/wissen/heinsberg-studie-herdenim... it is a good start & germany is doing now many more serological studies (also to monitor over time) and hopefully we'll soon gain more confidence re status quo and what it means
- bwb 7y ago
  Spain is doing one now with 30,000 families and Italy should have one finished soon.

dec0dedab0de 7y ago

This is neat, but a little scary. If I'm understanding it correctly, they are checking sewage for evidence of the virus, and estimating how many people have it based on that. This would be really cool if it were common place, and tested for all known viruses, drugs, fungus, bacteria, lead, whatever they can find. This could be used to track the health of the population over time and as it spreads. If it were publicly available this would be a great resource. The scary part is what if they start making the sewage sites smaller and smaller, or even just the collection locations to where its testing fewer people. Then use that information to enact quarantines or investigations.

jimbokun 7y ago
> Then use that information to enact quarantines or investigations. That's exactly what we want! Quarantine the specific areas where there is an outbreak, and relax the nation wide quarantines currently being enacted in many countries.
- zepto 7y ago
  Only if you have an extraordinarily transparent process for determining when a quarantine is appropriate.
zepto 7y ago
That’s why you need a constitutional safeguard against depriving people of their freedoms.
praptak 7y ago
The scary part is already happening to drug users. The police in China are analyzing sewage to pinpoint who uses illegal drugs.

gwbas1c 7y ago

I live in MA and got very sick on Feb 26, then had a horrible cold. My wife is a doctor, and she thought I just had one of the many things going around. I asked her if it was COVID-19 and she looked at the CDC's web site and said she didn't think so. Then a week later she flew out of Logan to spend a weekend in LA. I also went skiing in New Hampshire twice, and went to two networking events! Throughout March I had symptoms that I never had in my life... I couldn't get a test! The symptoms went away after 4 weeks. Did I have it? I have no idea, but if I got it, it most likely came from her or my kids, who all felt kinda wonky in mid February. My wife had a very bad headache two weeks before I got sick.

yters 7y ago
My family lives in MD, and same thing happened to us in Feb. A child in our daughter's daycare came down with severe pneumonia and ended up in the hospital, our daughter was sick with diarrhea and fever for a week, and my wife caught a bad cough that lasted for weeks and had trouble breathing. Thing is, we cannot know at this point whether everyone already has covid-19, since there are no anti-body tests. It is a live possibility, but meanwhile we are shutting down the world's economy.
- wbl 7y ago
  We know when Coronavirus entered the US and the serial interval, and can estimate via phylogeny how big the population of the virus is. The phylogenics+excess deaths are ruling out a mass infection that no one died from.
  - yters 7y ago
    How do we know when covid-19 entered the US? How do we know the R0? R0 is continually being estimated upward and death rate downward. We don't seem to have much clarity on any of this. Another problem is if covid-19 was already widespread, it would have been misclassified before the huge spotlight. So, increase in cases and deaths could be misattributed. If there is an overall increase in excess deaths, we still have a question of causality. Could the measures we are instituting themselves contribute to deaths? Just a lot of questions and lack of clarity in this matter.

yters 7y ago

If covid-19 is much less harmful than we originally thought, why were, and still are, medical experts proposing such draconian measures without a clear understanding of the true threat? Dr. Fauci, advisor to the president, proposed the other day that no one should ever shake hands again, in order to prevent spread. It is bizarre. Even when the disease first started to spread, there were people making these same points. In fact, most people thought the disease was no worse than a bad flu or cold, hence the difficulty to institute lockdown type measures in the first place. This is certainly not going to build trust in institutional expertise on these matters. So, once the medical experts are actually right, then they'll be ineffective at persuading people.

_wldu 7y ago

Researchers are finding that COVID-19 testing has roughly 33% false negatives: https://www.wsj.com/articles/questions-about-accuracy-of-coronavirus-tests-sow-worry-11585836001?mod=e2tw https://www.wsj.com/articles/questions-about-accuracy-of-cor... The LabCorp test is not FDA cleared or approved and is being used under an emergency act. "Testing was performed using the cobas(R) SARS-CoV-2 test. This test was developed and its performance characteristics determined by LabCorp Laboratories. This test has not been FDA cleared or approved. This test has been authorized by FDA under an Emergency Use Authorization (EUA). This test is only authorized for the duration of time the declaration that circumstances exist justifying the authorization of the emergency use of in vitro diagnostic tests for detection of SARS-CoV-2 virus and/or diagnosis of COVID-19 infection under section 564(b)(1) of the Act, 21 U.S.C. 360bbb-3(b)(1), unless the authorization is terminated or revoked sooner." The Quest test is not FDA approved either: https://www.questdiagnostics.com/dms/Documents/covid-19/SARSCoV-2_Patient_Fact_Sheet.pdf https://www.questdiagnostics.com/dms/Documents/covid-19/SARS... "It is possible for this test to give a negative result that is incorrect (false negative) in some people with COVID-19. This means that you could possibly still have COVID-19 even though the test is negative." "This test is not yet approved or cleared or authorized by the United States Food and Drug Administration (FDA)." Due to this, it's hard to trust test results. It's a best effort and not perfect.

xenonite 7y ago
Well, each test is different though. More so, testing wastewater is also a totally different story than testing humans. Although I find your comment interesting, I don't see how this relates to the topic of wastewater analysis.

epistasis 7y ago

I don't think that HN is a good venue for discussion of specialized preprints that have highly surprising results, in topics that are moving extremely quickly. Too few people in this community are able to evaluate the information contained, which leads to lots of pointless speculation, and lots of misinformation. Despite working in biology for 20 years, I would not trust any of my own interpretations of this pre-print. The only people who I would trust are named specialists in this field, that are willing to stake bits of their reputation on what they say. The only venue where that is happening in the public is on Twitter.

ianai 7y ago
I agree that HN is not capable of digesting this study reasonably not meaningfully. I question using Twitter for anything meaningful though.
- epistasis 7y ago
  Twitter is often extremely useful for scientific fields, and in many ways is perfect for it. You can post a figure and legend, tag people that may find it interesting, and start threaded discussions. It's all in the public, with no invitations or closed doors, so it is open to discovery by that dozen or two dozen people in the world that may be interested. Science is the ultimate long-tail of super-specialized interests with extremely small audiences, and Twitter is perfect for connecting those people with extremely esoteric interests. There is a lot of crap, but science Twitter is also the only reason I'm on it. Sadly, my own biases against Twitter Kept me off it for 8+ years, but after I started finding the right people to follow, a whole new world opened up, and it is now a vital tool for me to navigate the literature and learn quickly which new tools are best.
  - ericd 7y ago
    >There is a lot of crap, but science Twitter is also the only reason I'm on it. Sadly, my own biases against Twitter Kept me off it for 8+ years, but after I started finding the right people to follow, a whole new world opened up, and it is now a vital tool for me to navigate the literature and learn quickly which new tools are best. That's really interesting, I've been avoiding Twitter for the same reason, but I can see how it'd help keep up with fast-moving niche fields. Maybe I'll give it a try, thanks!

Zenst 7y ago

The whole avenue of analysiing waste water when you have centeralised procesisng of the inhabitants as a finger in the air feel upon things is already used in some avenues and like this, many more avenues of potential. Sure it won't be exacting, but does give a feel for things in a way that is very cost effective over alternatives in so many area's. For example, drug usage - measuring the waste water for levels of cocaine, etc etc etc is already used to some degree and proven in many studies. Sure it won't say who, what or exactly were and with that, also anonymised and ticks a few privacy box's in that respect. Let alone the aspect that your fecies and urine and property that we all happily sign away to the water/waste company and even pay them. They can do with it what they like if it comes down to it, but in this approach, nobody is identified and it is more a finger in the air measure of things and a good indication of any shifts/change overall for the costs and speed of doing so. Though personal toilets that will do some serious analysis of your waste for health reasons may well be a big in japan joke phase, but certainly at some level they do have merit and whilst the waste treatments today may be a good overall feel, the market and technology will gradualy filter down into the homes for those that want to be ontop of their health or just want that extra level of safty. Certainly a good initiative and practical approach, though such an approach does depend upon a good waste/water infrastructure and that will be mostly modern area's, towns cities and the like and for some area's, may not have that high a percentage using such centralising waste management. Though when we start tracking area's health media wise like we do weather and get the poo forecast, that's when I know reality has caught up with my darkest of humour.

snovv_crash 7y ago

This reminds me strongly of the methods used in Neal Stephensons's novel Zodiac, where they follow sewerage pipes to determine where the source of an infection is.

floatingatoll 7y ago

The paper includes a disclaimer: > MM and NG are cofounders of Biobot Analytics. EJA is advisor to Biobot. NE and CD are employees at Biobot. All these authors hold shares in the company. Another comment suggests that Biobot is YC. As far as I can tell, Biobot has never posted a Launch HN, but they did post a Covid page 3 weeks ago: https://news.ycombinator.com/item?id=22627746 https://news.ycombinator.com/item?id=22627746 They were in the news in 2018 for testing wastewater to measure the opioid crisis, but I can't find any HN discussions about any link or story that I can find myself, or from their list of media posts. https://www.biobot.io/media https://www.biobot.io/media Among those links are a video interview / product demo (Cheddar) and a podcast interview (Latina Founders).

ping_pong 7y ago

A Danish study recently concluded that actual infection rates could be 30x-80x higher than what is shown by positive test results. This could easily explain the higher levels than expected and is potentially a good thing and bad thing. It means that mortality is much much lower that expected. https://www.reddit.com/r/COVID19/comments/fxk917/covid19_in_denmark_status_entering_week_6_of_the/fmuw8a8/ https://www.reddit.com/r/COVID19/comments/fxk917/covid19_in_... (Google translation) Google translate of section 4.1.2 (pg.27): 4.1.2. Revised planning basis Statens Serum Institut informs on the basis of antibody studies in 1,000 blood donors in the Capital Region, lost in the period 1-3. In April, 2.7% had been detected with antibodies, which, with a sensitivity of 70%, corresponds to 3.5% of those examined had already been infected with COVID-19. Statens Serum Institut states that if this figure is transmitted to the entire population of the Capital Region, it is equivalent to approx. 65,000 people may have been infected as early as 26 March. At this time, 917 confirmed cases of infection were found in the region. This means that there can be up to 70 times more infected in the community than confirmed cases. In the work of the State Serum Institute in modeling the development of the epidemic in Denmark, on the basis of studies in, among other things, Iceland and Germany, it has been decided to work with the real number of infected in Denmark being 30-80 times higher than the number that remains. ver proven. It is therefore estimated that the dark number is significantly higher than in the first planning scenario, and it is estimated from the State Serum Institute that for every detected infection case up to March 28, there may be 30-70, which are actually infected. This ratio will be affected by the number of people who will be infected in the future. Thus, there is probably much more widespread contagion in society than previously thought. This does not have a direct impact on the planning basis for the health care system, as the increased spread of infection is in a part of the population who do not need hospital treatment and probably only to a very limited extent have sought medical attention. It should also be noted that it also means that the mortality rate of infection with SARS-CoV-2 (infection fatality rate, IFR) is lower than the mortality rate of registered case fatality rate (CFR) and possibly lower than that of WHO have evaluated. The WHO has estimated that the IFR is between 0.3-1.0 with wide variation across age groups. With more precise knowledge of the dark figures, the IFR for the COVID-19 epidemic in Denmark can be clarified and the expected mortality will be accurately estimated. The State Serum Institute states that over the coming weeks they will be able to continuously monitor the development of immunity in the population through cooperation with the blood banks, focused sample studies and testing for the population's immune status in general. The above also means that the previous assessment of the mortality in connection with COVID-19 in Denmark is no longer true. When a more accurate assessment of the actual prevalence of infection is obtained on the basis of the epidemiologic surveillance and a precise IFR for the Danish epidemic is estimated, a new and true mortality prognosis can be estimated. The need for ordinary beds and intensive beds is evident from the modeling, which will be continuously qualified. TLDR: blood donor antibody testing indicates true infection rates are 30x-80x higher than confirmed cases in Denmark and that 1.5 weeks ago ~3.5% of Copenhagen’s population may have already been infected by Covid-19.