The Sylva Herald, by Beth Lawrence

The Tuckaseigee Water and Sewer Authority has been asked to participate in a study that would help trace the spread of COVID-19.

At its May 19 meeting, the board heard a presentation from Mathematica, a data tracking group that works with governments at all levels to design and implement data tracing programs. The group is coordinating a program to track the spread of COVID-19 using wastewater treatment facilities.

Senior statistician Aparna Keshaviah gave the board a rundown of how the program works.

The idea was introduced to the board by Ron Mau.

“It sounded interesting with everything that’s going on with COVID and trying to get more information about the virus,” said Mau, a county commissioner and a county appointee to the TWSA board.

Mathematica worked with state and local leaders to determine the value of wastewater testing in a number of demographics to monitor the overall health of municipalities including opioid use.

Recent evidence has shown that the wastewater testing could be used to track the spread of SARS-CoV-2, the virus that causes COVID-19.

“When you think about wastewater as a public health data stream, certain strengths really stand out,” Keshaviah said. “The 15,000 wastewater treatment plants around the country capture wastewater from 71 percent of the population which is much more complete and broader coverage than many traditional data sources.”

Testing wastewater does not infringe on privacy or violate HIPAA regulations because it captures water from a large number of sources before entering the treatment plant.

The testing would translate the viral load, the virus count, in a wastewater sample to estimate the prevalence of the disease in an area.

“To date, there is little evidence of SARS-CoV-2 transmission via sewage systems, and most studies found that the virus shed in stools is not infectious,” Keshaviah said. “Given that wastewater treatment plants can serve hundreds to thousands of people, a test of a single wastewater sample collected at the central plant … extends the reach of a single test kit, a single set of reagents to assess the exposure of not one person but hundreds or thousands. That’s really critical given COVID testing limitations.”

The testing could uncover the virus in areas where people have not been tested because there are asymptomatic carriers of the virus.

Mathematica estimates that because of silent carriers, there are four to five times more cases in the county than what have been confirmed.

The tests could give public health officials better insight into management of the spread.

Repeated testing could pinpoint increases or decreases and help local leaders determine whether management strategies like closures and physical distancing are working, need to be loosened, strengthened or revamped. The data could also alert officials to a second wave outbreak.

Mathematica works with local officials to develop an assessment, create a wastewater sampling plan, find a reliable lab for testing and works with treatment plant employees to develop a set of best practices to gather samples.

“Once the workflows are set up for COVID monitoring, that same infrastructure can inform officials about a range of public health threats, everything from pathogenic bacteria and viruses to health and wellness measures including biomarkers of obesity, stress, diet to pharmaceuticals,” Keshaviah said.

Jackson County and TWSA could choose to participate in a number of studies; one is the North Carolina Sewage Surveillance Study.

Board Chair Tracy Rodes was intrigued.

“It’s very interesting, and I do think that it has a lot of promise for predicting hotspots and second waves particularly with the public school system when they start back up,” she said.

Health Director Shelley Carraway sat in on the meeting and called the idea of testing wastewater for SARS-CoV-2 “fascinating.” The process could be useful to the health department.

“Any way that we could find prevalence in our community, that helps guide the decisions,” she said.

The data public health works with currently is not as concrete as decision makers would like to have.

The program can be costly, but Mau has begun to look for grant funding.

Some granting agencies have expressed interest in supporting the program, Mau said.

If TWSA participates through the state run study, discounts on testing may be possible through the University of North Carolina.

The statewide study will likely commence in mid-June.

“I’m interested in seeing about the grant agencies because TWSA does not make policy except concerning water and wastewater,” Rodes said. “We are not a governmental entity in that (regard). The county can impose emergency regulations and such, so it seems to me that we would need a collaboration … in our local area.”

The board asked Mau and TWSA Director Daniel Manring to coordinate the project and find funding.

Mau briefly discussed the subject with the Jackson County Board of Commissioners at its regular meeting last week.