The state of Connecticut is working with Yale’s School of Public Health in the hopes of expanding a New Haven wastewater testing project into other municipalities, which would give city officials advance warning of potential coronavirus outbreaks.
Wastewater surveillance is the process of taking samples from a wastewater treatment plant and testing those samples for certain contents — in this case, for bits of coronavirus genetic code embedded in feces. The variations in the amount of code detected can tell researchers whether the virus is spreading throughout a community.
A team led by Jordan Peccia, of the Yale School of Engineering and Applied Science, has been testing the wastewater in New Haven since March. He told The Courant in May that his team could predict COVID-19 outbreaks up to seven days before those outbreaks were detected by more traditional testing.
Dr. Matt Cartter, the state epidemiologist, said the forewarning could give communities a chance to ratchet up social distancing and mask-wearing protocols when they are most needed, potentially preventing an outbreak from growing unnecessarily large.
Wastewater testing “can give you an advance warning that you may be about to see an increase in the number of cases or an increase in the number of hospitalizations,” Cartter said. Officials can begin “enforcing those public health messages if [they] know in advance where it might happen.”
Both Peccia and Cartter said that wastewater testing is not a replacement for individual testing. Crucially, individual testing would still be necessary to identify those who have the virus, begin a contact tracing investigation and identify others who may need to self-quarantine.
“Essentially, it’s another tool,” Cartter said. “It could give us one more piece of information.”
Waiting for funding
At a June 29 press briefing, Gov. Ned Lamont said wastewater surveillance had come up at a recent coronavirus-related meeting between the nation’s governors and Vice President Mike Pence.
Lamont said Connecticut will be able “to do that type of testing analysis in nursing homes, universities and we’re going to roll it out to all of our municipalities.”
But Peccia and Cartter said the reality is more complicated.
First, Peccia is proposing expanding to only a handful of municipalities. But the state also hasn’t yet secured funding for even that version of the project.
Cartter said that Yale submitted a partnership proposal to the state, in a package that included the wastewater surveillance project and other projects such as coronavirus-related data analysis, surveillance of long-term care facilities and contact tracing support.
Dr. Albert Ko, the Yale epidemiologist and former co-chair of the Reopen Connecticut Advisory Group who’s coordinating much of the package, said in an email that the partnership is “in its early stages of discussion.” He declined to comment further.
The state is seeking federal funding for the proposed projects. Cartter said the state is waiting on funding approval from the U.S. Centers for Disease Control and Prevention, and excepts to hear back by mid- to late-July. (Several officials, including Cartter and the state’s chief operating officer Josh Geballe, declined to comment on how much funding the state requested for the projects.)
If the funding is approved, Geballe said the state would “like to move sooner rather than later” to implement the projects, including the wastewater surveillance.
“I think there’s a very high probability that this is going to happen,” Peccia said. “But it hasn’t happened yet.”
Hopes and limitations
Peccia also said it’s not feasible to conduct wastewater testing in every city and town, in large part because residents in more rural parts of the state often use septic tanks. That means that those residents’ wastewater is not processed in a central location, and therefore couldn’t be easily accessed by researchers.
Instead, Peccia hopes to expand testing to five more municipalities, for a total of six, including New Haven. Peccia said the five municipalities he proposed are “big areas,” but he declined to name them before the project is approved.
“We’ve moved forward with the state in getting funding to do that,” Peccia said. “We’re just kind of waiting on all that to come to fruition.”
Several officials, including Cartter and Lamont, also mentioned the potential to conduct wastewater testing for more specific communities such as universities and long-term care facilities.
Peccia said this is a possibility, but would require an entirely different methodology from the one he and his team are using. In New Haven, Peccia’s team collects samples from highly concentrated “sludge” at a wastewater facility. This simplifies the process, Peccia said, because the team can collect smaller samples and also doesn’t need to concentrate the samples after collection.
In theory, researchers could collect samples from sewers on university campuses, for instance, but the process would be “significantly more complex” and expensive, Peccia said.
The obstacles haven’t stamped out the enthusiasm, though. Peccia said he’s heard many universities talk about implementing wastewater surveillance.
“I think a lot of people are excited about it,” he said. But “I don’t know if any of them have pulled it off.”
Emily Brindley can be reached at ebrindley@courant.com.