Wastewater testing for viruses has increased during the coronavirus pandemic. Alaska state health officials are working to expand these efforts.

Every Tuesday, a team of scientists at the University of Alaska Anchorage spends most of the day carefully extracting and testing microscopic ribonucleic acid strands found in jugs of wastewater. It is collected from the city's sewage facilities. This is done to detect levels of SARS-CoV-2, the virus that causes coronavirus disease (COVID-19).

The process, which UAA professor Brandon Briggs' lab has been involved with since the early days of the pandemic, is expanding in Alaska to use wastewater as a way to track not just the coronavirus, but a variety of other viruses and diseases. This is part of public health activities. Tuberculosis, RSV, influenza, monkeypox, norovirus, etc.

“I think there's a lot of utility to this,” said Clayton Weingartner, program manager for the state health department.

Wastewater testing can be used as an early warning tool — people often start shedding the virus before they start showing symptoms or feeling sick, he said.

And since most Alaskans are now using rapid at-home tests to check for COVID-19 (if they even test at all), wastewater monitoring is also the best way to measure the spread of the virus. It is one of the

“People are still getting sick, but they're not actually going to the hospital and getting tested,” Briggs said. “So neither the city nor the state actually knows what the true incidence of that particular pathogen is. And only once they have that type of information can they rely on a small number of people. We'll be able to better understand what's really going on in that community as a whole, rather than in the community.”

In early January, Anchorage wastewater collection data showed a significant spike in COVID-19 infections (which have since trended downward), and Dr. Luisa Castrodale, an epidemiologist with the Alaska Department of Health, said that The results are consistent with the trend data.

Additionally, while data collected through sewage cannot be manipulated to measure the number of infected people or incidence rates, the amount of virus that each person sheds when they get sick is different, so the value of the data is limited to early trends. Briggs said it is possible to demonstrate that.

Scientists and state health officials said they are now strengthening the state's ability to track the spread of the virus using wastewater testing.

The use of community wastewater for disease surveillance is not new. Scientists have been searching for clues in sewage since the 1800s. In the 1940s, researchers used wastewater testing to monitor cities with polio outbreaks.

During the COVID-19 pandemic, many states, including Alaska, received federal funding from the Centers for Disease Control and Prevention to test wastewater for the virus. Now, the state is looking to expand its efforts to more rural areas of the state and find ways to track other diseases.

The state recently hired a wastewater informaticist to help manage its efforts.

“It's been around for a while,” Briggs said. “But I think the pandemic has really highlighted the importance and the ability to get critical information out there so that we can see things start to move before it becomes a real problem.”

Just like following a recipe

On a recent Tuesday, in a sun-drenched room on the upper floor of UAA's ConocoPhillips General Sciences Building, three scientists, lab manager Eric Henderson and researchers Nate Beck and Victoria Triglia, spent a day working together. We have begun the process of testing the wastewater. It involved many steps and waiting time.

“It's like cooking, you just follow a recipe,” Henderson said.

Briggs said the process of testing wastewater for SARS-CoV-2 is similar to what happens in a lab after someone swabs their nose and takes a PCR test.

First, water is collected in the morning at the John Asplund wastewater treatment plant near Point Woronzof. after that, Scientists pour bottles of wastewater into a chilled centrifuge to separate liquids from solids.

This solid material, which is eventually spun into small pellets of about 1 gram, contains the most concentrated amount of RNA and DNA and is the most useful for testing, Triglia explained.

The researchers then extract RNA strands from the pellet and use this to measure the varying levels of virus in the sample.

These scientists have spent the past few years perfecting their testing efforts to get more accurate results, Briggs said.

Testing efficiency has also improved significantly, Briggs said, with the testing process taking about three or four days earlier in the pandemic to now being completed within 24 hours.

UAA's efforts are echoed by Verily, a company that also tests Anchorage wastewater samples at its Lower 48 labs. Verily's data is reflected in an online wastewater dashboard. Briggs said the benefit of in-state processing is that delivery times are even faster.

“We're trying to make sure we have the production capacity here in Alaska and be able to respond more quickly because we don't have to ship it down 48 states and wait two to three days for results. he said.

Move to expand testing activities in Alaska

At UAA, Briggs said his lab is expanding. The lab is working on sequencing efforts to detect other types of viruses and will soon publish weekly data online, he said.

He said his hope is that cities and states will start using this data to inform public health decisions and guidance and support decisions about where to allocate resources.

“Alaska's main focus right now is building the capacity to do (wastewater monitoring) independently here in the state,” Weingartner said. He said the state plans to expand additional testing sites in Massou and Fairbanks later this year, with plans to expand beyond COVID-19 soon.

He said the state is particularly working to expand into more rural areas of the state, where wastewater testing can be particularly difficult due to a lack of infrastructure and laboratory resources. Ta.

The state is also trying to figure out the best way to use the data it collects.

“We’re working on leveraging that data,” he said. “If we see a significant spike, we will respond.”

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