With Britain in the grip of the Covid-19 pandemic during the summer of 2020, scientists were frantically searching for ways to get one step ahead of the virus as it rampaged across the country, mutating at an alarming rate.
And one of the best methods they found was to regularly test raw sewage.
For it turned out that the wastewater from tens of thousands of homes across the country contained vital clues as to where the virus was spreading — even before this was picked up by GPs and hospital doctors.
Anybody infected with Covid sheds tiny fragments of the virus’s DNA in their poo, even if they have no symptoms.
Crucially, this DNA can be detected in sewage several weeks before surging infection rates indicate a local outbreak.
This branch of science, called wastewater-based epidemiology, proved to be the breakthrough that was needed in the fight against Covid, and from summer 2020 the UK Health Security Agency (UKHSA), which oversees such major public health initiatives, rolled out a large-scale scheme.
Pictured: a Covid-19 particle, anybody infected sheds tiny fragments of the virus’s DNA in their poo, even if they have no symptoms
The Environmental Monitoring for Health Protection, as it was called, was a programme to test, three times a week, untreated sewage samples from more than 300 treatment works across England, covering roughly 70 per cent of the population.
Data gathered by the programme played a key part in the mapping of Covid infection rates and informing policies, such as local lockdowns, to contain the spread of the virus.
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Such was the success of the sewage check scheme that nearly 60 other countries have since set up similar testing programmes and some, including the U.S. and India, are now expanding its use to check for future Covid variants.
However, Good Health can reveal that, instead of building on the success of the scheme, UKHSA quietly scrapped wastewater Covid surveillance in England several months ago.
This came to light when former Downing Street adviser Dominic Cummings said in a recent online blog that government insiders had told him the programme had been abandoned to save money.
He wrote: ‘Officials told me it was being shut down — for savings. Vallance [Sir Patrick Vallance, the government’s chief scientific adviser] and other officials objected but were over-ruled.
‘Yet it worked well and was copied all over the world. It can obviously be used not just for Covid but as part of an early warning system for other potential diseases.
‘It’s a tragic example of the refusal to learn from Covid.’
The value of wastewater-based epidemiology became evident again recently when traces of polio in sewage prompted health chiefs in London to offer nearly a million children under the age of ten an urgent booster vaccine to protect them against a virus that can cause paralysis.
Live polio virus has been detected in sewage in at least eight boroughs in the north and north-east of the city.
It was first picked up from one sewage plant in London back in February when the sewage surveillance programme was still in full swing.
Young children are thought to be most at risk as uptake of the polio vaccine in some parts of London is as low as 55 per cent.
The UKHSA website acknowledges that sewage surveillance ‘has played a key role in the detection of mutations of the Covid virus’.
Yet in a statement to Good Health it confirmed that it is no longer monitoring the spread of the Covid virus through waste-water surveillance.
The statement said: ‘As with all surveillance programmes at UKHSA, we have the ability to scale this back up should the need arise.’
However, the decision has been greeted with dismay among experts, who say they had hoped the UK would build on the success of the programme by expanding it to tackle other emerging health risks.
‘Scientists involved in the surveillance programme in England are disappointed it has ended,’ says Dr Andrew Singer, a senior scientist at the UK Centre for Ecology and Hydrology, near Oxford, which was allocated a £900,000 government grant in July 2020 to develop testing procedures for monitoring wastewater for coronavirus.
Pictured: A polio virus particle. Live polio virus has been detected in sewage in at least eight boroughs in the north and north-east of the city
‘This technology has the potential to help us tackle existing and emerging health risks, such as polio, influenza, monkeypox and antibiotic resistance.
‘It’s a low-cost, accurate, anonymous method for detecting disease outbreaks several days before a spike in hospital cases and can alert authorities to take action to reduce the spread of infection.’
Another expert in wastewater surveillance, who did not want to be identified, said: ‘I would love to know what the thought process was behind a programme that was so useful, being cut at such an early stage in its development. We had just started to get a good handle on coronavirus surveillance.’
Critics of the decision fear that the move could jeopardise England’s ability to respond to future viral threats.
In the meantime, other governments seem to be building their coronavirus surveillance systems around sewage monitoring — not turning their backs on it.
In March, U.S. President Joe Biden’s administration said it would become a key part of its future virus detection systems, while India is expanding wastewater checks on Covid to half a dozen new cities after a pilot scheme in the city of Bengaluru proved successful.
Closer to home, Wales has set aside £4 million to fund a six-month pilot project covering wastewater checks at 50 sewage treatments. (While the UKHSA does cover the entire UK, home nations can do their own thing if they see fit.)
The Wales scheme will involve sampling sewage on at least five days a week across the network, looking for signs of emerging infections and reporting to Welsh government advisers on a regular basis.
The checks will also look out for early warning signs of other infections — including flu, polio and norovirus — as well as signs of increasing antibiotic resistance, by testing minute quantities of the drugs that are shed into the sewage system.
Scientists were frantically searching for ways to get one step ahead of the virus as it rampaged across the country, mutating at an alarming rate
And the wording of the tender to run the testing contract makes it clear that the powers-that-be in Wales see sewage checks as playing a central role in protecting the population against another pandemic.
It states: ‘Wastewater-based epidemiology is a rapidly developing science. The new technology developed and deployed during the Covid-19 pandemic has the potential to support more sustainable services in Wales.
‘This programme has the potential to shift the balance of our health and care system towards earlier detection and intervention, helping to prevent illness.’
Dr Singer says: ‘Wales is demonstrating what other countries could and should be doing. Wastewater epidemiology has clearly demonstrated its value.’
Northern Ireland, meanwhile, has set aside £3.8 million to cover wastewater surveillance at 30 sites and has pledged to continue to support the project in the long term.
The Northern Irish health minister Robin Swann said in March: ‘There is no doubt Covid-19 remains a health risk.
‘This programme will play a key role in helping to protect the public by identifying areas where cases have increased.’
In Scotland, the Scottish Environment Protection Agency was given funding for its own Covid surveillance programme, involving frequent checks at 100 or so sewage treatment works, up until the spring of this year.
The beauty of sewage as a public health resource is that someone infected with Covid-19 is estimated to shed up to ten million particles of the virus’s genetic material in just one gram of faecal matter.
This means it’s possible for scientists to detect if just one person out of 100,000 in the local population is carrying the virus.
Scientists in the UK and Europe first began routinely checking wastewater around 20 years ago, mainly to track use of illicit drugs such as cocaine.
But in recent years, studies have found it can also be used to monitor everything from how much alcohol people really drink (as opposed to what they claim in surveys) to whether use of asthma-relieving drugs increases when air pollution levels are high.
Although the UKHSA has curtailed its sewage-based Covid checks, it says it is expanding polio surveillance.
In a statement, it said: ‘We are carrying out polio surveillance of wastewater in London and another ten to 15 sites will be set up nationally to determine if the virus is spreading elsewhere.’