(curious music)
- [Narrator] Public health experts around the country
are using every tool at their disposal
to track the spread of COVID-19 in their area.
For some cities and states, one of those tools is poop.
This is sewage water.
The virus shows up reliably in the feces of sick people
before they start to show symptoms.
All that ends up where feces usually ends up,
sewage plants like this one in Brooklyn, New York.
A lot less gross than I thought it would be.
The amount of virus swirling around in the plant
is a good indicator of how many people are infected.
It's an early window into how much illness is on the horizon
and is helping the city to code the future of the pandemic.
There's a condom.
That's gross.
(curious music)
- Early, like March, April,
there were so many people said,
I want your sewage of tested for COVID.
I want your sewage.
And I'm like, what are you gonna do with it?
What is your method like?
Who are you?
- [Narrator] Pam Elardo leads
the Bureau of Wastewater Treatment here in New York City.
It's the largest municipal wastewater
utility in North America.
It includes 14 separate wastewater treatment plants
spread through the city.
This one is the largest.
It processes waste for a million people.
- On a dry day, treats about 300 million gallons a day.
When it rains, it takes stormwater from the streets.
And when that happens,
it can be over 700 million gallons in a day.
- [Narrator] Early on in the pandemic,
scientists started to get interested in testing sewage
for the virus in order to track the spread of disease.
Private companies and research labs from across the country
began reaching out to wastewater plants like this one.
- They felt that there might be, it might be traceable.
The method hadn't been refined yet
but there was a lot of interest in it.
- [Narrator] Pam thought the idea was worthwhile,
but didn't want to outsource.
- I felt like, and my leadership team felt like,
we really need to be in charge of it
and control the process.
So we quickly were able to repurpose
part of our laboratories, our existing biological,
microbiology laboratory here at Newtown Creek,
to be able to do what we did in a short period of time.
Like literally weeks, is amazing
- [Narrator] To see what this all looks like,
we took a short tour of the plant.
The first stop, screening for all the stuff
people shouldn't flush.
- 80% of this is stuff that is not human waste.
We don't want to see anything except pee, puke,
toilet paper, only toilet paper,
not any other kind of paper and poop.
That's it.
This is what the plant's for.
- [Narrator] Then we tagged along on a sample collection
And this is sewage, right there?
First, plant employees drop a metal contraption
holding plastic bottles down
into the incoming stream of liquid sewage.
- Nice and slow. - Okay.
- [Man With Metal Contraption] Nice and slow.
- [Narrator] So this is gonna go to the lab
where they will analyze it for traces of the coronavirus.
- [Dimitri] So the fecal samples arrive in the coolers
every day, 365 days a year, and we process them
- [Narrator] Analyzing this sample is more involved
than the usual swab COVID tests.
Dimitri Katehis leads the lab's efforts.
- [Dimitri] So we take samples, influent samples,
twice a week from the influent to all 14 facilities.
That gives us a snapshot
of the genetic material from the virus.
So not infectious virus,
but rather just its genetic snippets.
What this does is effectively allow us to develop
a sort of an early warning system.
- [Narrator] The team uses a technique called PCR,
which magnifies tiny traces of genetic material
until it can be detected by a machine.
The less time it takes to magnify to a detectable level,
the more material there was to begin with.
That lets them roughly quantify
the amount of virus in the sewage.
- [Dimitri] When you go and you take a clinical test,
you are basically, the question is,
are you positive or are you negative?
Here the question is, how much genetic material is there?
- [Narrator] Can you translate that at all
to the number of people who might be sick in that area?
- [Dimitri] No is the short answer
because the shedding rates vary.
As an individual gets sick,
they shed viral material at different rates,
whether they're symptomatic or asymptomatic,
or frankly how ill that individual is.
The shedding rates are not adequately characterized yet
to allow us to take this information and back calculate
an estimate as to how many people are ill.
- [Narrator] What they can do is track
whether the amount of virus is rising or falling
and the relative size of the outbreak.
Do you have a sense of what,
what concentration tends to correlate
with like, a big outbreak versus a small outbreak?
- [Dimitri] We have unfortunately,
because we were starting to see that.
And what we're seeing is that values on the order of about
10 to 20,000 copies of RNA per liter
indicate a brewing condition.
And then when we start seeing values
in excess of 40 to 50,000 copies per liter,
there's a significant cluster
and there's a significant response in the community.
- [Narrator] Using this system, Dimitri and his team
were able to predict a recent hotspot in Coney Island.
And they helped sound an early alarm on Staten Island.
- [Dimitri] The city started noticing
that there's possibly an increase in Staten Island,
which had been very quiet up to that point.
And they asked us, are you seeing anything?
We actually were just wrapping up that sample
that Saturday morning and lo and behold
we saw a significant spike in both Port Richmond
as well as at Oakwood Beach,
our two plants that serve Staten Island.
And so we were able to provide that feedback
and they in turn were able to increase the clinical testing.
- [Narrator] This tool is still new.
And even though it's worked well so far,
the team is trying to refine and expand it.
Right now, for example,
it takes about three days to analyze each sample.
- [Dimitri] We are purchasing some automated equipment
to try to cut that down to two days
and give us one more day.
In what we're doing here, unfortunately, every day counts.
- [Narrator] Sewage monitoring on its own
can't solve a pandemic.
It has to be paired with other disease surveillance systems
like data on testing, hospitalizations and symptoms.
- [Dimitri] Now, the city has a model that brings in,
like as I said, a lot of data streams,
everything from ambulance runs in the neighborhood
to prescriptions being utilized and so forth.
And then they can make assessments
whether they need to direct more clinical testing resources
in certain neighborhoods, in certain areas,
or whether they need to, God forbid,
do more social distancing or enhanced enforcement.
We do a little bit of that as well.
- We'll never know exactly, definitively
how many people have COVID-19 at one particular time.
Everything is an estimate, but each strategy estimates
in a slightly different way.
So by combining them, we get the best idea
of what's actually happening.
Eventually, the team hopes they can use this method
to track other viruses
and to monitor other health threats to the city.
- Our basis is public health protection.
That's how our industry got started.
And so all of that means we should be contributing
where we can in terms of how the sewage system,
how the sewage information contributes to this pandemic
and any kind of future issues that we may come up against.
In the last 10 years, we've seen like a tenfold increase
in the amount of wipes coming here,
because the manufacturer puts the word flushable on the box.
We spend over $20 million a year of your money,
if you live in New York city,
throwing this stuff out.
It belongs in the trash can.
Trash it, don't flush it.