The sewage doesn't lie: A new COVID wave is upon us. Be prepared

York Dispatch editorial board

At this point in the COVID pandemic, not everyone gets tested when they come down with symptoms. And those who are tested are increasingly doing it at home — and, thus, not reporting the results to state health officials.

But everybody poops.

That's the principle behind wastewater monitoring, the practice of sampling sewage for evidence of various diseases or drug use in communities.

The Centers for Disease Control and Prevention launched a nationwide surveillance program to do that for COVID-19 two years ago. It uses the same science — polymerase chain reaction or PCR — as those swabs you've probably stuck up your nose at some point in the last two years.

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If the water contains a lot of coronavirus RNA — that is, the virus's genetic material — it means there's a lot of virus out among the population that's flushing that waste down their toilets.

The City of York's wastewater treatment plant.
Tuesday, August 25, 2020
John A. Pavoncello photo

"The wastewater surveillance is a good predictor of what's going to be seen in the clinical cases within the area," Roland Francis, who samples wastewater for Indiana Borough in the western end of the state, told the Post-Gazette. "Generally, if you see a spike in the concentration of viral load in the waste stream, that's followed by a spike in the number of cases in the local hospitals."

And we've got some bad news.

A month ago, nearly three-quarters of American wastewater systems that were monitoring for coronavirus reported a clear downtrend. Today, that figure is just over half.

In Pennsylvania, there are three wastewater treatment facilities that are still routinely reporting COVID testing data. Two of the three locations, in Allegheny and Montgomery counties, just reported sharp increases in viral loads. Best we can tell, no central Pennsylvania systems currently conduct such testing.

What does this all mean?

We're on the verge of yet another wave of COVID infection.

We already know that the pace of the decline in COVID cases being reported by state health departments is slowing — a 3% decrease in the seven-day rolling average, according to The Washington Post's national COVID tracker.

But, according the CDC's wastewater data, the reversal is more obvious.

Unfortunately, we're also heading into this new wave at a time when federal funding for COVID mitigation for everything from monitoring to COVID tests to treatment for the uninsured is evaporating.

Dr. Anthony Fauci, citing recent surges from the BA.2 subvariant in Asia and Europe, warned Sunday that we're likely to see an uptick in cases soon.

"The easiest way to prevent that," he told ABC News, "is to continue to get people vaccinated and, for those who've been vaccinated, to continue to get them boosted. That's where we stand right now."

So far, the best scientific evidence indicates that the new BA.2 subvariant is more transmissible — possibly 80 percent more than the original omicron variant, according to a British study — but the available vaccines offer roughly comparable levels of protection against severe illness, according to studies from the U.K. and Qatar.

So, here's the deal.

We don't need to panic about so-called stealth omicron.

But we do need to encourage our family, friends and neighbors to prepare for yet another wave of COVID-19: Get vaccinated. Get boosted. Now.