By Karen Kier, Pharmacist on behalf of the ONU HealthWise team

The idiom “waste not, want not” can be interpreted as if you use something wisely or completely, then you will be less likely to find yourself in need of anything. There are many theories as to the origin of this phrase, but some believe it has been around since the late 1700s. I was accustomed to hearing this idiom from my parents and grandparents. My parents were born during the depression and my grandparents lived through these hard times. My maternal grandma truly wasted nothing and she taught me how to get the most out of just about everything. So, you might wonder why I am writing about waste and want? Well, I learned something new about SARS-CoV-2 this week that has me intrigued.  

In September, 2020, the CDC started tracking SARS-CoV-2 in wastewater and created the National Wastewater Surveillance System (NWSS). The virus sheds RNA or genetic material in the stool, which ends up in wastewater going to treatment plants. Eighty percent of US households are served by municipal water collection systems. Individuals will shed the virus in the gastrointestinal tract whether they have symptoms or not. Testing wastewater is a complement to other surveillance testing systems. However, no one needs to go to a testing center or seek health professional advice for this system to work. We just flush the toilet! Data from water treatment plants can serve as an early warning system that a new wave of COVID-19 is coming. As the viral shedding in wastewater is increasing, the transmission of SARS-CoV-2 is increasing in that area. This increase can alert public health officials to a new wave or surge in the infection. Water samples are collected as they flow into the treatment plants and then those samples are sent to a lab to detect virus concentrations. These data are reported to the CDC, which tracks the results on their website by state and county. It is important to note that only select sites who are willing to participate are used for reporting to the database. 

So, is another surge of COVID-19 coming as has been seen in other countries around the world including Europe?  Although there is a decline in cases, deaths, and hospital admissions, our wastewater may be telling us a different story. According to the 15-day report from the CDC for March 2 to March 16, 2022, sixteen percent of sites showed a substantial increase in viral shedding in wastewater in the US. Based on Ohio county reporting data, Allen county and Union county had over a 1,000% increase of the virus in samples collected. Hardin county had a 1-9% increase while Hancock, Sandusky, and Wood counties showed a 10-99% decrease in the samples.  Marion and Auglaize counties had no recent data reported to the system.   

A February 3, 2022, study published in Nature Communications evaluated wastewater from New York City (NYC). The researchers detected some novel variants or lineages in the genetics of viruses found in the wastewater that have not been reported to the Global Initiative on Sharing all Influenza Data’s (GISAID) Epi CoV database.  The GISAID was established in May, 2008 to track the genetic data or variations for influenza (flu) virus. This information is what helps to inform what influenza strains should be in the flu shot. The Munich, Germany based GISAID started tracking genetic data on SARS-CoV-2 with the COVID-19 pandemic.  What is alarming about the novel variants in the NYC wastewater is they are new to the tracking system.  Based on the genetics of the viruses discovered, the four novel mutations were from an omicron COVID-19 infection.  

Omicron and its mutations are the predominant strain in the US right now and the news has been covering the BA.2 mutation. The BA.2 mutation is even more transmissible than the BA.1 omicron virus. The question of severity has not been completely answered. A Japanese study in hamsters showed a higher severity of illness for the BA.2 strain over BA.1, but human data from Europe and South Africa does not seem to confirm the animal research.  It is believed that exposure and infection with BA.1 omicron provides protection against the BA.2 virus.  

In light of the predominance of the omicron strain, both Moderna and Pfizer have made requests to the FDA to secure emergency use authorization for a second booster dose. This is based on study data indicating that higher antibody levels from the booster vaccine provides additional protection against the omicron strains.  

So, analyzing wastewater could help us track and predict future surges in SARS-CoV-2. 

Feel free to call the ONU HealthWise Pharmacy for the science on COVID-19. ONU HealthWise is offering COVID-19 and flu vaccines Monday through Friday from 4 pm to 6 pm. Call the pharmacy for an appointment for other time slots. The ONU HealthWise pharmacy offers Moderna, Pfizer, Janssen and flu shots and high-dose flu vaccines. Pediatric Pfizer vaccines (5 to 11-years) are available by appointment through the state Vaccine Management Solution (VMS) system.  Call the pharmacy to get more information.  

ONU HealthWise Pharmacy
419-772-3784
www.onuhealthwisepharmacy.com