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by April Shepherd, Journalist, Utility magazine

Wastewater sampling quickly became a key part of tracking the COVID-19 virus Australia-wide, combining research from the past and new fast-tracked methods to fight the pandemic. Water Research Australia tells Utility how collaboration made this project possible and the lessons learnt along the way.

Water Research Australia (WaterRA) members’ wastewater sampling and surveillance methods have been used to detect COVID-19 in Australia since the pandemic began, through the Collaboration on Sewage Surveillance of SARS-CoV-2 (ColoSSoS) project.

WaterRA developed the ColoSSoS project within four weeks of COVID-19 being declared by the World Health Organization (WHO) as a global pandemic, making an invaluable contribution to public health.

WaterRA has a 20-year track record of facilitating and delivering water-related research for members such as water utilities/agencies, health regulators, laboratories, and universities – with a heightened focus on water, wastewater, recycled water, and related innovative research.

The project is a result of WaterRA’s uniquely positioned organisation and long-standing research history, steeped in collaboration in the space of water and health – aiming to aid the pandemic response for members nationally and internationally.

The development of ColoSSoS

ColoSSoS partners track and monitor the presence of COVID-19 in the Australian sewerage network, detecting areas where cases have visited and live.

The project was born as the COVID-19 virus began, on 4 February 2020 – just weeks after the first case of coronavirus was detected in Australia on 25 January 2020 and before lockdowns, or stay-at-home orders as they were first known, began.

Dr Kelly Hill, the Project Director of ColoSSoS, said the project started when WaterRA and its members gathered, pulling together the first coronavirus fact sheet for the water industry.

Dr Hill said the group decided on research priorities to focus on, such as finding a simple way to discover if the virus can be found through wastewater monitoring when the virus is being shed by infected people in an outbreak situation.

“A project initiation was created in March 2020, while the actual national collaboration was an evolving project development process – we were building the plane while flying it – so to speak,” Dr Hill said.

“Within a week, an initial project governance map was created outlining working groups and mechanisms. Industry-wide workshops were held by WaterRA including our member organisations, and within two weeks, four working groups were developed each with objectives.

“This continued to evolve into the state node structure to ensure effective turn-around and reduce the likelihood of virus degradation through excessive transportation times.

“By the four-week timeframe there were 20 organisations signed onto the project, and by June 2020 this has grown to over 45 organisations. At its peak the program reached over 50 organisations.”

Four working groups

The project moved in four phases: Initiation, Method Development, Investigation and Continuous Improvement (which is exploring the possibility of routine surveillance and early warning potential).

To achieve the four phases, WaterRA created four working groups at the beginning of the pandemic to streamline their response:

• The first was a sampling group, initially featuring around 15 utilities across Australia, three State Departments of Health, and research organisations including Monash University. This then continued to grow with the expansion of sampling sites, more State Departments of Health joining, and inclusion of more water utilities

• The second focused on molecular analysis, featuring Sydney Water Laboratory Services, Australian Water Quality Centre (AWQC), ESR New Zealand, Victorian Infectious Diseases Reference Laboratory (VIDRL), the Walter and Eliza Hall Institute for Medical Research (WEHI), Australian Laboratory Services (ALS), and various department of health, and again grew with the additional State Departments of Health joining, the Commonwealth National Measurement Institute and more pathology laboratories around the country being set up for the testing of wastewater

• The third is a data interpretation and integration group, mainly featuring State Departments of Health across Australia and ESR in New Zealand

• The fourth is a communication-focused group, (state health departments collaborating on public messaging of detections and consistency in public messaging), including the University of Newcastle, Water Research Australia and Communications specialists from various water utilities including Sydney Water and Melbourne Water

Development and history of wastewater surveillance

Wastewater sampling to detect viruses has been in use since the 1960s, pioneered by Yale University whilst researching polio vaccinations, paving the way for the wastewater-based epidemiology (WBE) used presently.

Cell culture methods were developed and optimised in the 1980s and provided the basis of the early-years of detection and documenting infectious viruses in water supplies.

The ColoSSoS Project uses the over 20 years of health and water-based research undertaken by WaterRA, its predecessors, and peers, designing wastewater sampling surveillance methods to monitor outbreaks and assist in prevention.

The origins of WaterRA date back 20 years to the Cooperative Research Centre for Water Quality and Treatment (CRCWQT), with public health priorities coming to life in a 1996 CRCWQT project, The Early Detection of Outbreaks of Waterborne Gastroenteritis.

This project aimed to investigate and document a variety of existing surveillance systems relating to the detection of gastrointestinal disease in the community, and assess the feasibility of linking these with water quality data.

The above project set the groundwork for the wastewater sampling and surveillance methods that are used currently.

Dr. Kelly Hill

How does it work?

Viruses are commonly found in wastewater, with two main types of viruses discovered:

• Viruses that are more resistant with an external protein capsule, such as adenoviruses which can cause bronchitis and pneumonia, as well as polioviruses

• Viruses with a lipid envelope, which is more flexible and known to be more fragile, such as influenza and coronaviruses – including SARS-CoV-2

Several research initiatives fast-tracked the development of the ColoSSoS projects, including sampling, extraction, storage, molecular analysis, and epidemiological interpretation.

Dr Hill said the project team learnt very quickly how to implement the resources they already had set up, how to utilise these to get results quickly, and that state-based health departments driving the developments were aiding the innovative methods and positive impact this information could have.

“Utilitising the expertise of WaterRA and Project Manager Dr Daniel Deere by selecting laboratories with existing accreditation/routine analysis expertise meant rapid and high quality information could be passed to the COVID response teams in each state,” Dr Hill said.

As the Delta variant of COVID-19 unfurls worldwide, the sampling and detection process remains relatively the same.

“The different variants being detected in wastewater are being detected through whole genome sequencing of the wastewater sample following a positive polymerase chain reaction (PCR – considered the standard for testing) detection,” Dr Hill said.

Lessons learnt: fighting pandemics with collaboration

Dr Hill said that one of the biggest takeaways from the project was the power of collaboration between utilities, health departments and laboratories, and what they could achieve in a short period of time.

“Collaboration of the right organisations and across disciplines is hugely beneficial. The history of WaterRA bringing together health, utilities and research organisations was a lucky coincidence that meant we could utilise the existing trusted networks to rapidly implement a useful collaboration,” Dr Hill said.

The magnitude of the situation inspired many to help, with one of the largest challenges of the project being the need to collaborate with the right utilities at the right time.

“When it comes to a pandemic response for public health, organisations without expertise often try to help out of goodwill – this is helpful later on, but can distract from the direction of urgent implementation,” Dr Hill said.

Once the system was up and running, the project faced another challenge; tracking the virus, whilst keeping confidentiality and effective public communication at the forefront of the discussion.

“At the beginning there was a huge emphasis on confidentiality by the health departments to allow them to interpret the wastewater data and to integrate it with clinical, case number and local jurisdiction data. This ensured the most appropriate response to wastewater data was being incorporated into COVID response plans and being communicated to the public effectively by the health departments,” Dr Hill said.

Developments and improvements

As the virus evolves, so does the technology used to track it. Dr Hill and her team are constantly focused on how systems can be improved, and which areas should be the focus of future research.

“Virus detection in wastewater has been around for decades. We are working with our partners to improve on sampling methods, understand the potential benefits and risks of using passive samplers in the wastewater system, comparing them to auto samplers, grab sampling and testing their efficacy in various wastewater matrices,” Dr Hill said.

“Wastewater is a very difficult matrix to understand and work with, as it can vary from location to location, and throughout different times of the day.”

Dr Hill said that developments in whole genome sequencing, and how this could be used to provide certainty against PCR assays for variant detection will be a priority, especially as new variants of the virus start to evolve.

“This will be increasingly important as a toolbox for variant detection in future months as borders open and maintaining an understanding of variant movement throughout the community could be critical,” Dr Hill said.

As the future of our relationship with this virus develops, Dr Hill said maintaining laboratory expertise and proficiency will be prioritised.

“We are in the process of developing a second round of inter-laboratory proficiency tests which will incorporate aspects of variant detection and inhibition reduction,” Dr Hill said.

The future of this technology

As we learn to live with COVID, Dr Hill explains how this technology could be used for other uses besides COVID – from drug testing to capturing an overall snapshot of public health.

“Into the future there is the potential for this type of work to be integrated with the wastewater surveillance of drugs (such as that being conducted by the Australian Crime Commission) and surveillance of other contaminants (i.e. per and polyfluoroalkyl substances and anti-microbial resistance) to provide an overall picture of population health,” Dr Hill said.

The work Dr Hill, her team and countless Australian utilities and other organisations have done, and continue to do, has not just been pivotal to the way the country has tracked the virus, but saved lives – showing the true power of collaboration in the utility sector.

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