UB researchers find link between sewage medicine and Covid-19 outbreaks
The Covid-19 pandemic has shown that wastewater can tell us a lot about public health – and researchers at the University at Buffalo have found that it can tell us even more.
A UB effort to track Covid-19 by monitoring sewage has revealed a new early warning sign for Covid-19 outbreaks: acetaminophen levels in untreated sewage.
Researchers at UB’s RENEW Institute – short for Research and Education in eNergy, Environment and Water – were already tracking viral RNA in wastewater as an indicator of Covid-19, a practice that has been widely adopted around the world whole for community surveillance of Covid-19.
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Then Diana Aga, professor of chemistry at UB since 2002 who took over as director of the RENEW Institute last yearcame up with the idea of testing sewage for antibiotics and painkillers, as well as viral RNA, to see if their levels might correlate to a spike in Covid-19.
His team found that acetaminophen – the active ingredient in common over-the-counter painkillers, including Tylenol – stood out as a predictor of Covid-19 outbreaks. Acetaminophen levels jumped significantly two and a half weeks before clinical peaks in Covid-19, Aga said – and a week and a half before an increase in viral RNA signaled an upcoming spike in the SARS-CoV-2.
Aga and a team of students have also seen an increase in prescription antiviral drugs, which people can have in their medicine cabinet after previous treatments and use if they start experiencing viral symptoms. But the levels were nowhere near those of acetaminophen, Aga said.
“Of all the compounds we were looking for, acetaminophen was huge,” she said. “A normal level would be 10 micrograms per liter or less, but we were seeing up to 200 micrograms per liter leading to an outbreak of Covid-19. Normally we have to concentrate our samples for testing. This time we had to dilute them, it was so huge.
The findings have big implications for the surveillance of Covid-19 and other viral diseases. The study, published in the journal Environmental Science and Technology Letterssuggests that measuring drug concentrations in wastewater could be a valuable tool in predicting disease outbreaks.
“Many scientists are already monitoring wastewater and surface water for pharmaceuticals and looking for emerging contaminants,” Aga said. “The concept of looking for acetaminophen and correlating it with viral and Covid RNA is what’s new – and I imagine now people are going to do that because a lot of them already have the data.”
Aga’s own research has focused for years on analyzing groundwater and wastewater for personal care products and other trace chemical pollutants. His is one of a few labs at UB that use mass spectrometry to test samples of wastewater from county treatment facilities before the water is treated and filtered.
She approached her RENEW colleague Ian Bradley, whose lab has been analyzing sewage for viral RNA since the start of the Covid-19 pandemic.
“I said, ‘Why not split the samples so that my students can analyze the pharmaceuticals?’ The samples come from water treatment centers in Bird Island, City of Tonawanda, Kenmore and Lackawanna, she said.
This potential early detection tool comes at a time when other methods of monitoring Covid-19 cases may become less reliable with the availability of home testing and Covid-19 vaccines.
“A lot of people are currently being diagnosed using home tests, and a lot of them are unrecorded,” Aga said. “Additionally, there are more asymptomatic cases among those vaccinated, and these may also not be counted or reported.
“That’s why it’s important to measure viral RNA to monitor Covid at the community level and to research new methods of early detection, as people clear the virus before they show symptoms.”
Aga envisions a future notification system in which sensors will immediately detect increases in acetaminophen and viral RNA in local wastewater and upload the data electronically to provide early warning of a potential spike in illness.
“If we could do it online, you could watch it on your cell phone, see acetaminophen go up, and implement mandates, like putting back on masks and social distancing, to prevent a total shutdown” that many countries experienced in 2020, Aga said.
RENEW Institute UB faculty work on a variety of other research projects all aimed at providing cleaner, more sustainable and healthier systems for water and energy resources and human and environmental health. Learn more about buffalo.edu/renew/faculty/renew-faculty.html.
Want to know more? Three stories to catch up with you:
• Is the Covid-19 antiviral drug effective for children? A clinical trial at UB aims to discover
• Pandemic lessons: Covid-19 is cooling, but the spread of misinformation is even harder to stop
• UB medical school fights racism in health care
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