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28 May 2020 | Story Andre Damons | Photo Supplied
Dr Anthony Turton.
The major risk arising from COVID-19 is the fact that people can be infected but show no symptoms. It is these asymptomatic carriers that are the vectors accelerating infection in society. This is the central problem that has to date defied a solution.

Since the government cannot test every citizen in the country, the answer lies in sewage surveillance, says Dr Anthony Turton from the Centre for Environmental Management at the University of the Free State (UFS). 

Easier than testing millions of people
“We have 824 wastewater treatment works in South Africa. Each of these serves a population of known size. By taking samples of sewage according to a defined protocol, it is now technically possible to determine the viral load of the entire population in the catchment area of that sewage works. This data can be compared weekly, and from this we can determine if the total viral load is increasing or decreasing,” says Dr Turton.

According to him, this is much easier to do than the individual testing of millions of citizens, the results of which only give a snapshot of information relevant to those specific people at that precise moment in time. 
Dr Turton explains that the virus has a specific structure that gives it a number of properties. One of those properties is associated with the fatty outer coating, which is susceptible to detergents, ultraviolet light, and alcohol. This is known and forms part of the protocols to limit transmission. 

“What is known to scientists, but not yet apparent to the public, is that the virus is shed in human waste. This is known as viral shedding, and is now known to result in a traceable presence in both urine and faeces before a patient manifests with symptoms and after a patient has been treated. This does not mean that the virus is still infectious, although there is some mention of faecal-oral transmission in peer-reviewed literature, at least of the SARS virus.” 

"This is not yet fully understood, so the faecal-oral transmission pathway is mostly ignored by policy response, which is typically based on western premises such as a fully functional wastewater works. That may not be the case in developing countries, but the jury is still out on the faecal-oral transmission route,” explains Dr Turton.

What is of greater importance to society as a whole, Dr Turton continues, is the evolution of technology that is capable of detecting minute elements of the virus found in human waste. This is known in technical circles as sewage surveillance.
A person being tested has to go to a designated facility where they come into contact with other potential carriers; so even if they test negative today, this does not mean that they will not become infected on their way home.
“Such testing is costly, logistically complex, and is known to be out of reach even to advanced economies such as the USA, Britain, and Germany. But without testing, how can government still maintain its core mandate to protect citizens without destroying the economy by a perpetual lockdown?” 

“This is a dilemma that we need to confront, because the impact of economic meltdown can be bigger than the virus itself. The South African economy, which is already on its knees, cannot afford unemployment rates that might trigger social instability and unleash latent revolutionary zeal,” says Dr Turton.

A convenient way of gathering data
According to Dr Turton, samples are taken from the inlet to wastewater works where raw sewage is mixed. If more precise details are needed, sampling can occur on specific feeder lines, for example, from different suburbs representing different demographic samples of a larger and more complex whole. This ability gives sewage sampling a high level of nuance, because the pixel density of data built up over time is granular and precise. The important thing is that sampling must be regular and accurate, because each provides a single frame in the movie that we ultimately want our decision makers to watch. 

“Those samples are prepared in a specific way and sent to a laboratory capable of detecting precise elements of the RNA. Think of fingerprinting to understand this process. The Coronavirus has a precise fingerprint consisting of strands of carbon-based nucleotides arranged in a known sequence. It breaks down after the virus is destroyed but remains present like a bowl of minute pieces of spaghetti. Once detected and identified, it is then amplified or increased through a process known as PCR (polymerase chain reaction).” 

“In effect, this merely replicates what is originally present, like a photocopy machine. This is technically complex, and mistakes can be made each step of the way. However, if done properly, an accurate picture emerges. This picture is not about individuals who are positive or negative, but rather about the total viral load present in a defined cohort of people at a precise moment in time. It is not as granular as individual testing, but it is a convenient way of gathering data about the rate of change and specific epicentres of change or emerging hotspots.”

This technology has been successfully used in the Netherlands and is now being rolled out in other countries in the developed world. The right to use this technology has been secured for South Africa by the SA Business Water Chamber, a non-profit organisation, which entered into an agreement with KWR, the Dutch laboratory that has refined the technique. It is now being made available to any laboratory, privately owned, university owned or part of a national science council, with the intention of supporting decision-making by government. This will be of critical importance as the government decides to open up the economy, because sewage surveillance can detect a second wave before it is manifested as people reporting to doctors with symptoms.  

• The Business Water Council is a newly created structure for all entities involved in the business of water service provision, and is part of the Public Private Growth Initiative (PPGI) that aims to bring the private sector close to government in a collaborative effort to stimulate the economy and create jobs in a sustainable way. Funding entities have shown interest in supporting this process, given the strategic importance of sound decision-making for economic recovery after COVID-19 has passed. 

Any university with PCR capabilities can become a certified user of this technology, as can any commercial laboratory being rolled out as a humanitarian issue rather than a commercial one, even if it has an impact on the recovery of the economy.

News Archive

MBA Programme - Question And Answer Sheet - 27 May 2004
2004-05-27

1. WHAT MUST THE UNIVERSITY OF THE FREE STATE (UFS) DO TO GET FULL ACCREDITATION FOR THE MBA PROGRAMMES?

According to the Council on Higher Education’s (CHE) evaluation, the three MBA programmes of the UFS clearly and significantly contribute to students’ knowledge and skills, are relevant for the workplace, are appropriately resourced and have an appropriate internal and external programme environment. These programmes are the MBA General, the MBA in Health Care Management and the MBA in Entrepreneurship.

What the Council on Higher Education did find, was a few technical and administrative issues that need to be addressed.

This is why the three MBA programmes of the UFS received conditional accreditation – which in itself is a major achievement for the UFS’s School of Management, which was only four years old at the time of the evaluation.

The following breakdown gives one a sense of the mostly administrative nature of the conditions that have to be met before full accreditation is granted by the CHE:

a. A formal forum of stakeholders: The UFS is required to establish a more structured, inclusive process of review of its MBA programmes. This is an administrative formality already in process.

b. A work allocation model: According to the CHE this is required to regulate the workload of the teaching staff, particularly as student numbers grow, rather than via standard management processes as currently done.

c. Contractual agreements with part-time staff: The UFS is required to enter into formal agreements with part-time and contractual staff as all agreements are currently done on an informal and claim-basis. This is an administrative formality already in process.

d. A formal curriculum committee: According to the CHE, the School of Management had realised the need for a structure – other than the current Faculty Board - where all MBA lecturers can deliberate on the MBA programmes, and serve as a channel for faculty input, consultation and decision-making.

e. A system of external moderators: This need was already identified by the UFS and the system is to be implemented as early as July 2004.

f. A compulsory research component: The UFS is required to introduce a research component which will include the development of research skills for the business environment. The UFS management identified this need and has approved such a component - it is to take effect from January 2005. This is an insufficient element lacking in virtually all MBA programmes in South Africa.

g. Support programmes for learners having problems with numeracy: The UFS identified this as a need for academic support among some learners and has already developed such a programme which will be implemented from January 2005.

The majority of these conditions have been satisfied already and few remaining steps will take effect soon. It is for this reason that the UFS is confident that its three MBA programmes will soon receive full accreditation.

2. WHAT ACCREDITATION DOES THE UFS HAVE FOR ITS MBA PROGRAMME?

The UFS’s School of Management received conditional accreditation for its three MBA programmes.

Two levels of accreditation are awarded to tertiary institutions for their MBA programmes, namely full accreditation and conditional accreditation. When a programme does not comply with the minimum requirements regarding a small number of criteria, conditional accreditation is given. This can be rectified during the short or medium term.

3. IS THERE ANYTHING WRONG WITH THE ACADEMIC CORE OF THE UFS’s MBA PROGRAMMES?

No. The UFS is proud of its three MBA programmes’ reputation in the market and the positive feedback it receives from graduandi and their employers.

The MBA programmes of the UFS meet most of the minimum requirements of the evaluation process.

In particular, the key element of ‘teaching and learning’, which relates to the curriculum and content of the MBA programmes, is beyond question. In other words, the core of what is being taught in our MBA programmes is sound.

4. IS THE UFS’s MBA A WORTHWHILE QUALIFICATION?

Yes. Earlier this year, the School of Management – young as it is - was rated by employers as the best smaller business school in South Africa. This was based on a survey conducted by the Professional Management Review and reported in the Sunday Times Business Times, of 25 January 2004.

The UFS is committed to maintaining these high standards of quality, not only through compliance with the requirements of the CHE, but also through implementing its own quality assurance measures.

Another way in which we benchmark the quality of our MBA programmes is through the partnerships we have formed with institutions such as the DePaul University in Chicago and Kansas State University, both in the US, as well as the Robert Schuman University in France.

For this reason the UFS appreciates and supports the work of the CHE and welcomes its specific findings regarding the three MBA programmes.

It is understandable that the MBA review has caused some nervousness – not least among current MBA students throughout the country.

However, one principle that the UFS management is committed to is this: preparing all our students for a world of challenge and change. Without any doubt the MBA programme of the UFS is a solid preparation.

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