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Using sewage to test for COVID-19

28 May 2020 | Story Andre Damons | Photo Supplied

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

Questions about racial integration in residences answered

2007-07-31

Answers to frequently asked questions about the racial integration of student residences at the UFS

1. Why does the UFS want to change the current situation in the student residences?

There are many reasons why a new approach to placement in the student residences is necessary. However, the main reason is of an educational nature. As a university, the UFS should create an environment in its residences where students can learn to appreciate and respect the rich diversity that is on offer at the university. A university accommodates students from many different backgrounds in terms of race, language, religion, economic status, culture and other aspects. If a student can learn to appreciate the value in this rich diversity at university, he or she will also be able to appreciate the value of this diversity in the workplace and broader society.

The current situation of predominantly white and predominantly black residences has not been able to cultivate such an appreciation for diversity and respect for one another as human beings, and will not equip students with the knowledge and skills required to manage diversity.

Besides this, there are many other areas of life in the residences that need attention. For one, we need to urgently establish a human rights culture in the residences so that the rights of all students can be respected. We need to address the abuse of alcohol, provide disabled students with their rightful place, and last but not least, really entrench a culture of learning in student residences.

Let us make the residences places we can be proud of – places of learning, of diversity, of respect; places of growth and development. This is the ideal we should all strive to achieve.

2. Why does the management want to force us to integrate?

It is a false argument to debate the issue in terms of “force”. Any decision by a University, or any other organisation, regarding matters of policy, rules and regulations implies a restriction on the choice of an individual and an obligation to comply. What we should focus on is whether this decision of the Council is in the best interests of our students.

The management of the university believes that it has a responsibility to give students the best education possible, not only in terms of what you learn in the lecture rooms, but especially in the residences as well. The residences can be very powerful places of learning about matters of great importance, both academic and non-academic.

The parallel-medium language policy separates students into largely white/Afrikaans and black/English classes. Efforts are being made to bridge this divide in the classroom, but we can also try to eliminate it in the residences.

The university is committed to building a new culture for the entire institution that is based on values and principles – such as an academic culture, non-racialism, respect for human rights and diversity – among staff and students.

In the context of student residences, the application of these values and principles still allows substantial room for the voluntary exercising of choice by individuals as well as by Residence Committees, notably with regard to the placement of students (they can still place 50 percent of first-year students), as well as the determination of the future character and traditions of a diverse residence.

Furthermore, students can still choose their residences (subject to availability of places), can choose a roommate, and so forth.

3. What about freedom of association?

The rights we enjoy in a democracy must be balanced against other rights, as well as the laws of the country. This means that the right to freedom of association must be balanced against laws that make it illegal to discriminate against other people on the basis of race, language or religion, for instance.

Freedom of association pertains to the right of individuals to form voluntary organisations such as clubs or private boarding houses, or their right to join or not join existing organisations. You exercise that right when you decide to become a student of the UFS, and again when you choose to live in one of its residences.

However, once you have decided to join an organisation voluntarily, you cannot subsequently demand that that organisation should provide a “club” or residence to your liking where, for instance, you only associate with your choice of co-members. You must accept the policies of that organisation.

In any case, how would that right of yours be balanced against the right of another individual who wishes to associate with a different set of co-members? (For instance – what about the freedom of a student to associate with students NOT from his own background, but indeed from another language, cultural, racial or economic background?)

The constitutional right to freedom of association can, in any case, not be used to exclude or discriminate on the basis of race or religion (Section 18 of the Bill of Rights).

Besides, the new policy guidelines will still make provision for freedom of association. This right can be exercised freely within a diverse residence with regard to friendships, joint academic work, socialising, sport, etc.

4. Will residences not lose their traditions?

The University appreciates that there are many valuable elements of tradition in residences. However, we must bear in mind that the traditions and character of student residences have evolved and changed over time, and they will continue to evolve and to change. In addition, we do not need to accept all aspects of residence life purely on the basis of tradition, including the unacceptably high level of alcohol abuse and unsavoury, humiliating and discriminatory orientation practices. The new approach to integrated residences provides the opportunity to retain the positive aspects of the current traditions and character, but also to develop new traditions and give residences a new character.

We can now establish a tradition and a character for each residence that are reconcilable with the values of the University as a place of scholarship and are aligned with the human rights approach of our country’s Constitution, the laws of our country and the strengths and diversity of the students in a particular residence.

5. Have students been involved in this process? Is there a role for them to play after the decision has been taken by the Council of the UFS?

In the first semester of 2007, during two rounds of consultations, the primes, SRC and student organisations were consulted about the proposed new placement policy to increase diversity in residences. Some residences also made written submissions on the matter (such as Madelief, Soetdoring, Wag-'n-bietjie, Vergeet-my-nie, Emily Hobhouse). Other residences requested and were granted more time, but did not make any submissions in the end (such as Reitz and Armentum).

Management also had several meetings with the above-mentioned structures to hear first-hand from students their concerns and solutions regarding possible challenges presented by integration in residences.

During these interactions, several excellent ideas and proposals were put forward by students. These views had a definite impact on the eventual proposal that was taken to the University Council, in particular regarding the minimum level of diversity (30%) in junior residences and the fact that residences still want to have a say in the placement of students, rather than the placement decision being left in the hands of Management alone (hence the 50% placement portion of residences). Management values the effort that was put into the process by the primes and residence committees, and thanks them for their contributions.

However, it should be stressed that consultation should not be understood as a process of negotiation, nor does it imply that consensus must be reached. What it means is that Management must take a considered decision after hearing the views of stakeholders.

Management would like students to continue to provide input and ideas regarding the implementation details of the policy guidelines. Task teams have been established and students will be informed about how they can interact with the task teams on an ongoing basis.

6. But integration in the residences was tried in the past (in the late 1990s), and then it failed. Why will it work now?

Yes, the University of the Free State did integrate its residences as far back as 1993, and for a few years it worked. The UFS did it at that time and is now doing so again, because it is the right thing to do. Yet it is important to understand why the previous attempt at racial integration in residences was not successful.

Firstly, both black and white students were much polarised because of the apartheid past. Secondly, there was insufficient management support for students in the residences, the student leaders generally as well as residence heads, in terms of dealing with diversity and related issues. Thirdly, the institutional culture of the UFS and the residences in particular was not addressed as part of broader transformation and integration in residences, whereas it is now being addressed.

In addition, the current decision to integrate residences has the benefit of being implemented after several more years of integration in schooling, sport, workplaces and other aspects of life.

This decision is also based on Management’s commitment to give all the possible support it can to this process.

This is a very important initiative that the UFS is undertaking. Management, in co-operation with students, must ensure that it succeeds. Integrated residences that produce high-quality graduates equipped to deal with the challenges of the workplace and our society is a worthwhile ideal we should all strive to achieve.

If you would like to make a proposal regarding the implementation and practical aspects of the new policy, please send it to the following email address: rector@ufs.ac.za

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