Speaker 1: Oh hey, it's me. It's your Internet dad uncle back
Speaker 1: with a highly erotic, not uncomfortable at all episode about
Speaker 1: diseases and toilet water. Please don't leave me, Please don't go,
Speaker 1: don't go, stay, please stay. But if this is your
Speaker 1: first ever Ologies episode, there are way less gross ones.
Speaker 1: Let's be real, So go listen to a less gross one.
Speaker 1: If this is your first ever or you know what,
Speaker 1: pull up a throne, because this episode, when you get
Speaker 1: down to it, is amazing.
Speaker 2: It's so good.
Speaker 1: I nervously showed up early to chat with this government
Speaker 1: pathogen expert. I heard about this field wastewater surveillance and
Speaker 1: environmental microbiology a few months back, and on February fourth,
Speaker 1: I tweeted desperately, I'm just a podcast Twitter account standing
Speaker 1: before microbiologists who tests sewer water for plagues, hoping they
Speaker 1: follow me back, and amid much enthusiasm, this guest replied
Speaker 1: with a jiff that said I got you to and
Speaker 1: here we are, and yes it's Jeff. It's not Giff,
Speaker 1: he said it was Jeff. So after one thousand clearances
Speaker 1: with our nation's centers for disease control, we are off
Speaker 1: the races now. This ologists got an undergrad degree in microbiology,
Speaker 1: a PhD in microbiology from the University of Buffalo, and
Speaker 1: then also got a Master of Public Health in epidemiology
Speaker 1: from Emory University. She is now a Senior Service Fellow
Speaker 1: at the CDC And additionally she has a dog who's
Speaker 1: a very good dog and sweet and sometimes the dog
Speaker 1: weighs in from time to time in the background. Enjoy.
Speaker 1: So thank you for weighing in, by the way, and
Speaker 1: spreading the word of ologies like a pathogen, and for
Speaker 1: supporting at patreon dot com slash ologies for as little
Speaker 1: as a block a month. Thank you for rating and
Speaker 1: reviewing and keeping us up in the charts. I read
Speaker 1: every single review you've ever left, and as proof, here's
Speaker 1: one it's still we just left yesterday from Eon Blue Ophelia,
Speaker 1: who said that the ADHD episodes were life saving. Rachel
Speaker 1: also left a review saying that they were life changing.
Speaker 1: Also smells like maple syrup. A self described construction worker
Speaker 1: who randomly laughs at work. Go get that eco hydrology career.
Speaker 1: I hope you enjoy this one too.
Speaker 2: Y'all.
Speaker 1: A bunch of you left really sweet reviews this week.
Speaker 1: I read every single one. Thank you so much. Also,
Speaker 1: As a bonus, there's a surprise cameo in this episode
Speaker 1: from your favorite virologist about what to do now that
Speaker 1: mandates and masks are starting to fall Because this episode,
Speaker 1: boy do we talk about covid. Oh also, I cold
Speaker 1: called a listener in this and I threw money at them,
Speaker 1: so that's in there too. But onto the show. So
Speaker 1: environmental microbiology, bacteria, covid in toilet water, medications in the waterways, plumbing,
Speaker 1: the sewers, for medical mysteries, things you can learn from
Speaker 1: studying stomach bugs, the weirdest things that get flushed. How
Speaker 1: gross is it? For real? Can you get COVID from
Speaker 1: your stepdad's farts? And what is out there swimming in
Speaker 1: the world, and how can we measure it to our advantage?
Speaker 1: Including what's on the horizon with covid? So if you
Speaker 1: are getting excited, well there must be some in the water.
Speaker 1: So do enjoy the brain of environmental microbiologist doctor Amy Kirby.
Speaker 1: I like so did not want to mess up anything
Speaker 1: with this interview that I got here earlier than I
Speaker 1: have ever been for any at all.
Speaker 2: I'm so excited.
Speaker 3: So Hi, I'm Ali, Hi, I'm Amy. Nice to meet you.
Speaker 1: Could I have you say your first and last names
Speaker 1: in the pronouns that you use.
Speaker 3: Sure. My name is Amy Kirby and I use she
Speaker 3: hers pronouns.
Speaker 1: I'm so excited to talk to you. You're doing very
Speaker 1: important work, and I imagine as we're cresting a little
Speaker 1: bit of a swell here for BA two, you're probably
Speaker 1: pretty busy.
Speaker 3: We have busy since twenty twenty, and so I feel like,
Speaker 3: you know, I tell my team a lot. We're busy
Speaker 3: right now, but it's going to get better, and then
Speaker 3: something new happens, a new variant, a new surge, and
Speaker 3: we are busy again.
Speaker 1: I'm going to ask right out of the gate right now,
Speaker 1: how are we doing at the moment, BA two, How
Speaker 1: are we? How are we doing?
Speaker 2: So?
Speaker 3: We are doing good. So we are seeing overall very
Speaker 3: low levels in wastewater. So we have come down out
Speaker 3: of the omicron surge and we're back to very low
Speaker 3: levels in wastewater. However, that said, we are starting to
Speaker 3: see some communities that are seeing some increases, and so
Speaker 3: we're watching those very closely to see if those increases
Speaker 3: turn into sustained increases and regional increases that would indicate
Speaker 3: another surge is coming in the wastewater system. Right now,
Speaker 3: we can't distinguish between BA one and BA two. We
Speaker 3: just see total omicron, which to be fair, is not
Speaker 3: very informative at the moment. Everything is omicron, so that
Speaker 3: particular data point isn't super useful at the moment, but
Speaker 3: we will be able to distinguish those sublineages soon.
Speaker 1: I mean, I imagine it's just curveball after curveball after curveball.
Speaker 3: It is. And the variant tracking part has been really
Speaker 3: a challenge because you're always running to keep up with
Speaker 3: the next variant. There's two different methods that we use
Speaker 3: for variant tracking in wastewater, so one of them is
Speaker 3: PCR based, so you're getting and it's very quick and
Speaker 3: it's very quantitative, so we can use it to track
Speaker 3: changes in variants. Like it was very helpful to see
Speaker 3: the omicron surge because we could see delta going down
Speaker 3: and omicron going up and we got good numbers around that. However,
Speaker 3: you're always in a race to keep up with the
Speaker 3: newest variant, right that PCR only detects that one variant.
Speaker 3: Sequencing as a better approach because then we can see
Speaker 3: evidence of any of the variants of concern and easily
Speaker 3: adapt to new variants. But it's a slower process and
Speaker 3: isn't as quantitative, so the measures around how much of
Speaker 3: a variant as president a community are not as accurate
Speaker 3: for that approach.
Speaker 1: Just a quick COVID check in, where are we at? Okay,
Speaker 1: So I'm recording this on April twelfth, twenty twenty two. Yes,
Speaker 1: it is the same day it's released. That's how we roll.
Speaker 1: And right now, epidemiologists have their eyes on the omicron
Speaker 1: subvariant BA two and that was first identified in November,
Speaker 1: but it happens to cause more gastro and testinal issues,
Speaker 1: so a lot of people right now are mistaking it
Speaker 1: for our stomach book and it's known as the stealth
Speaker 1: variant because it looks like an earlier delta variant. But
Speaker 1: BA two is estimated to make up nearly ninety four
Speaker 1: percent of cases in the US right now. In the US,
Speaker 1: cases are up about ten percent, but in New York
Speaker 1: up about forty percent. Philly, I'm sorry, you're up fifty
Speaker 1: percent from two weeks ago. And it's probable that rates
Speaker 1: are higher as people are relying on at home rapid
Speaker 1: tests that they don't report, or just no tests at all.
Speaker 1: So what is on the horizon? Perhaps another wave as
Speaker 1: masks come off, warm weather gatherings, commens disco makeouts ramp up.
Speaker 1: It's summer, people get wild. But keep your ears open
Speaker 1: for another variant called XE. It sounds like a human
Speaker 1: mix of grimes and elon musk, but X is really
Speaker 1: a hybrid of Omicron's BA one and BA two strains,
Speaker 1: but with a few fresh mutations. According to Time magazine,
Speaker 1: early research suggests that X is around ten percent more
Speaker 1: transmissible than BA two. These variants, they come on like
Speaker 1: software upgrades in the middle of the night that nobody wants.
Speaker 1: But just check the news and you'll find plenty of
Speaker 1: headlines like latest wastewater data suggest rising COVID levels and
Speaker 1: COVID nineteen wastewater numbers skyrocket, And so, of course, of
Speaker 1: course I had to show up early to talk to
Speaker 1: the top CDC scientist who is elbowed deep in the data.
Speaker 1: Any cities at the moment that you're seeing little bit
Speaker 1: of elevation, New York, I understand, Eastern seaboard New Jersey.
Speaker 3: Yeah, I wouldn't call out a specific city at this point,
Speaker 3: but certainly we're seeing concerning increases in the northeast, and
Speaker 3: there we're seeing more and more of our communities starting
Speaker 3: to see these consistent increases, So looking similar to what
Speaker 3: we've seen in the past with surges, where a certain
Speaker 3: region will start sort of set off the surge and
Speaker 3: then it will move across the country, staying on high
Speaker 3: alert for that.
Speaker 1: Were you always someone who is very up on latest trends?
Speaker 1: Are you obsessed with TikTok trends? How do you feel
Speaker 1: in general about keeping up with what's happening.
Speaker 4: I don't.
Speaker 3: I mean, I'm a typical science nerd, right, how trendy
Speaker 3: can we be? But yeah, I mean I think it's
Speaker 3: always fun to stay on the cutting edge of what's coming.
Speaker 3: And I don't necessarily think of wastewater surveillance as being trendy.
Speaker 3: It's something that we've been thinking about for a long
Speaker 3: time in various fields, and we've been using it for
Speaker 3: polio for decades, and so it was really about seeing
Speaker 3: the opportunity to apply a technique to a new problem.
Speaker 3: Aready had the information that we needed and sort of
Speaker 3: how wastewater surveillance works. We just had to build the
Speaker 3: right system to use it. For COVID at the national scale.
Speaker 3: That is something I do like to do is watch
Speaker 3: for these opportunities and see, you know, where can we
Speaker 3: leverage the unique skills we have. So I'm an environmental
Speaker 3: microbiologist by training. We are not usually part of the
Speaker 3: public health infrastructure that's very skewed towards clinical microbiology, and
Speaker 3: so it was great to be able to hop in
Speaker 3: early and say there is a role for environmental microbiology here.
Speaker 3: Here's what we can bring to the table.
Speaker 1: What we can bring to the table is wastewater. Maybe
Speaker 1: we can bring it to the table, but set it
Speaker 1: down on the ground next to the table. I would
Speaker 1: love to know a little bit about the history of this.
Speaker 1: You mentioned other diseases. Can you tell me a little
Speaker 1: bit about where this started and where you started getting
Speaker 1: really excited about what we can find from wastewater.
Speaker 3: Sure, so the long history of the field is really
Speaker 3: based on polio valance. So when we started working towards
Speaker 3: polio eradication back in the sixties, one of the challenges
Speaker 3: there is that the clinical outcome that you're most concerned
Speaker 3: about for polio is of course a cute flacid paralysis, right,
Speaker 3: but that is rare most people that are infected with
Speaker 3: the poliovirus do not go on to have that very
Speaker 3: acute outcome. In fact, most of them don't have any
Speaker 3: symptoms at all.
Speaker 1: Just a little history lesson here in a trivia tidbit. So,
Speaker 1: we didn't have vaccine for poliomylitis virus until the nineteen fifties,
Speaker 1: and then in the nineteen sixties, polio inoculations arrived not
Speaker 1: by needles so much, but via a liquid tincture of
Speaker 1: weakened virus saturating a sugar cube. Hey, what you did,
Speaker 1: Mary Poppins come out is the nineteen sixty four spoonful
Speaker 1: of sugar helps them medicine go down the mix? Yep,
Speaker 1: that song was written the day that the songwriter's sun
Speaker 1: got his delicious polio vaccine. Cheeky, but yes. Scientific sewer
Speaker 1: spying also aided in the poliophyte And so we.
Speaker 3: Knew that if we were looking only for this very
Speaker 3: severe outcome, we were going to miss we. I wasn't involved,
Speaker 3: but you know, we collectively the field recognize that they
Speaker 3: would miss most of the cases in a community. And
Speaker 3: as you move towards eradication, that's more and more important
Speaker 3: because every one of those cases that you miss could
Speaker 3: be a source for another case. Poliovirus is an enteric virus.
Speaker 3: It's transmitted through fecal oral transmission, so shed and stool,
Speaker 3: You get it on your hands or on your food,
Speaker 3: and then consume it, and that's the transmission mechanism. Yeah,
Speaker 3: but okay, And so they knew that they could look
Speaker 3: in stool and in wastewater to detect the poliovirus, and
Speaker 3: they use it to identify neighborhoods where polio is circulating,
Speaker 3: and then they go into those neighborhoods and do a
Speaker 3: vaccination campaign to protect everybody. And so that's how they've
Speaker 3: been using it. It works very well to target that
Speaker 3: intensive polio vaccination where it's most needed, and that was
Speaker 3: where it's stayed basically until twenty twenty. Previous to working
Speaker 3: at CDC, I worked on neurovirus, which causes the stomach
Speaker 3: flu basically, and one of the things that we always
Speaker 3: used to say in the field is like, wouldn't it
Speaker 3: be nice if we could have a community stool sample,
Speaker 3: because so many people get neurovirus, they suck it up
Speaker 3: for a day and feel terrible and they never go
Speaker 3: to the doctor and so we don't measure those people,
Speaker 3: and wastewater surveillance was a way to think about doing that,
Speaker 3: but there wasn't enough benefit. The return on investment to
Speaker 3: establishing a wastewater surveillance system for neurovirus was not high
Speaker 3: enough to get the infrastructure built, and so we always
Speaker 3: just kind of hoped for it and never never really
Speaker 3: were able to move on it. And then when COVID
Speaker 3: hit and we saw that it behaves very similar to
Speaker 3: SARS one, which we knew was shed and stool, we
Speaker 3: immediately started thinking that we might be able to use
Speaker 3: wastewater surveillance for this, and were engaged with some early
Speaker 3: collaborators that had systems where they were already testing wastewater
Speaker 3: and so we could fund them to look specifically for
Speaker 3: SARS Kobe two to in wastewater to see, if you know,
Speaker 3: can we see early evidence that this will in fact work.
Speaker 1: More on this exact moment of inspiration in a bit
Speaker 1: and it's good trust me. But Amy says that they
Speaker 1: began building the foundational data in early twenty twenty and
Speaker 1: by May, around the time you were whisking up Folger's
Speaker 1: crystals into history's most disappointing treat adel goona coffee. We
Speaker 1: all fell for it. Amy's team at that time spring
Speaker 1: twenty twenty felt confident in the biology and the epidemiology
Speaker 1: of wastewater testing, so they moved fast and they needed
Speaker 1: to establish a system.
Speaker 3: And very quickly we started pulling together. You know, how
Speaker 3: do we get utilities on board to take the samples,
Speaker 3: what labs are going to be able to do the testing,
Speaker 3: What data system are we going to stand up to
Speaker 3: collect the data at the national level. Spent a few
Speaker 3: months all of that together, and the system was officially
Speaker 3: launched in September of twenty twenty and has been growing
Speaker 3: rapidly since then. Experts say, if you want to understand
Speaker 3: how COVID spreads, check your toilet and just like what
Speaker 3: you'll find there. The news isn't all that pretty. Wastewater
Speaker 3: samples revealing record levels of coronavirus across the US. We
Speaker 3: have over seven hundred sites reporting into the system, and
Speaker 3: collectively they represent just shy of one hundred million people,
Speaker 3: so we're already covering almost thirty percent of the US population.
Speaker 1: Wow, and do you have to train people at different
Speaker 1: sites how to collect samples? Do they ship them to
Speaker 1: CDC headquarters in Atlanta. How are you gathering all of
Speaker 1: the sampling?
Speaker 3: Yeah, that has been a huge effort. So one key
Speaker 3: was recognizing that there's already a lot of expertise out
Speaker 3: there in how to do these things well. So working
Speaker 3: with our utility partners, who are absolutely critical for this.
Speaker 3: If they won't take the samples, there's nothing to test.
Speaker 3: So working with them and ask king them what are
Speaker 3: the best ways to take this sample? Where in a
Speaker 3: treatment process should we be sampling, Are there better ways
Speaker 3: to do it? What equipment can help us, how can
Speaker 3: we normalize for how much sewage is flowing through the pipes,
Speaker 3: And really engaging with them around their expertise, talking to
Speaker 3: the laboratories about testing. We do not have a standard
Speaker 3: method for testing measuring sarscob too and wastewater. There's a
Speaker 3: handful of methods that have proven to all work reliably,
Speaker 3: and so we support all of those. And largely it
Speaker 3: was our academic laboratories where this expertise lie. They were
Speaker 3: very engaged in developing and really optimizing the methods and
Speaker 3: are still part of it. I mean, many of our
Speaker 3: states are using academic laboratories as their surveillance laboratories right now.
Speaker 1: So the field work, shall we say, involves utility workers
Speaker 1: gathering samples at seven hundred and fifty five different treatment
Speaker 1: plants all over the country, and the analysis work goes
Speaker 1: to different labs, and then the CDC manages all the
Speaker 1: datasets and figures out what in crap's name is going
Speaker 1: on below our feet and in our bodies. But like
Speaker 1: a drain, let's back up, and can you tell me
Speaker 1: a little bit about your start in this when you
Speaker 1: began your science journey. What kind of questions do you
Speaker 1: want to ask and what kind of tinkering and collecting
Speaker 1: and field sampling were you doing.
Speaker 3: So my history, like many people in public health, I think,
Speaker 3: was not a straight line to this work. So I
Speaker 3: always knew that I was really interested in infectious diseases,
Speaker 3: in the pathogenic process, and how something so tiny can
Speaker 3: cause such big impacts on people on society. I wasn't
Speaker 3: sure in like high school and college, what scale I
Speaker 3: wanted to work, you know, I think looking at things
Speaker 3: as detailed as gene regulation, which is what my graduate
Speaker 3: work was on, it's fascinating all the details of how
Speaker 3: these systems work at a molecular lefl but I also
Speaker 3: think things like infectious disease history are fascinating and how
Speaker 3: big pandemics like this can really shape history. As I said,
Speaker 3: my initial training was at the molecular level. So after
Speaker 3: I got my PhD in molecular microbiology, I got a
Speaker 3: master's of public health and epidemiology and continued to work
Speaker 3: at Emory University for about five years doing public health research.
Speaker 3: That's where I did the neurovirus research, and then in
Speaker 3: twenty seventeen came to CDC, initially focused on environmental antibiotic resistance,
Speaker 3: so starting our program to look at environmental AR and
Speaker 3: then when the pandemic started in twenty twenty, we knew
Speaker 3: there was a need or an opportunity for environmental microbiology
Speaker 3: to contribute even more broadly than wastewater surveillance. We remember
Speaker 3: there were a lot of questions about things like surface
Speaker 3: survival or disinfection and all of that. When SARS COB
Speaker 3: two is new, those are environmental microbiology questions. And so
Speaker 3: in February of twenty twenty, I was we say, deployed
Speaker 3: to the response, so still reporting to CDC campus, but
Speaker 3: a different room. So now instead of instead of doing
Speaker 3: my regular work, I was doing response work for COVID,
Speaker 3: and those early days were focused on disinfection, surface survival,
Speaker 3: all of the things that went along with that response work.
Speaker 3: I mean, for anybody that's interested in public health, it
Speaker 3: is the thing that we all live for because you
Speaker 3: get to answer the questions that matter and you never
Speaker 3: know what's going to be on your desk.
Speaker 1: What will be on your desk is so many things.
Speaker 1: But yes, always in the back of her mind was what.
Speaker 3: About wastewater surveillance? Can we generate data for wastewater surveillance? And,
Speaker 3: like I said, by about May of twenty twenty, that
Speaker 3: had become my full time job.
Speaker 1: You know, shit gets real when they use the word deployed,
Speaker 1: by the way.
Speaker 3: A lot of people get confused by that, and it's
Speaker 3: like we're in the same building, just a different room.
Speaker 1: Yeah, but a little bit higher stakes almost. It feels
Speaker 1: like it feels much more emergent. For sure, at least
Speaker 1: it sounds like it. But what what is your day
Speaker 1: to day lab work? Like how much are you analyzing
Speaker 1: data sets and how much are you tinkering with pipettes
Speaker 1: and teaching other people how to do it?
Speaker 3: Yeah? So I think one of the things that people
Speaker 3: often misunderstand about the way surveillance systems work that are
Speaker 3: run by CDC, we actually don't do the lab testing.
Speaker 3: So it's much more efficient for a large scale system
Speaker 3: to set up the testing in each state so it's
Speaker 3: close to where the samples are coming from. Right, a
Speaker 3: distributed method for testing. So we do a lot of
Speaker 3: technical assistance for labs and answer questions and help them
Speaker 3: get connected to all of the resources that they need,
Speaker 3: but we're not doing any routine surveillance testing on campus.
Speaker 3: What we primarily do here in the laboratory is method
Speaker 3: development and validation. So we're already thinking about this is
Speaker 3: a great system. We've built it for COVID, but we
Speaker 3: could look for so many other things. Right, I can
Speaker 3: go back to my old friend norovirus, oh hella, and
Speaker 3: now we've put in the investment to build this infrastructure.
Speaker 3: Now it's a much lower bar to also look for neurovirus,
Speaker 3: and so we can get that data in the future.
Speaker 3: So we're method development, validation, tinkering, make sure we really
Speaker 3: thoroughly understand how those lab methods work, so that when
Speaker 3: we're on the phone with the labs that are doing
Speaker 3: the work. We can be as good as possible in
Speaker 3: our technical assistance.
Speaker 1: Where do you get your practice wastewater?
Speaker 3: We have our sources, so we're based here in Atlanta,
Speaker 3: and Atlanta has, like many large cities, actually has multiple
Speaker 3: wastewater treatment systems, and so we have long standing collaborations
Speaker 3: with our local utilities. We can call them up and
Speaker 3: say can we get you know, five liters of wastewater
Speaker 3: on Tuesday? And I say sure, and we go get
Speaker 3: it and that becomes our sample matrix.
Speaker 1: How treated is it? Be real with me, where along
Speaker 1: the assembly line is it?
Speaker 3: So we collect it so the way it comes in
Speaker 3: and this is actually fascinating. I should say that all
Speaker 3: of the people that work certainly in news, the news
Speaker 3: is our acronym, right, A good government program has to
Speaker 3: have a pronounceable acronym. Where the National Wastewater Surveillance System
Speaker 3: and we pronounce it news. But all of our news folks,
Speaker 3: we're we get a little nerdy about wastewater systems, so
Speaker 3: we really like to go out and see how they work.
Speaker 3: For news testing, the wastewater comes into the plant, there's
Speaker 3: usually a very large grate that acts as a pre screen,
Speaker 3: and so it filters out all of the really big things.
Speaker 3: The I mean, they get all kinds of things, furniture,
Speaker 3: teddy bears, branches, sticks, tires, all the things that flow
Speaker 3: into sewer mains, and so it's going to get rid
Speaker 3: of all of those big things, but everything else is
Speaker 3: going to come through, and that is where we take
Speaker 3: our sample, so it is completely untreated.
Speaker 2: I've been swimming in raw sewage.
Speaker 3: I love it when we get it. People often think
Speaker 3: that there's like whole poops floating around there is That's
Speaker 3: not what the sample looks like. By the time it
Speaker 3: gets to us. There's a lot of mixing as all
Speaker 3: of the pipes come together, and so all of the
Speaker 3: stool will break down. What it really looks like is
Speaker 3: if you wade out into a river and kick up
Speaker 3: the mud on the bottom, or there's been a lot
Speaker 3: of rain and it's just kind of muddy river water,
Speaker 3: that's what it looks like.
Speaker 1: Yep, that's what I would figure. I feel like it's
Speaker 1: a lot more translucent than we imagine. Yeah, how do
Speaker 1: you make sure that you don't get pink eye all
Speaker 1: the time.
Speaker 3: So we have a lot of biosafety restrictions and frankly
Speaker 3: COVID is one of the least concerning things in wastewater
Speaker 3: for risk. Yeah. Really, what we're detecting mostly is decayed viruses,
Speaker 3: so they're no longer infectious, and so the risk for
Speaker 3: COVID from wastewater exposure is very low. However, plenty of
Speaker 3: other things. You can get pink eye, you can get neurovirus,
Speaker 3: you can get ecali.
Speaker 1: This is the CDC people. They're not doing sewer water
Speaker 1: analysis while eating a hot dog and wearing biz cash.
Speaker 3: There are rules, there's all kinds of pathogens there. We
Speaker 3: handle wastewater at a BSL two plus standard, so we
Speaker 3: have to have gloves, eye protection, force, closed toed shoes,
Speaker 3: lab coat, and then the plus, so that's a BSL two.
Speaker 3: The plus is respiratory protection and that's for that low
Speaker 3: but possible exposure to respiratory pathogens like COVID, so an
Speaker 3: N ninety five masks in addition to those things.
Speaker 1: How often are respiratory illnesses enteric? Like how often are
Speaker 1: they detectable through wastewater?
Speaker 3: That is an excellent question, and I think it's more
Speaker 3: common than we think because we know other respiratory infections
Speaker 3: like COVID do this. So SARS one, which luckily did
Speaker 3: not turn into a pandemic, is shed and stool.
Speaker 1: And just a quick background severe acute respiratory syndrome aka
Speaker 1: SARS covid one. This was a coronavirus that hopped from
Speaker 1: animals to humans and in two thousand three caused an
Speaker 1: outbreak with a case fatality rate nearly ten times that
Speaker 1: of our current SARS KOBE two. However, SARS one infected
Speaker 1: around eight thousand people in total, it killed seven hundred
Speaker 1: and seventy four, so we learned a lot from that
Speaker 1: smaller SARS outbreak, but not enough.
Speaker 3: We know that influenza is shed and stool. We know
Speaker 3: that respiratory sincitio virus, which causes a lot of really
Speaker 3: terrible infections in children, is also shed and stool. My
Speaker 3: guess is that is not an uncommon feature of respiratory infections,
Speaker 3: but we don't have a lot of data on it
Speaker 3: because the symptom and the transmission method is all respiratory,
Speaker 3: so the focus has always been getting those respiratory specimens,
Speaker 3: and fecal shedding has been sort of thought of as
Speaker 3: a weird quirk of the infection but not really relevant
Speaker 3: to the clinical course. And so we don't have good
Speaker 3: data on that, but that's people are looking at it now.
Speaker 3: We are getting more and more data on flu RS
Speaker 3: and some of the other respiratory viruses as well, so
Speaker 3: I expect we will learn a lot about that in
Speaker 3: the coming years.
Speaker 1: So just think of the last two years of your
Speaker 1: life on zooms meeting your friends babies through plate glass
Speaker 1: windows as our golden age of pandemia, because we're learning
Speaker 1: so much, so fast. And why I was so thrilled
Speaker 1: to chat about murky water with Secrets to Tell is
Speaker 1: because environmental microbiologists such as doctor Kirby can potentially get
Speaker 1: much more reliable and objective data by overcoming the human
Speaker 1: hurdles of test availability and self reporting. But what do
Speaker 1: they need to accurately predict a disease wave before it
Speaker 1: comes and crashes on us.
Speaker 3: So we can't use wastewater data for COVID to estimate
Speaker 3: cases right now, and that's because we don't have enough
Speaker 3: information about that shedding parameter to know, you know, how
Speaker 3: much virus is shed by a single infected case. So
Speaker 3: what we see is that the trends align quite well,
Speaker 3: but we detect them earlier in wastewater then we see
Speaker 3: them in clinical cases. Omicron peaks in both cases and
Speaker 3: wastewater are much higher than what we sol for delta, right,
Speaker 3: So the magnitude parallels what we expect for cases. And
Speaker 3: I think one of the things that we have always
Speaker 3: thought about with surveillance is you know, I know people
Speaker 3: get tired of hearing about this, but it's the surveillance
Speaker 3: iceberg has always been our analogy what we can detect
Speaker 3: in surveillance, particularly clinical surveillance, where you're waiting for someone
Speaker 3: to go to the doctor get tested. The test has
Speaker 3: to be correct and reported. Right. Those are a lot
Speaker 3: of steps. You're only getting the tip of the iceberg
Speaker 3: for all the cases because you lose information at each step,
Speaker 3: and really the biggest one is getting someone to go
Speaker 3: to the doctor. That's right. You know all of those
Speaker 3: community cases that we miss because they either don't go
Speaker 3: to the doctor or they don't even have symptoms, right,
Speaker 3: And so we can estimate back to get what we
Speaker 3: think the true burden of infection is. But I think
Speaker 3: wastewater data is really powerful because we can get at
Speaker 3: that community level without having to estimate anything. It's a
Speaker 3: way to measure it in the lab and So what
Speaker 3: we have to do now is figure out, Okay, when
Speaker 3: we get that wastewater level, what is the best model
Speaker 3: to go from that wastewater number to a number of cases?
Speaker 3: And I think we'll get there. We're not there yet.
Speaker 3: There's still more research to do, but that is really
Speaker 3: where we want to be able to go.
Speaker 1: Like, there is a specific algorithm or equation that can
Speaker 1: that is out there that is undiscovered as of Yeah,
Speaker 1: but they can maybe show like, if this is the
Speaker 1: level that's shed, this is a good number to try
Speaker 1: to figure out how many cases there are.
Speaker 3: Right, it's not even undiscovered, So there's already models out
Speaker 3: there to do this. The problem is, so I'm going
Speaker 3: to give you a little jargon here. The problem is
Speaker 3: the models are not what we call fully parameterized. Right.
Speaker 3: So the easiest way to think about this is, what
Speaker 3: if we have a certain amount of let's use Saruskobe two,
Speaker 3: RNA and wastewater. If we want to know how many
Speaker 3: cases we have from that, one of the things we
Speaker 3: need to know is how much virus does each case shed? Right,
Speaker 3: what's the divisor for that number? And that's the number
Speaker 3: we're missing. That's a parameter in the model. It's not
Speaker 3: the only one, but it's one of the key ones,
Speaker 3: and we don't have good data on that right now.
Speaker 3: We have very limited data. So what that means is
Speaker 3: that our model is very uncertain and we get a
Speaker 3: huge wide range of possibilities. And right now those estimates
Speaker 3: are so wide that they're really not useful. I mean,
Speaker 3: it's equivalent to saying, well, the likelihood is somewhere between
Speaker 3: one and one hundred percent, which is not a very
Speaker 3: useful thing. So we need to get those parameters tighter
Speaker 3: so that our estimates get tighter and more useful.
Speaker 1: And what influences the amount of RNA? Is it rna
Speaker 1: from the virus? It's that you're picking up, like is
Speaker 1: it the severity of the case. Is it how much
Speaker 1: fiber someone eats?
Speaker 3: It could be all of the above, So you know,
Speaker 3: certainly we want to look at symptoms versus no symptoms.
Speaker 3: Early data suggests that doesn't make a difference, but there's
Speaker 3: not a lot there. It could change with more data.
Speaker 3: Now we need to think about does vaccination change you're
Speaker 3: shedding right right? Does it look different if it's a
Speaker 3: breakthrough vaccinated case versus an unvaccinated case. Does shedding change
Speaker 3: with variants. Maybe omicron sheds a lot more than delta
Speaker 3: or alpha, and so we don't have that information. And
Speaker 3: then the other piece, so that's the sort of biological
Speaker 3: piece about the human infections.
Speaker 1: So part one is your biological pipes. And then number
Speaker 1: two is the industrial aspect, so the municipal guts and
Speaker 1: concrete shoots, this shit show ballet performed every day underneath
Speaker 1: our communities. It's beautiful.
Speaker 3: The other piece is what's the impact of the wastewater
Speaker 3: system itself, So how long is the virus in the system,
Speaker 3: in the pipes before it gets to the wastewater treatment plan.
Speaker 3: We sample it because the longer it's in those pipes,
Speaker 3: the more it's going to decay. Ah, So we have
Speaker 3: to take that into account. Also, a lot of things
Speaker 3: come into a wastewater treatment plant. Some of them can
Speaker 3: be very harsh, especially if you have a lot of
Speaker 3: industrial input, So there can be really harsh chemicals there
Speaker 3: that can accelerate that decay. And so we would need
Speaker 3: to know like what else is coming into the system
Speaker 3: that we need to be able to account for to
Speaker 3: correct those numbers, to account for those changes in the system.
Speaker 3: Those are the two big categories of data that we
Speaker 3: would need to put into that to accurately make that
Speaker 3: estimate back to cases.
Speaker 1: So, yes, our bodies may react to different variants differently,
Speaker 1: and your guts yours may process viral parts in novel
Speaker 1: ways with a vaccine fortified immune system. But we are
Speaker 1: not the only factor because remember that while wastewater treatment
Speaker 1: plants give us a great overhead view, there may be
Speaker 1: less control over the sampling conditions. But scientists are always
Speaker 1: solving problems, which really bowls me over. How do you
Speaker 1: feel when you have those kind of question marks or
Speaker 1: those puzzle pieces? How do you approach them? Because I'm
Speaker 1: thinking about being at your desk and being like, we
Speaker 1: don't know how much bleached in the water. We don't know,
Speaker 1: and I just picture myself sobbing. How do you approach
Speaker 1: like these hurdles and the curveballs and the new trends
Speaker 1: and variants, How does your science brain approach it?
Speaker 3: I mean, at CDC, it's all about having the right
Speaker 3: network and being collaborative with the science community at large.
Speaker 3: So you know, we have our networks of academic collaborators
Speaker 3: that we can reach out to and say, hey, have
Speaker 3: you ever thought about this? Problem. How do you measure
Speaker 3: so the time it takes for some you know, a
Speaker 3: flushed toilet to get from a house to a So
Speaker 3: the treatment plan is called residence time. How do you
Speaker 3: measure residence time? Can we get good estimates of that?
Speaker 3: What's the fluctuation? What's the decay? And so asking them
Speaker 3: all of these questions and getting their ideas, and do
Speaker 3: you have do you researcher a have a platform available
Speaker 3: where you could ask that question. If the answer is yes,
Speaker 3: then the question for me at CDC becomes, well, how
Speaker 3: can I support them getting the resources they need to
Speaker 3: answer this critical question. So that's how we solve it,
Speaker 3: largely is by relying on our collaborative network that's available
Speaker 3: to us.
Speaker 1: Well, I have a basic question here. But does that
Speaker 1: mean that knowing you have this network and that can
Speaker 1: help you solve these giant problems, does it make workplace,
Speaker 1: team building and office politics any more challenging or easier?
Speaker 1: Like knowing like you better have friends in the building
Speaker 1: because you're gonna have a lot of questions and you
Speaker 1: might need help, Like is everyone pretty tight at CDC?
Speaker 1: And just like doesn't let grudges stick around?
Speaker 3: I mean we're human I will say that we are human.
Speaker 3: You are human people working here. But yeah, I mean
Speaker 3: it is an excellent place to work. I would, you know,
Speaker 3: be lying if I said otherwise. I mean, ultimately, we're
Speaker 3: a very mission driven agency and everybody wants to support
Speaker 3: the science as best they can. And so if I
Speaker 3: am willing to go to a colleague and able to
Speaker 3: convince them that doing this is going to be the
Speaker 3: key to, you know, moving some public health issue forward,
Speaker 3: they are almost always willing to get on board. And
Speaker 3: so it is a very collaborative agency, both internally and externally,
Speaker 3: and that's that's how we're able to move quickly.
Speaker 1: Let that perfectly diplomatic answer serve as yet another reminder
Speaker 1: that science is done by human people once who have
Speaker 1: birthdays and go through breakups, and when they're not trying
Speaker 1: to fix a pandemic, they buy bathing suits of target,
Speaker 1: and they have opinions about cauliflower rice and in some
Speaker 1: people's professions, though, holding a grudge about a parking space
Speaker 1: could lead to thousands of people needlessly dying. So let's
Speaker 1: get along. What about myths that people think about your
Speaker 1: job or environmental microbiology, anything that you're any jokes that
Speaker 1: you have heard a thousand times, or any myths that
Speaker 1: you want to bust.
Speaker 3: Well, I don't know about jokes, but we are a
Speaker 3: bastion of puns. I have a lot of really funny
Speaker 3: people on my team, and so we talk about, you know,
Speaker 3: what can your pooh do for you to try and
Speaker 3: rally people to support wastewater surveillance. Your number two is
Speaker 3: our number one. We've got quite a few. And I
Speaker 3: have to tell you that the news acronym when we
Speaker 3: came up with that, the pun possibilities were a big
Speaker 3: part of why we we went with it because immediately
Speaker 3: we were like, oh, when you do your business, we
Speaker 3: get the news. That's perfect. So yeah, we do a
Speaker 3: lot of that.
Speaker 1: I had a hunch I could just smell it. Speaking
Speaker 1: of aromas, how does the legit CDC epidemiologists feel about
Speaker 1: Twitter user Terry draws stuff November twenty twenty revelation that
Speaker 1: quote there are angry ladies all over Yankee candles sight
Speaker 1: reporting none of the candles they got had any smell
Speaker 1: at all. I wonder if they're feeling a little hot
Speaker 1: and nothing has much taste for the last couple of
Speaker 1: days too. This tweet made the rounds. It led to
Speaker 1: Stanford psychophysiology PhD student Kate Petrova to decide, you know what,
Speaker 1: let's look into it and harvested one star reviews from
Speaker 1: scented candle emporiums all over the internet and then crunched
Speaker 1: those flaming numbers because sometimes the data it's right under
Speaker 1: your nose. Uh what about collaborations with the epidemiologists at
Speaker 1: Yankee Candle. Do you ever have to follow what they're finding?
Speaker 3: I do. That's a great question. I had forgotten about
Speaker 3: that whole piece that they were getting a lot of
Speaker 3: complaints because no one could smell their candles. You know,
Speaker 3: we are open to unique collaborations. I don't know that
Speaker 3: news necessarily has a role with Yankee Candle, but certainly
Speaker 3: we're always looking for new ways and novel approaches to
Speaker 3: get at these questions because they're hard. I mean, like
Speaker 3: you you said earlier, this is something that there's a
Speaker 3: lot of challenges and we don't have all the answers,
Speaker 3: But the way to get to them is to be
Speaker 3: open to possibilities.
Speaker 1: And it's literally life or death. The work that you're
Speaker 1: doing can can lead to huge breakthroughs that can really
Speaker 1: protect people. We got so many questions from listeners. Can
Speaker 1: I lightning around you?
Speaker 3: Of course?
Speaker 1: Okay, okay. So this first question was asked by patron
Speaker 1: Amy Naramatsu, who wrote in quote, I work for an
Speaker 1: environmental nonprofit and water quality is a huge part of
Speaker 1: our work. We test for bacteria and other nasty stuff
Speaker 1: and publish our findings. What's the best way to communicate
Speaker 1: this data, particularly for the general public who may not
Speaker 1: understand the language. So wait, Amy works for an environmental nonprofit.
Speaker 1: You know what, Let's make Let's make this episode weird. Okay,
Speaker 1: I'm gonna call Amy Naramatsu. Here you go. She's not
Speaker 1: expecting my call. I'm nervous about this for.
Speaker 3: The boys the Queen Rivers on Maryland. Sure, if you
Speaker 3: know your party, your digito protection, you may dial it now.
Speaker 1: Mm hmmm. Oh hi, Amy, I understand you're the community
Speaker 1: engagement coordinator.
Speaker 2: I know I don't like thinking too well.
Speaker 1: I'm actually I'm I'm calling from a podcast. It's it's
Speaker 1: fromologies Hi.
Speaker 2: I'm sorry, You're like, who's this bitch calling me? Number one?
Speaker 3: I am recording right now?
Speaker 1: Do I have your permission?
Speaker 2: Is that?
Speaker 1: Okay?
Speaker 3: Sure?
Speaker 1: Okay, it's a very quick call. Essentially, I wanted to
Speaker 1: call because this week's episode it's with doctor Amy Kirby,
Speaker 1: who's with the CDC. She's amazing, but because the CDC
Speaker 1: is a government entity, they can't select a charity. So
Speaker 1: she's like, I'm gonna leave it up to you. And
Speaker 1: you submitted a question. You mentioned that you're a community
Speaker 1: engagement coordinator for essentially for Shore Rivers, which helps clean
Speaker 1: up waterways. So I was wondering if we can make
Speaker 1: the donation to y'all instead.
Speaker 2: That yay, okay, good.
Speaker 1: Can you tell me, like in a nutshell, what shore
Speaker 1: Rivers does, like what your mission statement is?
Speaker 3: Yeah?
Speaker 2: Absolutely, So Shore Rivers is an environmental no profit.
Speaker 1: Based on there and we have a mission to protect
Speaker 1: and restore our waterways through science based advocacy, restoration and education.
Speaker 1: Who nailed it, look at that engaging the community.
Speaker 2: Amazing.
Speaker 1: Sorry that I seemed like such a creep at the beginning.
Speaker 1: I realized once you answered that I didn't have a
Speaker 1: plan for what I was going to say to you.
Speaker 3: I was like, oh, fuck my life.
Speaker 1: Thank you Amy for letting me completely interrupt your day
Speaker 1: with some charitable tomfoolery, and thank you doctor Kirby for
Speaker 1: having us just roll the dice this week for you
Speaker 1: and to learn more about shore rivers headshore rivers dot org,
Speaker 1: which will be linked in the show. Notes that donation
Speaker 1: was made possible by sponsors of the show. Thank you sponsors. Okay,
Speaker 1: no question too, crappy, Let's see what's coming down the pipe.
Speaker 1: So this first one was asked by specs Owl and hey,
Speaker 1: Artemis wants to know what's the deal with medications down
Speaker 1: the drain? And they say, I know we're not supposed
Speaker 1: to because it'll get in the water, but I want
Speaker 1: to know how it permeates and how much and all
Speaker 1: of that. And a bunch of people asked about hormonal
Speaker 1: birth control in the wastewater, looking right at you, Katie
Speaker 1: Court right, and first time asker Margaret Reese, is that
Speaker 1: something that you are also having to find ways to
Speaker 1: measure and come up with some public health guidelines around.
Speaker 2: Yeah.
Speaker 3: So I'm like jumping up and down at this question,
Speaker 3: because yes, please don't put your medications down the drain. Frankly,
Speaker 3: enough of it comes out in urine and stool on
Speaker 3: its own. We don't need the added input from the
Speaker 3: pills themselves going down the drain. Yes, I mean this
Speaker 3: is something that we are interested in doing. There are
Speaker 3: researchers that are already out there looking at can we
Speaker 3: measure pharmaceuticals in waste water? And what does that tell
Speaker 3: us about the health of the community right Looking at
Speaker 3: things like pain medications are one another option that seems
Speaker 3: like antidepressants. Can we use those as large scale markers
Speaker 3: of community health issues that we can provide better interventions for.
Speaker 1: And luckily scientists are on this and there are reams
Speaker 1: of studies that you can thumb through, such as the
Speaker 1: twenty nineteen Banger Pharmaceuticals of Emerging concern in Aquatic systems, Chemistry,
Speaker 1: occurrence effects and removal methods, which I read late at night.
Speaker 1: And this paper whispered facts to me such as the
Speaker 1: presence of pharmaceutical contaminants in groundwaters, surface water, seawater, wastewater
Speaker 1: treatment plants, soils and sludges has been well documented.
Speaker 2: It said.
Speaker 1: A range of methods including oxidation, photolysis, UV degradation, nanofiltration,
Speaker 1: reverse osmosis, and absorption has been used for their remediation
Speaker 1: from aqueous systems. So there's a lot of shit in there.
Speaker 1: They're trying a lot of stuff, and this paper warns
Speaker 1: that despite our efforts, we are clearly not getting at all.
Speaker 1: It also told me that pharma consumption ebbs and flows
Speaker 1: just like lapping waves of sewer water. And the study
Speaker 1: went onto site data that greases. Twenty ten economic crisis
Speaker 1: set off surges in the consumption of psychoactive pharmaceuticals. Also,
Speaker 1: different parts in the world have higher estrogen water toxicity,
Speaker 1: while antibiotics are all the rage in other raging waters
Speaker 1: and wastewater filled with antibiotics. Guess what that is. That's
Speaker 1: just a giant cocktail party for evolution, just a big
Speaker 1: petri dish. It's a hometown training grounds for antibiotic resistant
Speaker 1: germs that we can't kill. And I just can't help
Speaker 1: but consider the land that we're on, the mountain streams
Speaker 1: and the bays and the oceans and the deltas, and
Speaker 1: how they're very chemistry has been altered by the remedies
Speaker 1: that we rely on to survive and skimming lists of
Speaker 1: water contaminants like beta blockers and anticoagulants and hormones and
Speaker 1: pain killers and antidepressants and lipid lowering drugs and anti fungals.
Speaker 1: You know, I read that as an American, I couldn't help,
Speaker 1: but wonder you know, is it cheaper to get my
Speaker 1: prescriptions by sitting in a creek? And which rivers have
Speaker 1: the good stuff? Well, Christy Sullivan, I wanted to ask
Speaker 1: this is it up top listener question? Wants to know
Speaker 1: who was the person who said, hear me out, I've
Speaker 1: got a good idea. And the sentence ended with collecting
Speaker 1: and analyzing wastewater was that.
Speaker 3: You I actually am going to give the credit to this,
Speaker 3: and he's going to die when he hears me say
Speaker 3: this to our branch manager. So very early on he
Speaker 3: was like, can't we measure this and pooh? And I
Speaker 3: was like, yeah, I think we can.
Speaker 1: Branch manager's name. Do you want to give him a
Speaker 1: shout out by name?
Speaker 3: Sure? His name is Eric Gross.
Speaker 2: His last name is Gross.
Speaker 3: Yes, his last name is Gross.
Speaker 2: Amazing? Is he a doctor?
Speaker 3: He has an MPH. He actually sadly doesn't work in
Speaker 3: our team anymore. He moved to a different area of CDC.
Speaker 3: He called himself our resident being counter because he handled
Speaker 3: all of the finances.
Speaker 1: I was gonna say if he's he should get an
Speaker 1: honorary to say be doctor Gross because a lab coat
Speaker 1: with doctor Gross is amazing.
Speaker 3: He'll love it.
Speaker 1: Nina Evesy had a question. I'm sures on a bunch
Speaker 1: of people's minds. They say, oh, I'm super intrigued by this,
Speaker 1: but are there any privacy issues with going through people's
Speaker 1: poop or is it like those fingernail clippings in the
Speaker 1: waste bind in law and order. Once it's out of
Speaker 1: your system and in the system, it belongs to the system, right.
Speaker 3: Yeah, So, I mean there is a lot of DNA
Speaker 3: and wastewater, right, So the privacy concerns are not unfounded,
Speaker 3: and it's definitely something that we need to address head
Speaker 3: on and be very transparent about what we are testing
Speaker 3: and what we are not testing, and how that data
Speaker 3: is going to be used. As far as who actually
Speaker 3: owns it. Once it gets to the treatment plant, it's theirs,
Speaker 3: and actually once it's in the pipes that they control
Speaker 3: to get there, they are officially owners of it and
Speaker 3: responsible for whatever happens to it.
Speaker 2: This sack of shit is mine.
Speaker 3: A lot of the information we're gathering is about the
Speaker 3: community at large, so we want to be very transparent
Speaker 3: with the community about you know, how we're using this data.
Speaker 1: Yeah, that makes plenty of sense. I also feel like
Speaker 1: the resources it would take to run a DNA sample
Speaker 1: on each individual person or each individual fragment, that seems
Speaker 1: like beyond the capabilities even of the system.
Speaker 3: Right, Yeah, I mean it's not something that we're interested
Speaker 3: in doing. I think about it from what we call
Speaker 3: a future use perspective, Right, what could people do ten
Speaker 3: years from now with these samples? Twenty years from now?
Speaker 3: And so we want to put guardrails on that now
Speaker 3: because down the road that may be something that's much
Speaker 3: easier to do. But that is an inappropriate use of
Speaker 3: public health data. It's not what we're gathering it for.
Speaker 3: And so we want to make sure there's protection around
Speaker 3: these samples so that they are used only for things
Speaker 3: that are a community good.
Speaker 1: But she makes an excellent point and raises the black
Speaker 1: mirror hypothesis, which is not a real term. It's just
Speaker 1: something that haunts me when I'm in a scroll hole
Speaker 1: or I happen upon a jovial news clip about a
Speaker 1: robotic police dog. Are there any specters in Amy's head?
Speaker 1: Mallory Nettleton wants to know if you've ever seen anything
Speaker 1: weird or surprising while you're testing but it is filtered
Speaker 1: or at least de chunked by the time it gets
Speaker 1: to correct.
Speaker 3: Yeah, we haven't seen it with wastewater, with other poop
Speaker 3: related studies, absolutely, I mean, you can you learn a
Speaker 3: lot from people, really from what Yeah, you can learn
Speaker 3: what they eat and their patterns. I often tell my husband,
Speaker 3: I'm like, I spent way too much of my adult
Speaker 3: life pondering people's bathroom habits for various reasons.
Speaker 1: Anything you can elaborate on, because I am curious.
Speaker 3: The thing that always puzzles me is bathroom patterns. So
Speaker 3: I used to do neurovirus human challenge studies that I
Speaker 3: worked at Emory. So we would bring people into the
Speaker 3: hospital and intentionally give them neurovirus. Of course, all fully
Speaker 3: they knew what we were doing, right fully consented, they
Speaker 3: agreed to this to look at immune reactions or treatment methodologies,
Speaker 3: those sorts of things.
Speaker 1: Right, let me just I'm going to hop in here
Speaker 1: and truncate this for us. All So, doctor Kirby found
Speaker 1: that some patients were like number two sample, Yeah, I
Speaker 1: got five of them for you today, and other people,
Speaker 1: all of us the same species, were like, I just
Speaker 1: I just gave you one yesterday, come back in like a.
Speaker 3: Week, just this huge variation in patterns and then trying
Speaker 3: to account for that in our data. Like, if you're
Speaker 3: thinking about daily stool production and daily virus shedding, how
Speaker 3: do you compare the person that goes three or four
Speaker 3: times a day to the person that goes once every
Speaker 3: four days, as long as it's normal for them. We
Speaker 3: worked around it, but I was surprised at how broad
Speaker 3: the variation was.
Speaker 1: I think it's interesting that you were surprised at the variation,
Speaker 1: and I am surprised that someone's like, yes, norovirus, where's
Speaker 1: the waiver, I'll sign it.
Speaker 3: We got a lot of that. There are most definitely
Speaker 3: two types of people in the world, the absolute yes,
Speaker 3: I'll do it, and then no, way, you could not
Speaker 3: pay me enough. I haven't met anyone that's like, well,
Speaker 3: maybe you do.
Speaker 1: People get remunerated for their contributions to science in that way.
Speaker 3: They do, Yes, okay, Our challenge study subjects did get
Speaker 3: reimbursed for their time.
Speaker 1: Well as someone who was lucky enough to dodge some
Speaker 1: neurovirus salsa at a barbecue once. I mean, no one
Speaker 1: at that barbecue got paid. So there are people out
Speaker 1: there getting it for no money, just for some free salsa. Oh,
Speaker 1: longtime listeners, know that my inherent revulsion for raw tomatoes
Speaker 1: saved my actual ass. Now, what about organisms that are
Speaker 1: not people? Lee was not the only person with this question.
Speaker 1: Dana Teter asked, can you tell from wastewater tests if
Speaker 1: the pathogen you find has human origin or animal origin?
Speaker 1: And if not, what further sleothing needs to be done?
Speaker 3: Sloothing We cannot tell. So when we detect a specific pathogen,
Speaker 3: we can't tell if it's from humans or animals, assuming
Speaker 3: it's a pathogen that we know is found in both. Right,
Speaker 3: If it's strictly a whatever bird pathogen, then we know
Speaker 3: it's from birds. However, what we can do is we
Speaker 3: can look for other markers, microbial markers that are only
Speaker 3: found in one of those sources. So we use specific
Speaker 3: microbial markers that are only present in human feces yum,
Speaker 3: so we can say, okay, there's human feces in this wastewater,
Speaker 3: which we would expect. We can also look for markers
Speaker 3: associated with specific animals rats, birds, dogs, cats, and so
Speaker 3: we can say what other animals have contributed significantly to
Speaker 3: this wastewater that may be the source of these pathogens.
Speaker 1: You know, which brings me to a good question. Timothy
Speaker 1: Wang and Saddani Scheimler asked, what are the issues with
Speaker 1: flushing pet poop and are there ways to monitor animal
Speaker 1: based disease versus human disease? Which you just answered, But
Speaker 1: should people be flushing cat poop in your opinion as
Speaker 1: someone who is an environmental microbiologist.
Speaker 3: I mean they can. It's a safe way to dispose
Speaker 3: of pet waste in our household, so that's fine. I mean,
Speaker 3: I will, you know, stand up for my utility colleagues
Speaker 3: and say, please don't flush cat litter. It clogs up
Speaker 3: the system and causes all kinds of problems. But cat poop,
Speaker 3: dog poop is fine. I think it's an interesting question
Speaker 3: of whether we could monitor diseases animal diseases that way.
Speaker 3: The challenge there would really be scale right. You might
Speaker 3: predict that, for example, in the city, it's much more
Speaker 3: likely that pet waste gets flushed than in the country,
Speaker 3: and so you need to account for that difference in
Speaker 3: your evaluation.
Speaker 1: Also, heads up, cats can be trained to use a toilet,
Speaker 1: and apparently so can some birds like parrots, which makes
Speaker 1: sense given that they can learn to insult us in
Speaker 1: our own language. Now, dogs too have been trained to
Speaker 1: use toilets and even flush, So imagine New Yorkers. If
Speaker 1: you start now it's April, perhaps you'll have this training
Speaker 1: thing on lock before winter comes and you're standing on
Speaker 1: a frozen sidewalk waiting for poop to drop. I thought
Speaker 1: furf brownov had a good question. It's a sensitive question.
Speaker 1: I'm going to ask it anyway, they said. When I
Speaker 1: heard about monitoring COVID through wastewater, my immediate fear was,
Speaker 1: can I get COVID from smelling someone's fart?
Speaker 2: So?
Speaker 1: Can you get a disease from inhaling particles after someone
Speaker 1: rips some of that trumpet? Do you ever have to
Speaker 1: worry about something going from enteric to airborne?
Speaker 3: So for COVID, this is not a risk that we
Speaker 3: are concerned about, And mainly that's because we don't think
Speaker 3: there's no evidence that the virus that is shed in
Speaker 3: stool or through the GI tract is infectious. In fact,
Speaker 3: most of our evidence suggests that it is not. So Paul,
Speaker 3: we can't totally rule out the possibility, very very low
Speaker 3: that any virus coming from the GI tract is going
Speaker 3: to be infectious, and so a fart wouldn't be any
Speaker 3: more infectious than a poop, right. However, I think this
Speaker 3: is an interesting question for other infections where we know
Speaker 3: that a lot of infectious virus is shed. So we'll
Speaker 3: go back to my old friend norovirus again. There we
Speaker 3: know that infectious virus is shed at very high levels
Speaker 3: and stool. So is there a possibility that aerosolized virus
Speaker 3: from a part could cause infection?
Speaker 1: Wow? This gets grosser.
Speaker 3: We don't know that. But what we do have really
Speaker 3: good evidence of is that when people vomit with neurovirus,
Speaker 3: which also happens a lot, right, it is the winter
Speaker 3: vomiting disease, the particle. This is really gross. I'm sorry
Speaker 3: to throw this out there at the end, but when
Speaker 3: people vomit, there's lots of aerosolized particles from that, and
Speaker 3: there's multiple outbreak studies showing that. You know, really, the
Speaker 3: only exposure we can figure out is that that person
Speaker 3: across the room must have inhaled aerosolized vomit. I don't like,
Speaker 3: we don't know that it goes through their nose necessarily,
Speaker 3: more likely they were breathing through their mouth and it's
Speaker 3: kind of equivalent to consuming it.
Speaker 1: I think that's the worst thing guys ever heard.
Speaker 3: But certainly there's very strong a FI evidence that that
Speaker 3: can happen with a fecal oral transmitted virus. Whether or
Speaker 3: not you would actually aerosolize enough virus through a fart
Speaker 3: through your clothes to be a risk, I don't know.
Speaker 3: I think it's unlikely, but I wouldn't rule it out.
Speaker 3: There's a biological pathway there.
Speaker 1: I mean, how lucky are we that we have someone
Speaker 1: answering these questions for us somewhere?
Speaker 3: Like I said, I spend way too much time thinking
Speaker 3: about people's bathroom habits.
Speaker 1: What is the hardest part about your job or what
Speaker 1: do you hate the most? I mean, you are doing
Speaker 1: the lord's work. But what's the worst part about analyzing poop?
Speaker 3: I mean, well, the worst part I think about analyzing
Speaker 3: poop in anything stool related in public health is the
Speaker 3: stigma that people still have around poop in their own poop.
Speaker 3: So there's an immediate revulsion, which I understand it now.
Speaker 3: It's actually protective if you think about the evolutionary reasons
Speaker 3: for it. But what that means is that people don't
Speaker 3: want to participate in studies like our Nora virus study.
Speaker 3: They don't want to answer questions about their bathroom habits
Speaker 3: and how often they poop at work versus pooping at home,
Speaker 3: which is important for us to understand how wastewater surveillance
Speaker 3: works and the most effective approaches. They don't really want
Speaker 3: to think about scientists somewhere digging through their you know,
Speaker 3: wastewater to answer questions. It's just there's this immediate rejection
Speaker 3: of it, and that we have to factor that response
Speaker 3: into all of our studies. That there's a bias that
Speaker 3: comes with that right of people that just won't participate
Speaker 3: because it's gross. I'm used to it at this point,
Speaker 3: but it is hard to overcome.
Speaker 1: That's such a good answer and so understandable that that
Speaker 1: is a giant psychological barrier of other people's to getting
Speaker 1: your work done. You know, I can't imagine if birds
Speaker 1: were like, I don't really want you to see my net.
Speaker 1: Just don't look at my nest, Just can you not?
Speaker 1: Just I don't even nest. I don't even have a
Speaker 1: nest actually, like never, Like that's there's not a lot
Speaker 1: of shame around so many other fields. That's so interesting.
Speaker 1: What about the thing that you love the most.
Speaker 3: I mean, it's corny, but the thing that I love
Speaker 3: the most is being able to make a difference. It's
Speaker 3: the reason I went into public health and got out
Speaker 3: of molecular micro I wanted to be able to see
Speaker 3: that the work that I'm doing has an impact in
Speaker 3: the community. And I mean I loved the work I
Speaker 3: was doing pre COVID, but man, as soon as you're
Speaker 3: deployed to the response, that application of your work takes
Speaker 3: on a whole different urgency and quickness. You know, you
Speaker 3: see things going to practice within days instead of weeks
Speaker 3: or months or years.
Speaker 1: Well, thank you for doing it. I'm such a fan
Speaker 1: of what you do. I just think it's so interesting
Speaker 1: and it's just the way of the future.
Speaker 3: I feel like, oh, thank you. Well, yeah, we think
Speaker 3: it's going to be absolutely a new paradigm for disease
Speaker 3: surveillance because it doesn't work require any action from people, right,
Speaker 3: it's totally passive to the community. So it's been great
Speaker 3: to talk to you and really thank you for this opportunity.
Speaker 1: Ah but wait, we have a little more. I'm speaking
Speaker 1: in a little insight from a virology guest and repeat
Speaker 1: guest doctor Shannon Bennett of the California Academy of Arts
Speaker 1: and Sciences, who I got a chance to see a
Speaker 1: few weeks ago. We chatted in San Francisco, face to
Speaker 1: face with multiple layers of polypropylene in between, about variance
Speaker 1: and advice going into our third COVID summer.
Speaker 2: What are we supposed to do?
Speaker 1: I mean, and I guess just given what we're talking about,
Speaker 1: we'll just keep masks on.
Speaker 4: Might as well?
Speaker 1: We're well, we're in a small space. Yes, Oh, first off,
Speaker 1: I don't think I had to do this work. But
Speaker 1: if you could say your first and last name in your.
Speaker 4: Pronouns, Shannon Bennett, she here.
Speaker 1: Now we last got to hang out in person March
Speaker 1: of twenty twenty.
Speaker 4: You masks, no sittings within six feet comfortably in an
Speaker 4: indoor setting.
Speaker 1: What a luck, What a luxury it was. If another
Speaker 1: virus emerges, do you think that this SARS Kobe two
Speaker 1: experience will have us be it all better equipped to
Speaker 1: handle another outbreak of some kind?
Speaker 4: Oh?
Speaker 3: Yeah, that's good.
Speaker 4: Yeah, no is This has been an amazing time of
Speaker 4: building capacity around the world to identify these novel events
Speaker 4: and sequence these viruses and share the data. I mean,
Speaker 4: just look at how quickly we were able to develop
Speaker 4: effective vaccines. Honestly, nobody would have ever predicted that we
Speaker 4: would have been able to have vaccines that at the beginning,
Speaker 4: we're ninety five percent effective against infection. Nobody tries to
Speaker 4: even design vaccines to protect against infection. They try to
Speaker 4: design them to perfect to protect against disease. And so
Speaker 4: it's amazing that we have this new vaccine technology. And
Speaker 4: it's because, in part, we were able to accelerate the
Speaker 4: vaccines because of a massive sort of data sharing, massive
Speaker 4: cross sector collaboration, massive infusion in production lines for the vaccine.
Speaker 4: We've learned so much.
Speaker 1: Right, I mean it's kind of forged in fire in
Speaker 1: some way where well we didn't necessarily have all of
Speaker 1: this in place, but we have it now. Yeah, that's good. Yeah,
Speaker 1: you know, things are starting to open up a little bit.
Speaker 1: You know, we're here at a Science Nightline event that
Speaker 1: we have not had in two years, though it will
Speaker 1: be masked for attendees. Anything that as we get into summer,
Speaker 1: people gets warm, people start to act out, They're like,
Speaker 1: let's do it, let's get out. Yeah, festivals, I'm ready.
Speaker 1: I've been bored anything any cautionary advice or anything any guidelines.
Speaker 4: So I'm fully vaccinated and boosted and honestly wearing a mask.
Speaker 4: I don't want COVID, but if I did get COVID,
Speaker 4: it would probably be just fine, right, I probably have
Speaker 4: a pretty mild course. It would be a pain because
Speaker 4: I'd probably have to control my movements and quarantine. But
Speaker 4: there are a lot of people that for whatever reason,
Speaker 4: they're either not eligible, they can't get the vaccine, they
Speaker 4: don't have a good immune response to the vaccine. And
Speaker 4: so right now, I mostly wear my mask to protect others.
Speaker 4: And I think as a society, we're still seeing this
Speaker 4: thing called extra deaths.
Speaker 2: Right.
Speaker 3: That sounds terrible, Yeah.
Speaker 4: I know it does sound horrible. We understand that a
Speaker 4: certain and hopefully entiny proportion of our population will always
Speaker 4: have a very bad outcome to a disease infection event,
Speaker 4: and with flu, we just you know, we just you
Speaker 4: know what that looks like, and we just have to
Speaker 4: live with it. People are still dying of COVID, people
Speaker 4: are still dying of omicron, and even very young people,
Speaker 4: and so we need to decide how much of that
Speaker 4: we can live with, And then I will start thinking
Speaker 4: more and more about where and when I can take
Speaker 4: my mask off relative to the safety of other people.
Speaker 1: Smart consider it. I think it's one of those things
Speaker 1: where no one's ever like I really regret wearing a
Speaker 1: mask to that, but there are times when people are
Speaker 1: probably wish I would have worn a mask somewhere, so
Speaker 1: you know, yeah, better safe than sorry. They yeah, Well,
Speaker 1: I imagine you're going to have a lot of young
Speaker 1: birologists who are sort of shuffled into this field for
Speaker 1: motivated by very personal reasons. So there's going to be
Speaker 1: a lot of people probably who have an interest in
Speaker 1: tackling things before they really become an outbreak.
Speaker 3: So I agree.
Speaker 1: So there you have it. Ask three smart people. Doesn't
Speaker 1: it's a very not smart and truly shameless questions. Thank
Speaker 1: you for sticking it out. I know that you're like,
Speaker 1: should I listen to this? You know, you know more
Speaker 1: now and you have helped with the hardest part of
Speaker 1: doctor Kirby's work, which is people running away screaming from it.
Speaker 1: And there are links to the studies we cited. There
Speaker 1: are references. There's the link to the charity for the episode.
Speaker 1: There's a link of birds on toilets and more. Up
Speaker 1: at Alleywoard dot com slash ologies slash environmental microbiology. That's
Speaker 1: linked in the show notes. You do not have to
Speaker 1: write it down. You can follow the CDC. Their handle
Speaker 1: is at CDC gov. You can follow us if you please,
Speaker 1: at Ologies on Twitter and Instagram. I'm on those as
Speaker 1: Ali Ward Ali with one L. You can head to
Speaker 1: ologiesmerch dot com to put some ologies things on your body.
Speaker 1: If you tag it ologies merch on Instagram, we repost
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Speaker 1: Transcripts and Bleeped episodes are both available for free at
Speaker 1: the link in the show notes. Every few weeks we
Speaker 1: release asmologies episode that has been defilthed for kids' ears
Speaker 1: and condensed zeke Fredriguez Thomas of mind Jam Media works
Speaker 1: on those, and Stephen Ray Morris helps out to you.
Speaker 1: Kelly ar Dwyer updates the website. She can make you
Speaker 1: a website if you like her links in the show
Speaker 1: notes and Giant Thanks to the Man the mullet, the mustache,
Speaker 1: jarreted Sleeper, who if you find him on Instagram at
Speaker 1: Jarrett Sleeper, you can weigh in on his recent headshots.
Speaker 1: Tell him which one is the most astonishing. It's difficult
Speaker 1: to choose. Nick Thorburn made the theme music. And if
Speaker 1: you listen to the end of the episode, I burden
Speaker 1: you with a secret if you will. And you know
Speaker 1: what's weird is I've been doing this show for like
Speaker 1: two hundred and fifty episodes or something. I should know
Speaker 1: exactly the number, and I should celebrate that. And I'm
Speaker 1: still I still get nervous when I record asides. I
Speaker 1: don't know why I can edit them. If I mess up,
Speaker 1: I can edit them. It's fine. Why am I? What
Speaker 1: do you care? Just get into it, you know. And
Speaker 1: I'm still like, Oh what if I'm Bob? You know
Speaker 1: what it is? I think I still like this job.
Speaker 1: I've been doing it since twenty seventeen. I still like it. Okay,
Speaker 1: see you next week. Sorry this one was so gross.
Speaker 1: Love you, bye bye. Give them a cup of sewer water,
Speaker 1: don't you go