Editorial: Wastewater tests a key COVID tool

How can this state — or any state — keep up with the shape-shifting coronavirus that spawned a pandemic now well into its third year?

It’s definitely an elusive goal, but because knowledge is power, having more information will always offer advantages. Consider how difficult it was, in the early days of the crisis, to gauge the spread of COVID-19, and prepare a community for it, while testing capacity was still so limited. That, as everyone knows, did nothing to help contain the virus.

So improving surveillance of the SARS-CoV-2 virus, in all its forms, will be helpful, especially if it delivers useful data to Hawaii decisionmakers on a timely basis. And it’s good news that the state Department of Health (DOH) is, at last, advancing plans to build a state-run wastewater surveillance system.

This may be just a supplemental weapon in today’s COVID-19 fight in the islands — but even so, local systems elsewhere already are alerting officials to the spread of monkeypox, the next disease tormenting a growing population. It’s really for the future that Hawaii should have a more robust means of receiving an early warning of pathogens in the environment.

Although the federal Centers for Disease Control and Prevention has a national database that includes some Hawaii sites, the state DOH asserts that a locally managed system would be faster at assessing the disease count in wastewater and getting the information out.

The hope is that DOH can stick to its timetable and have its system operating before fall. Hawaii is already behind other states in doing so, with officials citing the departure of two key laboratory staffers as the reason for the delay. Replacements now have been hired, said department spokesman Brooks Baehr, so they expect to be on board and working toward that goal in the coming weeks.

Baehr said wastewater analysis by the CDC earlier this year was able to detect the variant BA.2 on Kauai long before individual test results could reveal it.

Of course, the assumption was that the mutation would find its way there in the end, he said. While there was no immediate need for an early alert — there is not yet a range of treatments, for example, for specific variants — scientists could develop a way to tailor the public-health response to an emerging threat. Knowing sooner rather than later could become a key advantage.

According to the CDC website (808ne.ws/wastewater), people infected with COVID-19 can shed the virus in their feces, even if they don’t have symptoms. The virus can then be detected in wastewater, enabling wastewater surveillance to chart the disease status, even among those who don’t know they’re affected.

Trends in the virus can be recorded, Baehr said. If virus levels signal a surge, officials could combine them with data from individual tests as a basis for implementing restrictions.

The public has begun to abandon protective protocols such as masking and getting booster shots, he added, so the hope is that additional evidence could prompt a more careful response.

It is not a perfect measure. Patients with different variants shed virus at different rates, so it’s not always clear how many more people may be infected, based on wastewater. It is not a substitute for individual testing — at least not yet.

But what is clear, unfortunately, is the vulnerability of the Earth to the spread of dangerous microbes. There will be other pandemics, perhaps sooner than we might expect. Anything to provide advance notice so that governments and policymakers can get protections in place bolsters public health. If we don’t want to repeat mistakes of the past, this is the time to head them off.