Israel takes crack at sniffing out COVID outbreaks in people’s poop

14 cities to have their sewage tracked in a bid to spot virus spikes early; university deploys toilet analysis to find dorms with infection before it spreads across campus

Nathan Jeffay is The Times of Israel's health and science correspondent

The installation of sewage-monitoring stations at the Technion-Israel Institute of Technology (courtesy of the Technion-Israel Institute of Technology)
The installation of sewage-monitoring stations at the Technion-Israel Institute of Technology (courtesy of the Technion-Israel Institute of Technology)

Citizens of 14 cities will be able to do their civic, er, duty to help identify early COVID-19 outbreaks by simply visiting the john, as Israel launches a pilot program to analyze sewage for signs of the coronavirus.

The program will also include the campus of a university, which believes it will help to ensure a safe return to studies.

Early in the pandemic Israeli scientists developed the know-how to document where outbreaks are occurring based on the level of genetic material or proteins of the virus found in feces. They said that as the virus can show up in feces very early after infection, it has significant potential as an early-warning system as local outbreaks are just beginning.

But the government didn’t implement monitoring programs, and the technology was stuck for months at the stage of research and a single-city pilot in Ashkelon.

Now, sewage from Jerusalem, Kfar Saba, Netanya, Beersheba and 10 other Israeli cities is being analyzed, after the Health Ministry agreed to fund a large pilot project with a view to rolling out tracking nationwide.

Doctoral student Karin Yaniv analyzes samples from Israel’s new tracking system at a lab at Ben Gurion University of the Negev (courtesy of Ben Gurion University of the Negev)

Meanwhile, the Technion – Israel Institute of Technology in Haifa has privately installed infrastructure across its student accommodation that collects sewage samples every half-hour,  to catch outbreaks before they spread across campus.

The Technion, the first Israeli university to monitor student sewage, is following in the footsteps of an estimated 65 American colleges that are doing so.

Both tracking programs are based on research by the same academic team, and one of its members, Eran Friedler, told The Times of Israel that they are “significant tools” in Israel’s virus fight, adding: “The second wave is now diminishing and it’s exciting that, if the examination of sewage in cities is successful, monitoring stations could be rolled out all over the country and early warnings will be provided to help prevent large outbreaks.”

Regarding the campus tracking at the Technion, where he is associate professor of Civil and Environmental Engineering, Friedler said: “Thousands are students are due to return to campuses, with some of them already back, and this can be very useful in allowing this to happen as safely as possible.”

One of the key experts focused on the urban program already has a reputation for fighting disease through sewage monitoring. During a polio outbreak in 2013, Ben Gurion University industrial engineering professor Yakir Berchenko tracked the extent of polio in sewage, and gave health services time to run a vaccination campaign before the disease paralyzed any children.

Engineers work on a new set of underground sewage pipes in Netanya (Photo credit: Chen Leopold/Flash90)
Illustrative image: engineers work on a set of underground sewage pipes in Netanya (Photo credit: Chen Leopold/Flash90)

The coronavirus project in cities, which started a few days ago, is led by Ben Gurion University of the Negev. It is a collaboration with Friedler, Dr. Itay Bar-Or, a virologist from Sheba Medical Center, and the company Kando. It is similar to sewage-monitoring programs that are being trialed in other countries.

The program has been designed to guide Health Ministry virus-fighting efforts, for example by prompting large-scale testing and concentrated virus-prevention efforts in areas where sewage shows signs of coronavirus outbreaks.

But Friedler said that during the pilot program phase, scientists will still be perfecting data-crunching methods. This means that the Heath Ministry isn’t relying on sewage data, but could well pay attention if outbreaks are spotted.

Eran Friedler (center) of the Technion-Israel Institute of Technology, with colleagues (courtesy of the Technion-Israel Institute of Technology)

At the Technion, automatic sampling stations have ben set up across student accommodation. Bathrooms near lecture theaters and other public areas were going to be included but were omitted when researchers concluded that “people refrain from defecating in public toilets,” said Friedler.

He stated: “Samples are collected every 30 minutes, and twice a week we’ll be taking them for analysis. If there are outbreaks we’ll know where they are by dormitories. We can also get a sense from the levels of coronavirus traces found regarding how serious an outbreak we are experiencing.”

“The alert will prompt us to go in to the relevant dormitories to perform swab tests and also warn people. None of our monitoring efforts are intended to replace existing methods used against the virus, but they have the potential to give early warning and help allow other tools to be deployed effectively.”

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