During the COVID-19 pandemic, wastewater monitoring and analysis became an important tool in monitoring and measuring the amount of virus in communities.
But some experts caution that the data collected from these studies may also raise privacy concerns, especially because samples are often collected from public sources without personal consent.
“Bioethics, which is what health care providers do, has historically been based on ‘do no harm’—and based on the idea of informed consent,” said Steve Hrudy, professor emeritus at the University of Alberta’s Department of Laboratory Medicine and Pathology. “Well, informed consent isn’t really possible for this kind of technology.”
Hrudey is chair of the National Research Advisory Group for the COVID-19 Wastewater Coalition, a non-profit group established in the spring of 2020 to help build and share information about wastewater monitoring efforts across the country .
Hruday. A 2021 paper co-authored by and six other researchers recommended that wastewater monitoring programs for COVID-19 follow a list of 17 guidelines for ethical public health surveillance presented by the World Health Organization.
Those guidelines suggest that monitoring programs should adhere to four main goals: working toward the common good, equality, respect for individuals, and good governance.
“The case for maximizing the potential of this approach is compelling, but the benefits of wastewater monitoring clearly must outweigh the ethical risks to the community,” reads the paper.
poop doesn’t lie
Humans can shed the genetic material of the SARS-CoV-2 virus in the form of RNA. Sometimes the virus can be detected in samples of human wastewater before a person displays symptoms of the disease.
“If you’re flushing it right away, within days of being infected, that information is already being flushed down the toilet. [and] traveling to your wastewater treatment plant, where it’s being collected and analyzed, you know, us or someone like us,” said Newsha Gheli, co-founder of wastewater epidemiology company Biobot Analytics Told.
Gheli, who studied in Waterloo, Ont. and Montreal before co-founding Biobot in the US, said the technology used by her company can currently detect a positive case in a sample of a population of 6,500 people.
This data has become increasingly important as provinces and territories reduce access to PCR tests in late 2021, particularly as the Delta and subsequent Omicron waves saw significant spikes in reported and suspected positive cases.
Experts like Gheli say the data may be very accurate, but there is no way to identify a person, even if they detect a single positive case.
Your stool does not contain identifying information, such as fingerprints, as it was.
“When we get a positive test, we don’t know what it came from. You know, it’s like saying, ‘Oh, we have a lot of cars on 401s today.'” You have no idea who is driving those cars,” said Kim Gilbride, a professor and molecular microbiologist in Toronto Metropolitan University’s Gilbride Lab for Wastewater Monitoring.
sludge life, feces pellets
Gilbride’s lab analyzes samples of sewage that are delivered from the Greater Toronto Area: some from hospitals, long-term care homes, while others come from the Humber wastewater treatment plant.
Those bottles are mostly filled with cloudy water, but some of them are more opaque and are labeled “sludge”.
“When you open one of them – yes, you have to duck for cover,” said Babneet Channa, a research assistant who helps process the samples.
Channa and another assistant, Matthew Sentilly, work mostly with equipment that is fitted with a fume hood to expel those odors. They put the samples into test tubes that spin inside a centrifuge – rendering the sludge into a relatively inert, pea-sized pellet for analysis.
“It’s anonymous. We don’t really, like, go after people and say, ‘It’s you,’ you know, or ‘This is your house,'” said Nora Danna, a post-doctoral researcher who also works in the laboratory.
Data can help or hurt people in the neighborhood: Hruday
That’s not enough to assuage the concerns of Hrudy, who says “you can zero in on very small areas” if samples are identified and collected from specific sewer networks in a city.
With narrow enough data, public health officials can deploy to neighborhoods to prevent the outbreak from spreading further. But it can also be misused to stigmatize the people who live there — or worse, Hruday warned.
It is not even purely theoretical, he said.
there has been Cases in Hong Kong and Singapore Where wastewater monitoring has been used in apartment buildings and then officials track positive samples from individual apartments, Hrude said.
“The officers showed up and said, ‘Well, you know, you have a case here and you need to get tested,'” he said.
“Now, you could argue that there is a public health rationale for this. But you can see that a slippery slope is possible.”
Hrudy also said he has seen a draft research proposal suggesting that it may be possible to chart the infection rates of neighborhoods with COVID or other traceable diseases in blocks.
“It was in enough detail that you could almost identify the street address,” he said.
However, he insisted that the proposal was theoretical – presenting only what may be possible – and did not know whether anyone in Canada had attempted it or used it to provide access to private citizens’ data. .
“Health officials are bound, at least in Alberta and I suspect in most provinces, by very strict privacy laws relating to personally identifiable health records,” he wrote. sunday magazine In a follow-up email.
He is not alone in raising these concerns.
A 2021 article in the European Journal of Law and Technology, by Dutch scientist Bart van der Sloot, shows a potential future use that almost read like science fiction: wastewater monitoring robots that can crawl through residential pipes , can take samples from the same road or even one. single house.
Gheli agrees that there is a need to lay down a more definitive ethical ground for how wastewater monitoring is used – and the latter instead. But we’re not there yet, she said.
“I think within a year or two we will be in a different place, because it is absolutely necessary for us, I think, to talk through and solve these difficult questions,” she said.
With files from Peter Mitten. Radio segment produced by Peter Mitten.
