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betsy ladyzhets 📊
@betsyladyzhets.bsky.social
editor/co-founder @thesicktimes.bsky.social & freelance science/health journalist | she/her/🏳️‍🌈| betsy@thesicktimes.org thesicktimes.org/
2.1k followers155 following266 posts

Tomorrow, I'll be interviewing NIH Director Dr. Monica Bertagnolli for @thesicktimes.bsky.social#LongCovid & related diseases. Long Covid community, what questions do you have for Dr. Bertagnolli? Reply here or email me!

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Long Covid Questions for the National Institutes of Health (NIH)?
Ask them in the comments or email Betsy at betsy@thesicktimes.org
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Wastewater surveillance is a key remaining metric for tracking Covid-19 spread. @betsyladyzhets.bsky.social#LongCovidbit.ly/3zPkhCY

graphic reads, “Wastewater surveillance for Covid-19 keeps evolving. Here’s what you need to know. By Betsy Ladyzhets.” The graphic features workers testing wastewater in reflective vests.
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BLbetsyladyzhets.bsky.social

Sharing a relevant section from a story I did for Nature earlier this year that discusses this issue -- www.nature.com/articles/d41...

Interpreting poo
In December 2023 and January 2024, it was
clear that COVID-19 was spreading widely in
several parts of the world. But public-health
agencies had severely cut back on conventional
testing and surveillance programmes,
leading to uncertainty about how much the
coronavirus was spreading, and a sudden
focus on wastewater-based epidemiology.
Some scientists and social-media commentators
stated that SARS-CoV-2 levels in wastewater
correlated with specific case numbers,
estimating huge surges in the United States
and Europe. But others cautioned that wastewater
surveillance is not reliable enough to
predict true infection numbers. There’s a “false...
sense of precision” in such estimates, says Sam
Scarpino, an epidemiologist at Northeastern
University in Boston, Massachusetts, who has
worked on COVID-19 data systems.
Estimates are difficult to make because the
sewage data differ considerably from conventional
health indicators. In typical surveillance,
data represent individual infected people who
can be identified through contact tracing,
isolated and treated. In wastewater surveillance
operations, data can represent entire
communities.
They make “a litre represent a million people”,
says Douglas Manuel, a public-health physician
at the University of Ottawa in Canada.
Manuel and his colleagues have identified several
variables that can alter results from such
screenings; these include population density,
precipitation, sample composition, handling
and testing methods and quality-control measures4.
For example, as snow melts in Ottawa’s
spring, it flows into the wastewater system
and “scours out” solid waste...
To account for those variables, researchers
tend to compare measurements from one site
over time. The US Centers for Disease Control
and Prevention (CDC), for instance, developed
a metric called the wastewater viral activity
level that compares a testing site’s recent
SARS-CoV-2 measurement to past ones, then
averages those comparison values across
larger regions.
These comparison metrics can be helpful
for presenting wastewater results to the public,
but they gloss over the data’s complexity.
Bilge Kocamemi, an environmental engineer
at Marmara University in Istanbul and a project
coordinator for Turkey’s wastewater testing,
says that she quickly realized that “scientific
representation of the data makes the data
unusable for the public”. Instead, she and
her colleagues developed a relatively simple
COVID-19 map: testing sites are displayed in
different shades of yellow and green, depending
on how high SARS-CoV-2 levels are. This
coloured scale is not precise, Kocamemi says,
but...
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BLbetsyladyzhets.bsky.social

I have great respect for the work Hoerger does, but would take his estimates with a big grain of salt. Wastewater experts I've talked to are pretty skeptical about this work b/c there's still a lot we don't know about how viral levels in sewage correlate to illness in the community.

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betsy ladyzhets 📊
@betsyladyzhets.bsky.social
editor/co-founder @thesicktimes.bsky.social & freelance science/health journalist | she/her/🏳️‍🌈| betsy@thesicktimes.org thesicktimes.org/
2.1k followers155 following266 posts