Chesterton Tribune

 

 

CHS grad Dr. Doug Brackney on the cutting edge of C19 research

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By KEVIN NEVERS

Arguably the greatest challenge faced by public health officials in their efforts to get a leg up on COVID-19 is that gaping window--between five days and as long as two weeks--before an infected person begins presenting symptoms.

In the meantime, the presymptomatic carrier--possibly a mask refusenik, possibly a superspreader--becomes one more vector in the pandemic, until of course he or she becomes an actual patient. It’s this lag between infection and symptoms which has caught so many communities’ healthcare systems by nasty surprise, as waves of folks who were fine yesterday but sick today converge on ERs, clinics, or their primary care physicians.

Now, however, 1997 CHS graduate and virologist Dr. Doug Brackney may have found a way to close this window somewhat: by sampling the primary sludge at wastewater treatment plants and testing for the novel coronavirus.

Chinese researchers discovered early on not only that the live coronavirus can be found in patients’ feces but that its RNA can be too. At the time the lesson learned was that fecal contamination could be a common vector of transmission, in communities with poor sanitation or inadequate plumbing.

But Brackney and his colleague Jordan Peccia, a professor of environmental engineering at Yale University, wondered whether another lesson might be learned as well: namely, whether the viral RNA could be detected in the primary sludge at wastewater treatment plants, and if so whether a “community level transmission” could be extrapolated from that viral presence.

Another way of putting it: whether viral RNA concentrations in primary sludge could provide an early warning of an impending outbreak in a community.

Brackney and Peccia’s finding: that indeed they can.

Brackney is neither an epidemiologist nor an environmental engineer. He’s a virologist who wrote his dissertation at Colorado State University on the dengue virus, did a post-doc at the University of New Mexico on the West Nile virus, and is now studying virus-vectors--arthropods like mosquitoes, fleas, and ticks which transmit pathogens to animals--as an associate scientist at the Connecticut Agricultural Experiment Station. Then came C-19 and his team’s research, like the work of a lot of other people, became temporarily non-essential.

“When the SARS CoV-2 pandemic exploded, like most of society all labs were required to cease work on current research projects except those studying SARS CoV-2,” Brackney told the Chesterton Tribune. “I felt like I had a skill set that could be useful in these times, so I reached out to a friend and colleague at Yale University and asked if there was a way I could apply my expertise and skills to help the research efforts. He put me in touch with Jordan Peccia.”

The result of their collaboration: “SARS CoV-2 RNA concentrations in primary municipal sewer sludge as a leading indicator of COVID-19 outbreak dynamics,” posted on May 22 by medRxiv.

The study worked this way: between March 19 and May 1, Peccia’s lab collected and processed samples of primary sludge--the solids which have settled out of raw wastewater--from the treatment plant serving New Haven, Conn., a community of around 200,000; Brackney performed diagnostics on the samples; and a team of epidemiologists did the modeling.

The math in their paper is way beyond the ability of a Chesterton Tribune reporter to wrap his head around, but the result is straightforward: concentrations of the novel coronavirus RNA in the primary sludge matched the epidemic curve “perfectly,” Brackney said, but with one key difference, that those concentrations began increasing seven days before the number of reported C-19 cases did, and three days before the number of hospitalizations did.

That’s a full week of lead time for local healthcare systems to batten their hatches and for public health officials to make their dispositions. Also, as Brackney noted, falling or rising concentrations of the viral RNA can be used “to inform public health policies, such as lifting or imposing restrictions.”

Brackney does offer a couple of caveats. For one thing, primary sludge testing “might not be effective in rural areas where many homes have septic systems.” For another, “this approach does require trained professionals to collect and collate the data as well as specialized instrumentation.”

Still, Brackney said, “this approach can easily be scaled up cheaply” and prove “a cost-effective approach for surveillance of large populations.” He even foresees--as a hack to the problem posed by the need for high-tech instrumentation--a “statewide system where samples are sent to a centralized lab and processed the same or next day.”

Their paper itself suggests one more advantage of this surveillance method: it could be used “to preempt community outbreak dynamics” especially in places where there is limited clinical C-19 testing capacity.

Not every scientist has the opportunity to participate in game-changing research of any kind. Even fewer have the opportunity to level the playing field amid a public health crisis of this magnitude. So Brackney is delighted to have had the chance to play his role.

“This was a great collaborative effort of numerous world experts in virology, epidemiology, and environment engineering, and I am happy to have been able to contribute to this potentially transformative approach for surveillance.”

 

Posted 6/16/2020

 
 
 
 

 

 

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