Solid Evidence

Nothing specific about SC2 lineages. I can tell you about every single virus in their sewershed though. Lots of fish viruses.

Three more BA.3.2 detections from US wastewater. Rhode Island (different sewershed, but near the previous one), Vermont, and Florida. All from CDC NWSS data.

Looks like it might be getting a foothold in New England.
@snpoehlm.bsky.social @ryanhisner.bsky.social @siamosolocani.bsky.social

Not yet.

Ahh, OK. I know I piss people off sometimes, but I usually know when I do it.

Who is 'she'? Neither Poncin, nor Tehilah seem to have blocked me.

Who were you responding to? It just says 'post blocked' on my screen. Must be someone I pissed off already.

Does anyone know what strain of H5N1 is responsible for the most recent poultry outbreaks, particularly in Indiana? D.1.1 I presume?

Claude

I don't follow. When I detect something from a single person it's crossing the line? I've detected measles before that I'm pretty sure is from a single person, did that cross the line too?

I was abbreviating the process. You narrow the pool with wastewater, and then have an IRB to get informed consent from people in the remaining pool (which is what we did before).

The question of whether we should do it still stands.

And followup, how much can we appropriately narrow the pool?

But that's the difference, we can't identify subjects from the wastewater. All we can do is narrow the pool, the question is how far we can narrow it before we are required to get consent.
CDC is already publishing data from sewersheds under 1500 people, so I know we can narrow it that far.

FWIW

There has got to be a line, but I don't think it's really been established where that line is. I was just polling to see how most people felt about it.

no

It's an environmental sample. I've talked to our IRB about it and they always tell me to go away. Unless you take the sample from a household that has only one person you can't pin it to a person.

I agree. Wasn't sure before, but I think BA.3.2 is probably going to start accelerating.

What if it were smallpox?

'there are clear, established, rules of this.'

Really, where? What is the line? 1,000 people? 100 people? 10?

It's very unlikely you would be able to get it down to a single person with WW, but you could narrow it down to a small enough number that you could get informed consent.

This is a hypothetical, we aren't doing it.

We have an IRB to get consent for individuals providing samples, but that's from individuals. It would not be possible to get consent from 100k people.

So there is an expectation of privacy with wastewater but not with trash? Either way it can never truly be traced to a person without a sample from the person, which falls under HIPAA.

Depends on the underlying condition but it's not accurate to automatically assume there is nothing they can do.

I get your point, but I do have a hard time reconciling the inconsistency with what is the legal and accepted norm with other forms of household waste.

Why is wastewater different? It's an obvious question that someone needs to ask sooner or later.

Do they get the point even though they didn't notice there was BA.3.2 in the plane waste until I pointed it out?

We had no approved IRB to test them at the time.

There's no test that doctors can even order to test for SARS-CoV-2 in stool.

It's possible that they suspect it, but unless they enrolled in my study, they would have no way of knowing if it's true.

Sure it could be the health department that reaches out, that's how it was with the Wisconsin lineage. You have to find them first though.

That almost sounds worse. Everyone in that little neighborhood would know about it and would be speculating about which one of them it was.

I would want to know. The solution depends on the underlying issue. It could be a something like transplant patient whose immune suppressing drugs are set too high. They probably think they have IBD or something and have no idea of the real reason.

Do you think it would be morally and ethically correct to track them down through wastewater to let them know?

3/3

Today, there is a person in Lincoln, NE that has had COVID for at least 4.5 years (probably in their GI tract) that almost certainly does not know they are infected.

We see the lineage every week. It would be easy to track them, at least from a technical perspective.

2/