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As COVID-19 infections rise again at an alarming rate, Chicago is scrambling to catch up with other cities that are forecasting outbreaks by analyzing human waste that has been flushed into thousands of toilets.

Signs of the novel coronavirus appear in the sewers about a week before hospital immersion with symptoms of the disease, which has killed more than 1.3 million people worldwide in the past nine months, including 246,000 in the US.

To give doctors and nurses more time to prepare for outbreaks, 20 communities in 43 countries are collecting wastewater samples and posting graphs showing changes in the genetic signature of the SARS-CoV-2 virus over time.

Researchers from four universities and the Argonne National Laboratory are rushing to add Chicago to the list early next year.

“It is much more efficient to test wastewater from a neighborhood where a few samples can repeatedly test 500 people,” said Sam Dorevitch, a researcher from the University of Illinois at Chicago who was involved in the project.

Chicago research is part of a rapidly growing effort to streamline the methods used for decades to track disease and pollution. The sewage monitoring helped investigators track a 2013 polio outbreak in Israel and more recently directed social services in a handful of American cities hit hard by the opioid epidemic.

New studies that focus on the coronavirus are based on flat, scientifically acceptable jargon. However, a wastewater testing company founded by researchers at the Massachusetts Institute of Technology is more direct, mirroring potty training books for toddlers.

“Everyone poops and pees every day,” explains Biobot Analytics from Cambridge on its website. “This information is an indication of our health and well-being as a community.”

Based on interviews with a dozen scientists and government officials tracking the coronavirus, one of the biggest challenges seems to be determining where to collect wastewater.

Chicago’s sewage maze winds more than 4,500 miles under the city’s streets. It’s split into the Chicago Department of Water Management and the Metropolitan Water Reclamation District, two agencies with a history of bureaucratic turf wars and a reputation for blaming each other when the system fails.

District officials send samples from three sewage treatment plants to researchers at Stanford and the University of Michigan on a weekly basis. These samples will be passed on to the group of universities in Illinois, who will use computer models to estimate where neighborhood-level samples could identify virus hotspots.

“Elsewhere, they followed the initial wave and how the lockdown reduced the SARS-CoV-2 signal in wastewater,” said Aaron Packman, an environmental engineer from Northwestern University. “It has picked up again after states and cities eased their lockdowns.”

Boston and Tempe, Arizona, are two of the U.S. cities ahead of Chicago, largely because both had studied opioids in wastewater well before the pandemic began.

The pioneers also focused on informing the public of the results, and pondered how to debunk inevitable conspiracy theories.

“We stress that we are not testing to the level of an individual homeowner,” said Rosa Inchausti, Tempes director of strategic management and diversity. “However, when we saw a (coronavirus) surge in one of our neighborhoods, we told people they were at higher risk, flooded the area with masks and encouraged testing.”

Regular monitoring of Chicago wastewater could help determine if face-to-face contact needs to be restricted in certain neighborhoods. After vaccines arrive, wastewater tests could mark parts of the city left behind for vaccinations.

Behind the scenes, there’s an interesting competition between researchers and tech startups looking to discover fast, innovative methods that are easy to replicate – a grail packman described as more TikTok than MySpace.

The Chicago Project, funded with a $ 1.25 million grant from the Walder Foundation in Skokie, also includes researchers from the University of Chicago and the University of Illinois at Urbana-Champaign.

Another group of scientists, led by Julius Lucks, professor of chemistry and biotechnology in the Northwest, is perfecting a method that involves adding a few drops of wastewater to a test tube that contains a reagent for the coronavirus, which may speed up test results .

Biobot, the Massachusetts startup, is conducting tests and graphing the COVID-19 signature in Boston and more than a dozen other communities.

“The virus has educated the country about the potential of this technology to improve public health, among other things,” said Mariana Matus, co-founder and chief executive officer of the company. “It could help policymakers decide whether it is safe to send children to school or open restaurants. In other words, if it is okay to resume normal life.”

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