Everyone poops. I learned that from children’s books from when my kids were little. I’ve also earned a living learning that lesson (i.e I’m a gastroenterologist). Since COVID is shed in poop, one way to track population experience of the pandemic is by testing wastewater. In communities throughout the country, public and private enterprises have undertaken testing sewage to estimate COVID burden. (Of course none in Texas where we are good about denying the pandemic exists or is spread via respiratory droplets).

I first learned about this when our family was in Park City, Utah a couple of weeks ago. In that state, Brigham Young University, the University of Utah, and the State of Utah have been measuring COVID burden in wastewater since late 2020. Their findings mirror others that COVID burden in wastewater increases predictably before each surge and also predicts when a surge has peaked. For example, a news report from UCSD in San Diego (where I trained in gastroenterology) along with the San Diego Health Department from December 19, 2021 declared they saw more COVID in their wastewater then they had ever seen since the pandemic started. Sure enough within 2 weeks, California experienced the Omicron surge which has been the largest surge of hospitalizations since this whole thing started. Furthermore, reports from other communities from wastewater testing suggest that the burden of COVID is 3 to 5 times what is reported. Certainly, this goes along with observations that many if not most people with mild symptoms are not even testing. So there are many more Americans positive for COVID than we see on news reports. Evidenced through high COVID loads in the wastewater.

Wastewater testing is also bringing us some room for optimism. In Boston and Denver, sewage COVID loads are starting to decline suggesting that the peak of hospitalizations may have been reached in those communities. Hopefully that will trickle down to rest of the country.

I’m proud of the data that poop testing is bringing to interpreting the pandemic. I’ve always said about poop: “Dare’s gold in dem dare hills!”