“In essence we can measure in the sewage of a city just about [anything] that your doctor can measure for an individual patient. [Y]ou can think of the whole city as one big organism that has one metabolism. And at the wastewater treatment plant you can think of it as [the] heart where all the fluids from the city arrive and you find all the chemical signatures and profiles.” Rolf Halden, ASU Director of Biodesign Institute, on waste-water tracing
P
andemic waste has largely been framed in popular imaginings as a sense of deficit (Huffstutter 2020), supply chain loss (Yaffe-Bellany and Corkery 2020), or management worry (Seselja and Mackintosh 2021). Wastewater tracing of SARS-CoV-2 viral RNA shed in feces, on the other hand, has gained particular interest and praise as a tactic of revaluing waste and of public health potential amidst outbreak (Bushman 2021; Molteni 2021). In The Ethics of Waste (2006), Gay Hawkins inquires:
“Does the management of shit—a process that is at once technological, governmental, intimate—energize our ethical imagination or numb it?” (48). An excellent question to revisit in an outbreak-centered light. Amidst our pandemic now, sewershed epidemiological tracing trends reflect a complex, sometimes troubling, tool for SARS-CoV-2 management and surveillance.
As the epigram shows, engineer Rolf Halden talks about wastewater tracing using the metaphor of the body as a site for revealing truths about certain exposures, from the chemicals in quotidian products washed down the drain to the microbes we are exposed to, even sickened by. In July 2020, I joined the International Water Association’s COVID-19 Wastewater-based Epidemiology Conference to hear microbiologists speak on global uses of this method. Specialists reported what they found to be positive reasons for the use of wastewater surveillance, including how monitoring is already in established use for tracking polio, norovirus, Hepatitis A, therapeutic drug tracing, opioids and antimicrobial resistance. This occurs on the population level rather than individual testing basis, which some argued might shift stigma away from vulnerable populations or targeted individuals. Wastewater monitoring is seen as complementary to other strategies like testing, vaccines and self-isolation. It reveals important time span differences of viral shedding, providing a snapshot of broader populations from pre/post symptomatic to asymptomatic carriers. This method is prized as an early-warning, potentially more rapid, surveillance system, sometimes a few days to even weeks before clinical evidence (Morvan et al. 2021, preprint); and can be place- or even building-specific, which is why college campuses are especially picking up on its use for living with viruses, aiding in the return to face-to-face campus life. There are now more than 200+ campuses worldwide using such systems (Harris-Lovett et al. 2021).
To return to the Hawkins quote then, in contexts of outbreak, sewer water has very much “energized the ethical imagination” for collective strategies in the name of public health—some researchers and laboratories even pivoted away from other specialties and projects entirely to aid in SARS-CoV-2 tracing efforts (Harris-Lovette et al. 2021). Yet there are also multiple critiques, such as bioethical concerns related to data release and reporting impacts on minoritized communities (Hrudey et al. 2021); monitoring frequency differences affecting the health data snapshots available (Karthikeyan et al. 2021; Karthikeyan and Knight 2021); and concerns over how to best account for viral decay in wastewater which may impact accuracy in detecting presence of SARS-CoV-2 (Weidhass et al. 2021).
What key insights into this methodology can scholars and activists of waste, discard and STS bring to the epidemiological table, and why is it imperative that we do so? Cultural Studies and STS scholars bring specialized attention to long histories of the lack of consent in medical, science & technology practices that may resonate still. We bring knowledge of the disproportionate racialized, gendered and class-based policing of bodies, of neighborhoods and specifically of the waste of targeted communities. We bring a critical focus to the politics of data, to the (sometimes) proprietary biotechnological tools with data interests (e.g. testing kits), and to the bioethical stakes of data’s use. It is imperative that specific neighborhoods or communities are not targeted, criminalized, or disproportionately excluded from access to robust pandemic health resources, as a result of wastewater data release. There are stakes accompanying an epidemiological tracing method praised as useful expressly because it does not require consent, or because it gains in geolocation targeting precision as this UC San Diego study exemplified through automated systems use (Karthikeyan, Nguyen, et. al 2021), even as scientists strategize tactics for increased public engagement, trust-building and human subjects ethics. As public health scholars have pointed out, “environmental scientists and engineers familiar with the techniques required for [wastewater surveillance] have not necessarily had experience with the ethical obligations [of] generating and handling human health data” (Hrudey et al. 2021).
To tussle with the opening epigram about sewers as truth-revealing—the viral politics of wastewater tracing brings waste yet again to the pandemic forefront, revealing a twist in common narratives of waste as loss or devalued materials. The microbial ‘vitality’ made visible, however, is not one-dimensional or monolithic truth. What I mean is: presence of a virus is evidence of something, but what that is and what its presence might mobilize is much more complex. These nuances are crucial because, for instance, identifying information can technically be extrapolated from feces. Bodies do not shed the virus into wastewater in standardized amounts or lengths of time. Sewers are not infrastructurally uniform, if present at all. Current technologies may not have the capacity to detect variants. Stakeholder and data interests in wastewater monitoring are many—sometimes they reflect interest in public health protections and transparent public information, other times they reveal proprietary biotechnology interests or surveillance initiatives with policing or monetary intent (Sulej-Suchomska et al. 2020). Sewer shed data is thus profoundly insightful; but also messy and political, and the fluorescent presence signaling SARS-CoV-2 virus found therein may have multiple truths and intents with varied outcomes.
Acknowledgments
Thank you Society & Space editorial team! Thanks to Eben Kirksey and Alfred Deakin Institute for the invitation to speak on the theme of Viral Politics, which encouraged early musings of this work. Thanks also go to waste expert Angeliki Balayannis for sage revisions advice; and to UCLA endocrinologist Michelle Rensel for her discerning editorial eye on first drafts and generous sense of humor about my scatological research banter.
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Rachel Vaughn is Lecturer in the UCLA Institute for Society & Genetics and Biotechnology Cluster Program. She is coordinator of the Coronavirus Multispecies Reading Group with Eben Kirksey; and her research engages the intersections of Food, Discard, Metabolism and Feminist Science & Technology Studies.
