Tag Archives: hospitals

Fully vaccinated people can shed masks in most places and travel -U.S. CDC

By David Shepardson

WASHINGTON (Reuters) -The U.S. Centers for Disease Control and Prevention (CDC) on Thursday advised that fully vaccinated people do not need to wear masks outdoors and can avoid wearing them indoors in most places, updated guidance the agency said will allow life to begin to return to normal.

The CDC also said fully vaccinated people will not need to physically distance in most places. The agency also hopes the guidance will prod more Americans to get vaccinated.

President Joe Biden emerged at the White House for remarks without a mask. “I think it’s a great milestone, a great day,” he said.

“If you’re fully vaccinated and can take your mask off, you’ve earned the right to do something that Americans are known for all around the world: greeting others with a smile,” he said, flashing a brief smile himself.

CDC Director Rochelle Walensky said the new guidance just two weeks after its most recent update, was based on a sharp reduction in cases, expansion of vaccines to younger people and vaccine efficacy against coronavirus variants.

“We followed the science here,” Walensky said adding, “a coalescence of more science that has emerged just in the last week.”

Biden earlier shed his mask during a meeting with lawmakers, Republican Senator Shelly Moore Capito told reporters. “We heard all about it. The president took his off too,” she said.

Some journalists at the White House also shed their masks.

The CDC had faced criticism, even from public health officials, that it has been too cautious in its guidance. Critics have said people need to see more benefit of getting vaccinated in terms of returning to normal activities.

“In the past couple of weeks, we have seen additional data to show these vaccines work in the real world, they stand up to the variants, and vaccinated people are less likely to transmit the virus,” the agency said in a news release.

It added, “We needed to take the time to review the full body of evidence to get this right, and that’s how we came to this decision.”

‘NEED A REWARD’

Dr. William Schaffner, an infectious disease doctor at Vanderbilt University Medical Center, said he supports the new guidance that many had been calling for.

“People in state health departments and infectious disease doctors have been saying this for some time because they’re so impressed with the effectiveness of the vaccine, and also, they have the feeling that people who are vaccinated need a reward,” he said.

Republican Senator Susan Collins had been critical of the CDC’s delay in revising the guidance.

“Today’s announcement on masks, while overdue, is certainly a step in the right direction,” she said in a statement. “If people find they cannot do anything differently after a vaccine, they will not see the benefit in getting vaccinated.”

The revised guidance is a major step toward returning to pre-pandemic life, but the agency still recommends vaccinated people wear masks on planes and trains, and at airports, transit hubs, mass transit and in places like hospitals and doctor’s offices.

The U.S. government last month extended mask requirements across transportation networks through Sept. 13. Walensky said the CDC plans to soon issued updated guidance for transit.

The new guidance says vaccinated Americans can resume all travel, do not need to quarantine after international trips and do not need to be tested for COVID-19 if exposed to someone who is COVID-19 positive but asymptomatic.

However, Americans still face some international travel restrictions, including non-essential trips to Canada.

Masks became a political issues in the United States with then-President Donald Trump resisting mandating masks while President Joe Biden embraced masks and mandated them for transit hubs. Some U.S. states issued aggressive mask mandates while others declined or dropped them months ago.

The CDC said fully vaccinated people should still wear masks where required by federal, state, local, tribal or territorial laws, and abide by such rules and regulations, including from local businesses and workplace guidance.

In late April, the CDC said fully vaccinated people can safely engage in outdoor activities like walking and hiking without wearing masks, but recommended continuing to use face-coverings in public spaces where they are required.

Walensky said on Thursday immune-compromised individuals should consult doctors before shedding masks and emphasized people who have not been vaccinated should continue to wear them. She added vaccinated people who have COVID-19 symptoms should put masks back on.

(Reporting by David Shepardson; Additional reporting by Steve Holland in Washington and Julie Steenhuysen in Chicago; Editing by Franklin Paul and Bill Berkrot)

Polish hospitals under strain as coronavirus cases hit 2021 record

WARSAW (Reuters) – Poland reported a record number of new coronavirus cases on Wednesday just shy of 30,000, as the pandemic cripples hospitals in some parts of the country and the government mulls sending patients to different regions to help cope.

Poland has been hit very hard by a third wave of cases and a highly contagious variant of the virus first discovered in Britain. The regions of Silesia in the south and Mazowiecki, where the capital Warsaw is located, in particular have struggled.

The government has faced criticism for failing to support the healthcare system as cases rise, while it has called on the public to observe current restrictions more closely.

“Poland’s eyes are focused on Silesia,” Health Minister Adam Niedzielski said on Wednesday, adding that the government was considering moving patients from the south to the east, where more beds are available.

In Silesia, Tuesday data showed that of 305 available respirators, 257 were occupied, while 2,894 of 3,723 hospital beds were occupied.

Doctors said the whole country’s healthcare system was struggling, however.

“We are lacking beds everywhere, let’s not fool ourselves. This is an all-Poland situation,” immunologist Pawel Grzesiowski told Reuters.

On Wednesday the number of occupied beds rose to 26,511 from 26,075, while occupied ventilators rose edged up to 2,537. The ministry said it has 35,444 hospital beds available for COVID-19 patients and 3,366 ventilators.

Poland reported 29,978 new infections on Wednesday and 575 daily coronavirus-related deaths, a record in 2021.

The country has reported 2.12 million confirmed cases overall and 50,340 deaths.

The government ordered theatres, shopping malls, hotels and cinemas to close last week as cases rose.

More restrictions loom ahead of the Easter holidays, typically marked by packed church services and family gatherings in the deeply Catholic country.

“We have to suffocate the third wave. That’s why we will announce new restrictions…that will be enforced during the week before and the week after the (Easter) holidays,” Prime Minister Mateusz Morawiecki told a news conference on Wednesday.

Those restrictions are expected to be announced on Thursday.

(Reporting by Agnieszka Barteczko, Joanna Plucinska, Alicja Ptak and Pawel Florkiewicz; Editing by Andrew Heavens and Hugh Lawson)

France reports 4,246 COVID-19 patients in intensive care, new 2021 high

PARIS (Reuters) – The number of people in intensive care units in French hospitals with COVID-19 rose by 27 to 4,246, the highest so far this year, the health ministry reported on Thursday.

The number of new positive cases also remained on a steadily increasing trend, up by 34,998 to 4.18 million in the second-biggest increase in absolute numbers this year, following an increase of 38,501 on Wednesday.

Compared with last Thursday, the case count was up by 4.8%, the 10th consecutive increase week-on-week, but remained well below week-on-week increases in the range of 20 to 30% ahead of a second lockdown in November.

The virus’s cumulative death toll rose by another 268 to 91,679, ministry data showed.

The government will detail further confinement measures at a news conference at 1800 GMT.

(Reporting by GV De Clercq; Editing by Benoit Van Overstraeten and Alex Richardson)

Portugal’s daily COVID deaths hit record high as hospitals struggle

By Catarina Demony and Miguel Pereira

LISBON (Reuters) – Portugal, initially praised for its swift response to the coronavirus pandemic, recorded a record number of COVID-19 related deaths on Monday as its hospitals struggled to cope.

The Portuguese government, facing concerns over low compliance with lockdown measures brought in last week, also introduced further rules to try to curb the spread of the coronavirus among its population of 10 million people.

Portugal posted 167 COVID-19 related deaths over the last 24 hours, bringing the total to 9,028 since the pandemic began.

“After so many cases, and so many deaths, nobody can … think COVID-19 only happens to others,” Portugal’s Prime Minister Antonio Costa told reporters.

Under the new rules, those not able to work remotely will have to carry an employer declaration and people will not be allowed to travel between municipalities over the weekend.

“You see a lot of people not following (the rules) during this new lockdown,” Anabela Ribeiro, 55, said as she left a busy train station in the heart of the capital Lisbon.

“Stricter measures are needed,” Ribeiro added.

Hospitals are struggling to cope with the soaring number of infections, with Portugal now the country with the highest rolling average of new cases over the last seven days per million inhabitants, ourworldindata.org said.

Portugal also reported a record 664 coronavirus patients in intensive care, just below the 672 maximum allocation of ICU beds out of a total of just over 1,000, health authorities said.

With 6,702 new cases the cumulative tally of infections in the country has now reached 556,503.

“The impact is huge because the number of beds doesn’t increase, the walls are not expandable and health workers are not multiplying,” Antonio Pais de Lacerda, a doctor at Lisbon’s biggest hospital, Santa Maria, said.

Portugal has already nearly doubled the number of ICU beds since the start of the pandemic, when it had just 528 critical care beds and Europe’s lowest ratio per 100,000 inhabitants.

(Reporting by Catarina Demony and Miguel Pereira; Additional reporting by Victoria Waldersee and Patricia Vicente Rua; Editing by Andrei Khalip, Timothy Heritage and Alexander Smith)

No work without COVID test in central Slovakia as hospitals overflow worst-hit region

PRAGUE (Reuters) – Slovaks in the country’s central Nitra region would not be allowed to work unless they have tested negative for the coronavirus as the area’s main hospital was inundated with COVID patients and deaths were high, officials said on Tuesday.

The central European country of 5.5 million has seen record numbers of new cases and hospitalizations in the past days, with 3,146 people in hospitals as of Monday, despite a partial national lockdown.

People from the Nitra region of about 160,000 would not be allowed to attend work as of Monday without a negative test, Prime Minister Igor Matovic told a televised news conference from the central Slovak city.

“The situation in Nitra is so dramatic that only voluntary testing would not be enough,” Matovic said. “This is a better way to protect workers, companies, the health of the people.”

Slovakia has limited movement of people to necessary work commutes, shopping and nature walks within their district, but new cases have remained high, with around 10,000 found on Monday through PCR and antigen testing.

Jaguar Land Rover is the biggest employer in the Nitra region with around 2,800 workers.

Milan Dubaj, head of the Nitra University Hospital, said more than 10 people were dying in his COVID-19 ward every day, and called the situation “desperate”.

“We have around 200 patients, including up to 20 on ventilators, and over 10 die daily,” he told the news conference.

“I am at loss how to describe the psychological and physical exhaustion of our staff … In recent days, our urologist died, a COVID urgent care worker died and at 2 p.m. today, an internist died,” he said.

Slovakia has so far recorded around 2,600 deaths caused by COIVD-19, and over 600 more classified as “with COVID”.

(Reporting by Jan Lopatka; Editing by Steve Orlofsky)

New York, Florida tell hospitals to speed COVID-19 vaccinations or lose supply

By Carl O’Donnell and Jonathan Allen

NEW YORK (Reuters) – The governors of New York and Florida sought to accelerate the slower-than-expected rollout of coronavirus vaccines by warning hospitals on Monday that they would reduce future allocations to those that fail to dispense shots quickly enough.

In New York, hospitals must administer vaccines within a week of receiving them or face a fine and loss of future supplies, Governor Andrew Cuomo said.

“I don’t want the vaccine in a fridge or a freezer, I want it in somebody’s arm,” the governor said. “If you’re not performing this function, it does raise questions about the operating efficiency of the hospital.”

The U.S. federal government has distributed more than 15 million vaccine doses to states and territories around the country, but only around 4.5 million have been administered so far, according to data from the U.S. Centers for Disease Control and Prevention (CDC) released on Monday.

The U.S. government has fallen far short of its target of vaccinating 20 million people by the end of 2020. Officials said they expect the rollout will pick up significantly this month.

Surgeon General Jerome Adams told CBS News that there are 15 million to 20 million doses of vaccine available.

“We should be hopeful about that while acknowledging we have got to do better and we are going to keep doing better,” Adams said. “And I promise you, you will see in these next two weeks numbers increase substantially.”

The United States had reported a total of 20.5 million COVID-19 cases and 351,480 deaths as of midnight on Sunday. On a seven-day rolling average, it is reporting 210,190 cases and 2,636 coronavirus deaths per day.

In Florida, where officials have put senior citizens ahead of many essential workers for getting the vaccine, Governor Ron DeSantis announced a policy under which the state would allocate doses to hospitals that dispense them most quickly,

“Hospitals that do not do a good job of getting the vaccine out will have their allocations transferred to hospitals that are doing a good job at getting the vaccine out,” DeSantis said at a briefing.

“We do not want vaccine to just be idle at some hospital system,” he added, though he did not say they would face fines.

Florida will also deploy an additional 1,000 nurses to administer vaccines and will keep state-run vaccination sites open seven days a week, he said.

New York has dispensed about 175,000 doses of the 896,000 it has received since mid-December, according to CDC data. Florida has dispensed 265,000 of the 1.14 million doses it received.

In New York City, Mayor Bill de Blasio said obstacles were slowing his goal to have 1 million residents receive a first of two vaccine doses by the end of January. A little over 110,000 residents have received their first dose so far, according to city data.

De Blasio urged the state to broaden early eligible groups beyond healthcare workers and nursing home residents to include essential workers such as teachers, police officers, fire fighters, grocery store personnel and people who are more than 75 years old.

New York City currently has 125 vaccination sites and plans to double that by the end of the month, the mayor said.

“This has got to be a seven-day-a-week, 24-hour reality going forward,” de Blasio said.

Monday also marked the first day when some Americans were due to receive their second vaccine shot, three weeks after getting the first dose. Among them was Maritza Beniquez, a healthcare worker in Newark, New Jersey.

“I now have body armor,” she said after receiving the dose in a video posted on Facebook by New Jersey Governor Phil Murphy, who was part of a small gathering that witnessed the event.

(Reporting by Jonathan Allen, Carl O’Donnell, Rebecca Spaulding and Peter Szekely in New York; Additional reporting by Barbara Goldberg, Anurag Maan, Doina Chiacu and Susan Heavey; Editing by Bill Berkrot)

COVID-19 surge pushes U.S. hospitals to brink as 2nd vaccine nears approval

By Susan Heavey and Sharon Bernstein

WASHINGTON (Reuters) – An unrelenting U.S. coronavirus surge pushed besieged hospitals further to the brink as the United States pressed on with its immunization rollout on Thursday and prepared to ship nearly 6 million doses of a new vaccine on the cusp of winning regulatory approval.

COVID-19 hospitalizations rose to record heights for a 19th straight day, with nearly 113,000 coronavirus patients counted in U.S. medical facilities nationwide on Wednesday, while 3,580 more perished, the most yet in a single day.

The virus has claimed over 311,000 lives in the United States to date, and health experts have warned of a deepening crisis this winter as intensive care units (ICUs) fill up and hospital beds spill over into hallways.

“We expect to have more dead bodies than we have spaces for them,” Los Angeles Mayor Eric Garcetti said at a briefing on Thursday, adding that the country’s second-largest city had fully exhausted its ICU capacity.

The number of U.S. cases rose by at least 239,018 on Thursday, according to a Reuters tally, the highest one-day increase since the pandemic began, driving the number of known infections nationally to more than 17 million.

The tolls mounted as U.S. regulators weighed whether to grant emergency use authorization for a vaccine developed by Moderna Inc, just a week after an earlier vaccine from Pfizer Inc and German partner BioNTech SE won consent for mass distribution.

A panel of outside advisers to the U.S. Food and Drug Administration overwhelmingly endorsed Moderna’s vaccine candidate for emergency use after a daylong meeting on Thursday. FDA authorization could come as soon as Friday.

Both vaccines require two doses, given three or four weeks apart, for each person inoculated.

The initial 2.9 million doses of the Pfizer/BioNTech vaccine began shipping on Sunday and were still making their way to hospitals across the country and into the arms of doctors, nurses, and other frontline medical professionals.

Some of the first shots were also going to residents and staff of long-term care facilities. Other essential workers, senior citizens and people with chronic health conditions will be next on the list.

BEDS IN CORRIDORS

It will take several months before vaccines are widely available to the public on demand, and opinion polls have found many Americans are hesitant about getting inoculated.

Some are distrustful of immunizations in general, and some are wary of the unprecedented speed with which the first vaccines were developed and rolled out – 11 months from the first documented U.S. cases of COVID-19.

Health authorities have sought to reassure Americans that large-scale clinical trials and rigorous scientific review found the vaccines to be safe as well as highly effective at preventing illness.

Those messages have been combined with urgent pleas for Americans to remain diligent about social distancing and mask-wearing until immunizations become widely available.

Data shows infections continuing to spread virtually unabated across much of the country, apparently fueled by increased transmissions of the virus as many Americans disregarded warnings to avoid social gatherings and unnecessary travel over the Thanksgiving holiday last month.

California has been hit particularly hard in recent weeks, with many of its hospitals reporting ICUs at or near capacity, a dire situation that triggered a renewal of sweeping stay-at-home orders across much of the state.

“Hospitals and healthcare workers continue to be stretched to the limit, as we continue to surge beyond even what we anticipated. And we’re not even through the holidays yet,” said Adam Blackstone, a spokesman for the Hospital Association of Southern California.

In San Bernardino County, where available ICU space was down to zero, newly admitted patients at Arrowhead Regional Medical Center were lined up in beds in corridors waiting for care, spokeswoman Justine Rodriguez told Reuters.

With the strain taking a growing toll on medical staff, the race to expand vaccinations is seen as critical to preventing a collapse of healthcare systems.

Health and Human Services Secretary Alex Azar told CNBC on Thursday that 5.9 million Moderna vaccine doses had been allotted for state governments to receive and were ready to distribute nationwide starting at the weekend.

The Moderna vaccine has less onerous cold storage requirements than the Pfizer/BioNTech shot, making it a better option for remote and rural areas.

Nevertheless, ambivalence over the vaccine has emerged even among pockets of healthcare workers designated as first in line for inoculation.

“Some are on the fence. Some feel that we need to get it done. It’s split down the middle,” Diego Montes Lopez, 28, a phlebotomist at Martin Luther King Jr. Community Hospital in South Los Angeles, said of co-workers after getting injected himself.

But Dr. Simon Mates, an ICU co-medical director at Dignity Health California Hospital Medical Center in downtown Los Angeles, said the physicians and nurses he knows view the vaccine as having arrived at a crucial moment.

“Our biggest concern was: ‘What if one of us gets sick?’ But now with the vaccine, that concern seems to be ebbing,” said Mates, who learned Wednesday that he had already received the vaccine, rather than a placebo, as a participant in the Pfizer trials. “It’s one less thing to worry about.”

(Reporting by Susan Heavey, Sharon Bernstein, Dan Whitcomb, Manas Mishra, Peter Szekely, Richard Cowan, Susan Cornwell, Lucy Nicholson and Anurag Maan; Writing by Daniel Trotta and Steve Gorman; Editing by Steve Orlofsky, Bill Berkrot, Grant McCool and Richard Pullin)

U.S. hits highest death toll since May with hospitals already full

By Daniel Trotta

(Reuters) -Daily U.S. deaths from COVID-19 surpassed 2,000 for the first time since May and with hospitals across the country already full, portending a surge in mortalities to come as the coronavirus pandemic casts a shadow over the holiday season.

The death toll reached 2,157 on Tuesday – one person every 40 seconds – with another 170,000 people infected, numbers that experts say could grow with millions of Americans disregarding official warnings and traveling for Thursday’s Thanksgiving holiday.

The deadliest day in more than six months was still short of the record of 2,806 deaths on April 14, in the early stages of the pandemic, according to a Reuters tally of official data. That one-day figure is sometimes reported higher due to a backlog of deaths that were not compiled until April 14.

With U.S. hospitalizations for COVID-19 reaching a record high of 87,000 on Tuesday, the nation’s leading infectious diseases official urged people to keep Thanksgiving gatherings as small as possible.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, stressed the need to “hang in there a bit longer” on wearing masks, maintaining distance and avoiding crowds, especially indoors.

“If we do those things, we’re going to get through it. So that’s my final plea before the holiday,” Fauci told the ABC News program “Good Morning America” on Wednesday.

Families with university students have been forced to evaluate the risk of reuniting for Thanksgiving.

Francesca Wimer, a student at Northwestern University in Illinois, flew home to Washington wearing an N95 mask and a face shield and checked into a hotel for 14 days, quarantining to protect her parents and grandparents.

“She was returning to a vulnerable set of people. We didn’t trust that a test was enough,” said her mother, Cynthia Wimer.

Others are just staying put.

Luke Burke, studying at Syracuse University in upstate New York, was planning to spend Thanksgiving with his family in New Jersey until his roommate tested positive last week.

“I’m sorry I can’t be there with my parents, but it’s the right thing to do,” Burke said.

Meanwhile school districts across the United States face pressure from all sides as they grapple with how to educate children during the pandemic, a Reuters survey of 217 districts showed.

Many parents are balking at online instruction, while others worry about sending kids back into classrooms prematurely. Teachers say they are not comfortable teaching in person.

“Every school district across the nation is in the position in which no matter what decision they make and how well thought out it is, it will leave some in the community thinking it’s the wrong decision,” said Larry Rother, senior executive director of pre-kindergarten through 12th-grade educational services in Chandler, Arizona.

Help may be coming with vaccines showing promise.

Officials from the U.S. government’s Operation Warp Speed program told reporters on Tuesday they plan to release 6.4 million COVID-19 vaccine doses nationwide in an initial distribution after the first one is cleared by regulators for emergency use, which could happen as soon as Dec. 10.

If all goes well, 40 million doses will be distributed by the end of the year, they said.

A Food and Drug Administration ruling on emergency use for Pfizer Inc’s vaccine is expected on Dec. 10.

(Reporting by Daniel Trotta, Lisa Shumaker, Gabriella Borter, Lisa Lambert, Kristina Cooke, Benjamin Lesser, M.B. Pell and Simon Lewis; Editing by Chizu Nomiyama, Andrea Ricci and Jonathan Oatis)

With U.S. hospitals overrun, surgeon general urges Americans to ‘hold on’

(Reuters) – U.S. Surgeon General Jerome Adams on Tuesday pleaded with Americans to grasp “the severity of the moment” and remain vigilant against the coronavirus pandemic, as record hospitalizations pushed healthcare professionals to the brink.

“We are almost to a vaccine. … We’ve got new remedies out there. We just need you, the American people, to hold on a little bit longer,” Adams, a White House Coronavirus Task Force member, told Fox News in an interview.

He urged people to adjust their plans ahead of the Thanksgiving holiday on Thursday, which has led to the busiest U.S. air travel since the early days of the pandemic in March, with millions of people flying despite the hazards of a crowded airport. U.S. health officials last week strongly recommended that Americans avoid travel for the holiday.

Global pharmaceutical companies have reported promising trial results in the development of vaccines, which could be administered to high-priority patients in December. Meanwhile, the U.S. government will begin distributing Regeneron Pharmaceuticals Inc’s newly authorized COVID-19 antibody combination therapy starting Tuesday.

But hospitals need immediate relief.

The United States was on pace to surpass 85,000 hospitalizations for COVID-19 on Wednesday, a record, as 30 of the 50 states reported record numbers of patients this month.

That has taxed already exhausted healthcare providers as more than 1,500 coronavirus deaths and 171,000 new cases pile up daily.

After pounding big U.S. cities in the spring, COVID-19 now has engulfed rural and small-town America. Case rates in the 12 Midwestern states are more than double that of any other region, according to the COVID Tracking Project, up more than 20 times from mid-June to mid-November.

Many Midwestern hospitals severely lack beds, equipment and clinical staff, providers say. Some are repurposing areas to accommodate COVID-19 patients or cramming multiple patients in a single room, and are asking staffers to work longer hours and more frequent shifts.

“There’s a disconnect in the community, where we’re seeing people at bars and restaurants, or planning Thanksgiving dinners,” said Dr. Kelly Cawcutt, an infectious disease physician at the University of Nebraska Medical Center. As health workers, she said, “we feel kind of dejected.”

Thirty states had a record number of hospitalized COVID-19 patients in November, including all 12 Midwestern states, according to a Reuters tally of official data. Michigan reported over 4,000 hospitalized COVID-19 patients on Monday, surpassing its previous record on April 13.

“A quarter of all of our coronavirus cases this year have occurred in the last month. … Those cases are turning into hospitalizations and deaths,” Adams warned, saying heart patients, pregnant women and others could be turned away.

“That’s the reality.”

(Reporting by Susan Heavey, Nick Brown and Lisa Shumaker; Writing by Daniel Trotta; editing by Jonathan Oatis)

Sewage testing could protect schools, hospitals from COVID-19 outbreaks

By Allison Martell

TORONTO (Reuters) – Early in the pandemic, a few cities and countries around the world began testing sewage for evidence of the coronavirus, hoping to detect rising infections early.

Now some researchers are fine-tuning that strategy by moving upstream to test waste from single hospitals or other buildings, aiming to quickly pinpoint burgeoning COVID-19 outbreaks and stop them with testing and isolation.

While the virus primarily spreads through droplets expelled from the mouth and nose, it can also be shed via human waste.

Testing sewage is cheaper and less invasive than swabbing hundreds of people, and it could be done more frequently. With the virus again surging across much of the world, schools, hospitals and care homes badly need to catch new cases early.

“What we’re trying to do is identify outbreaks before they happen,” said Francis Hassard, a lecturer at Cranfield University, part of a project that started collecting samples at 20 London secondary schools last month.

Hassard’s UK government-funded team will expand sampling to at least 70 schools. The program is a research project, meant to test the approach, and is not yet a full-fledged surveillance system.

In the Canadian province of Alberta, researchers at the University of Calgary have been gathering samples from three local hospitals, including the site of a recent outbreak in which 12 people died.

The team was still refining their methods when that outbreak began. When they went back to test wastewater, they found the amount of coronavirus genetic material rose 580% as the virus spread, said Kevin Frankowski, executive director of Advancing Canadian Wastewater Assets.

“We saw a very significant change,” said Frankowski. “It was really strong proof that this … approach works.”

The project shares data with Alberta Health Services, which runs the province’s hospitals. If levels spike again, they could respond by testing individuals or taking other steps to mitigate spread, depending on the situation, said Frankowski.

In the United States, professional services company GHD set up wastewater testing at a handful of university residences, and recently started advertising the service to long-term care homes, drawing significant interest, said Peter Capponi, a principal at GHD.

CLOSE TO THE SOURCE

So far, most sewage testing has been done at treatment plants. Dutch authorities publish a national statistic, based on samples from all over the country, and French authorities have cited similar data for months. The state of Ohio monitors water at treatment plants across the state.

However, it can take 24-to-36 hours for waste to arrive at a treatment plant, and heavy rain or industrial effluent can dilute samples.

When viral levels rise at a treatment plant, it is not always obvious what should be done. But when virus material suddenly appears in sewage leaving a single building, the path forward is more clear.

At the University of Arizona, for example, sewage from one residence turned positive on August 25. The next day, the university began testing students. Two tested positive and were isolated, heading off what could have been an outbreak, the school said in a release.

With most of these efforts in early stages, it is not yet clear how well the approach will work at scale.

Not every infected person sheds virus in their waste, and there is some disagreement among researchers on how early in the course of COVID-19 that shedding begins on average.

Human behavior can affect data collection. Do enough children use the bathroom at school to generate good data? The virus does not show up in urine, just solid waste.

There are also logistical issues.

“Buildings have multiple discharge points,” said GHD’s Capponi. “Some of them are not accessible. Some may show up on a design drawing, but were not constructed that way.”

Outside the controlled environment of a treatment plant, sewage is less uniform. Sampling equipment can get clogged with toilet paper and other debris, said Hassard.

And a single “grab” sample might miss the virus. The UK project collects throughout the school day.

Higher-tech auto-samplers can collect waste over a longer period, but are in increasingly short supply as more testing programs ramp up.

MilliporeSigma, a unit of Germany’s Merck KGaA, makes the Centricon P-70 filter used on some waste samples.

The company has doubled production, a spokeswoman said, after an “unprecedented surge in demand” from governments hoping to test for the virus.

(Reporting by Allison Martell in Toronto; Edilting by Caroline Humer and Bill Berkrot)