Each week for the past two years, a small vial of the sewage flowing through Spokane’s two wastewater treatment facilities has been collected and tested for COVID-19.
The testing has been an essential tool for the Spokane County Health District’s fight against the pandemic – giving the public health agency aggregate data of the amount of COVID in the city’s water supply and a heads up on any surge of cases.
Now, the health district is expanding its testing capabilities to identify the different variants of COVID-19 that have become all the more important as the virus has mutated. According to health officer Dr. Francisco Velázquez, knowing what variant of COVID-19 is most prevalent in Spokane will allow the public to know if they need to get another vaccine and what vaccine to get.
“COVID has not gone away. But it has changed. We just have different sub-lineages and these changes in the sub-lineages change how the virus acts. Our symptoms aren’t quite as severe. People aren’t seeing hospitalizations, but it is even more present,” he said in an interview.
“At the same time we’re going to see the vaccine change and the vaccine is going to change based on the sub-lineages that are most prominent in your area. And so I think it’ll help people to look at that and think, ‘I need to go get an updated vaccine every year, because look how the virus has changed since the last time I had a vaccine.’ ”
Velázquez also believes the variant data will help him explain to the public why continued vaccination is important even as the threat of COVID has faded from public consciousness.
“You will have new vaccines because the virus is not the same as it was last year,” he added.
Data provided to the Spokesman-Review shows a COVID subvariant referred to as XBB.1.5 as the dominant variant in Spokane County since February. This version of the virus is an offshoot of the Omicron variant and is known for its high level of transmissibility – following the pattern of the virus becoming more transmissible with fewer instances of severe illness. Following this pattern, Velázquez expects new vaccines to be released each year that target these new sub-lineages of the virus that may evade previous versions of the vaccine.
Current COVID-19 vaccines in use are already different than those first released in 2021, which were more effective at combating the Delta and original Alpha variants. Earlier this year, the FDA amended authorization for this original vaccine in favor of a bivalent that contains new mRNA components meant to tackle these new strains.
Beginning July 28, Spokane residents will be able to view weekly updated variant data on the health district’s online COVID-19 dashboard, which was previously updated only with seven-day increments of hospitalizations and the prevalence of the virus in Spokane County wastewater. That data shows a general dropoff of both metrics in 2023 compared to last year before a slight uptick this summer.
Velázquez said the increase of cases was anticipated and seen across the United States.
“Everybody is together in the summer. You know, people are traveling to family gatherings, at parties, and are in close proximity. And the virus follows those same patterns,” he said.
The health district was in part able to anticipate these COVID trends because of its wastewater surveillance program. Sewage is collected at the county facility two to three times a week into 500 milliliter vials that are then sent and tested at the state Department of Health. Once analyzed, that data is sent back to the district.
Because wastewater flows through two facilities that treat the whole county, the Health district is unable to pinpoint how much of certain COVID variants come from a specific area of the city. A joint venture with WSU could lead to sewage samples taken from manholes in specific neighborhoods.
Health district spokesperson Kelli Hawkins said the agency is playing a supporting role in the collection and testing of the samples at a WSU lab in Pullman.
“The goal is to provide a better outbreak response to those areas that show a higher rate of disease burden,” she said.
The state Department of Health is also planning to expand its wastewater surveillance system to track the flu and RSV.
Once this is in place, it will allow the Health District to “create an accurate picture of what the three main respiratory viruses are doing at any particular point in time in Spokane,” according to Velázquez.
“And that is very important, particularly for healthcare, because that’s how they project and predict what they need to have in terms of resources at a clinical level.”