POLITICO NIGHTLY: A Covid test that really stinks

BY MYAH WARD AND RENUKA RAYASAM THE SCOOP ON POOP — Just days after students got back to campus the last week of August, the University of Arizona stopped a Covid outbreak by testing the wastewater in their dorms. Yep, wastewater — all the dirty stuff from the toilets, showers, sinks, washing machines, dishwashers, you name it. Think, the grossest swimming pool you could imagine. Every morning, around the time the majority of students take a shower or relieve themselves after a night’s sleep, a member of the university’s wastewater testing team removes a 250-pound manhole cover outside of a dormitory and gathers a wastewater sample from the sewer, said Ian Pepper, director of the Water and Energy Sustainable Technology Center at Arizona. The samples are taken to a lab to separate the virus from everything else in the wastewater. After Pepper’s team found traces of Covid that first week, the university tested all 311 of the building’s residents and employees. The tests found two asymptomatic students. The university moved them to a quarantine dorm before a larger outbreak occurred. Wastewater-based epidemiology has been used to identify polio outbreaks. Now universities across the country like Arizona, Syracuse and Louisiana State University are using it to try to detect Covid. Days before signs of illness, people shed the virus in their waste, so finding Covid in the wastewater can provide “seven precious days for intervention,” Pepper said. The tests are being used beyond college campuses. LSU, which is working on a system for testing the wastewater in its on-campus buildings, started by testing wastewater for 220,000 residents in Baton Rouge this summer. In early June, as Louisiana’s case rate was tapering off, Gov. John Bel Edwards moved the state into Phase 2 of reopening. “Fourteen days exactly after Phase 2 reopened, the virus levels in the wastewater spiked, hundreds of times,” said John Pardue, an LSU professor of civil and environmental engineering. When Edwards issued a mask mandate in July, the concentration of virus in the wastewater plummeted, Pardue said. A nationwide wastewater surveillance system would have helped the U.S.’s pandemic response, said David Larsen, an epidemiologist and public health expert at Syracuse University. “The Chinese CDC released the genome in January,” Larsen said. A wastewater test in the pandemic’s first months could have served as an early-alert system for where the virus was spreading, he said. “You could immediately say, we have it in these cities. We don’t in these cities.” When used to survey an area larger than a college dorm, the data can’t tell you which households have the virus. But wastewater data has shown officials in Stafford County, Va., that Covid is more widespread than they originally thought, said Jason Towery, the county’s director of public works. Not knowing how to use the data is one of the barriers facing a nationwide wastewater surveillance system, Larsen said. But with a vaccine at least a year away, he said, it is likely to become an important tool for monitoring Covid trends. “Confirming that it’s under control and public confidence that it’s under control,” Larsen said. “That would be huge to get us back to work.” To have a wastewater surveillance point with twice-weekly tests in every ZIP code in the U.S. would cost the government $3 billion annually, Larsen estimates. “It’s really not much. The cost per person monitored is like $10, if that, a year.” The CDC and HHS are working on a national wastewater surveillance system and data portal. The data will be collected from local and state governments willing to provide it, and it will be up to the participants to find partners for sample collection and testing. A nationwide wastewater-testing program that can test for a broad base of pathogens, including the coronavirus, could have been up and running in the U.S. in March, Larsen said. “My kids would be in school right now. Our economy would not have tanked the way that it has.” Welcome to POLITICO Nightly: Coronavirus Special Edition. Reach out rrayasam@politico.com or on Twitter at @renurayasam.   HAPPENING TOMORROW - HOW WILL WE RETURN TO AIR TRAVEL? Air travel has been significantly disrupted by the coronavirus pandemic. The decline in passengers has cost billions — an unprecedented blow to the economy, at home and abroad. As Congress mulls granting an extension in payroll assistance in the CARES Act to U.S. airlines, join CEOs Patrick Steel of POLITICO and Scott Kirby of United Airlines for a virtual conversation about the future of air travel and what it will take to get Americans back into the sky. REGISTER HERE.     FIRST IN NIGHTLY TRUMPCARE — Joe Biden may not be able to unwind everything President Donald Trump has done to diminish Obamacare. Despite Trump’s failure to repeal Obamacare, he’s forced changes on the health care system that Biden will find hard to immediately reverse, if at all: Trump’s expansion of skimpier health insurance alternatives to Obamacare, curbs on reproductive health funding and rollback of contraception coverage have been upheld in the courts. Efforts to reverse those policies are likely to draw legal battles in a court system that will bear the imprint of Trump’s conservative appointees for years, health care reporter Susannah Luthi writes. The unrelenting partisan divide over Obamacare has left lawmakers unable to make minor fixes to the law a decade since its passage, let alone a major revamp of how Americans get coverage. Powerful health care lobbies, despite backing Biden’s call for more Obamacare funding, have been preparing a ferocious assault against the public option, a centerpiece of Biden’s health plan to build on Obamacare. Biden’s campaign and Democratic strategists insist that the coronavirus emergency, which has left millions more jobless and lacking health insurance, has boosted support for comprehensive legislative action on health care. But Democratic health care experts are also zeroing in on quicker, unilateral fixes. Here’s how those experts think Biden could push forward his health agenda without Congress — and where he may have trouble reversing Trump policies. House Republicans gather to introduce their proposed legislative agenda, called the “Commitment to America,” at the U.S. Capitol in Washington. | Getty Images FROM THE HEALTH DESK CAPUTO APOLOGIZES — Top HHS spokesperson Michael Caputo called an emergency staff meeting today to apologize for drawing negative attention to the Trump administration’s health care strategy and signaled that he might be soon departing his role, according to five people with knowledge of the meeting. The departure of Caputo, who has closely controlled the health agencies’ dissemination of information about coronavirus, would be a blow to the Trump administration's efforts to promote a possible vaccine, if one is approved in the fall, Adam Cancryn, Dan Diamond and Sarah Owermohle write. Caputo told staffers that his series of false accusations on Facebook Live this weekend — which included unfounded allegations that the Centers for Disease Control was harboring a “resistance unit” — reflected poorly on HHS’ communications office. He blamed his recent behavior on a combination of physical health issues and the toll of fielding death threats against his family. Caputo also acknowledged that he had never read one of the CDC’s Morbidity and Mortality Weekly Reports, despite his team’s ongoing efforts to try to edit those documents. Caputo told staff that he is scheduled to meet with HHS Secretary Alex Azar later today, the people with knowledge of the meeting said. President Trump — a close ally of Caputo who helped install him as HHS’ communication head this year — is expected to be involved in any decision about Caputo’s next steps. Three people with knowledge of Caputo’s decision-making confirmed he was mulling stepping aside as the department’s assistant secretary for public affairs to take medical leave. One former HHS official told POLITICO that Caputo, a former Trump campaign official, has long complained of the stress caused by having been mentioned in Robert Mueller’s investigation on Russian interference in the 2016 election. During the meeting with his staff today, Caputo made allusions to the fact that HHS had functioned for a long time in the past without a permanent top communications official, said one HHS official. Caputo also disputed anonymous White House criticism about his mental health — saying that some of his comments have been taken out of context — and concluded the meeting by encouraging his staff to listen to music by the Grateful Dead. ASK THE AUDIENCE Nightly asks you: Curbside delivery? Movies released straight to your home theater? Take-home cocktails? What changes from the Covid era do you want to remain, even after a vaccine arrives? Send us your answers on our form, and we’ll feature select responses in Friday’s edition. THE GLOBAL FIGHT LOCKED IN THE CABINET IN DUBLIN — Every member of the Irish Cabinet will have to isolate until they know if an unwell minister has coronavirus, Andrew McDonald writes. Stephen Donnelly, the minister for health, told colleagues he was feeling ill following a full meeting of the Cabinet this morning. He will now be tested for Covid-19. A spokesperson for the Irish Prime Minister Micheál Martin — who is now isolating alongside his ministers — confirmed the government had accepted the advice of Acting Chief Medical Officer Ronan Glynn to avoid unnecessary social contact. The lower house of the Irish Legislature has also been adjourned for the rest of the week. House Speaker Seán Ó Fearghaíl told members from the chair that “there is no possibility of transacting business” with the Cabinet in isolation. The news of Cabinet isolation came as a surprise to some Cabinet members. The Irish Times reported that Justice Minister Helen McEntee had to be informed during a broadcast interview, while another said the move was “news to me.” NIGHTLY NUMBER 8 percent The proportion of employees in New York City who had returned to their offices by mid-August, according to a Partnership for New York City survey. Just more than a quarter expect to be back by the beginning of the year. PARTING WORDS ‘HORRIFIED’ — Jennifer O’Malley Dillon, Biden’s campaign manager, attacked Trump and his team for the packed rallies they’ve recently resumed, warning that “people will die” because of the acute risk of coronavirus transmission at the largely maskless events. In a POLITICO Playbook interview, O’Malley Dillon pointed to indoor campaign events Trump held this week, in direct contradiction of the coronavirus guidelines of his administration. She also brought up the packed event on the South Lawn of the White House where Trump celebrated the normalization of relations between Israel, Bahrain and the United Arab Emirates. O’Malley Dillon added that she was “horrified” to see pictures from the day before of about 100 Trump supporters in a ballroom in Arizona, mostly maskless, for an event billed as a roundtable by a campaign. “People will die because of these types of events and that’s from the president of the United States,” she said.   DON’T MISS OUT ON POLITICO’S AI SUMMIT: How is artificial intelligence redefining the global balance of power? What’s next in Europe’s plan to pass laws for AI? How is the Covid-19 pandemic impacting tech policy priorities? Find out at the POLITICO EU AI Summit on September 30 and October 1. Hear from top global AI leaders such as Michael Kratsios, The White House’s chief technology officer, Margrethe Vestager, European Commission’s executive vice president for a Europe fit for the digital age and Didier Reynders, European commissioner for justice. Register now.     Did someone forward this email to you? Sign up here.   Follow us on Twitter Renuka Rayasam @renurayasam   FOLLOW US

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