Monitoring COVID-19: Could medicine found in wastewater provide an early warning?

In a pilot project exploring ways to monitor COVID-19, University at Buffalo scientists hunted for pharmaceuticals and viral RNA simultaneously in wastewater in Western New York.

The results of their study, published on May 18 in the journal Environmental Science & Technology Letters, suggest that measuring the concentrations of medicines in wastewater could add another layer to disease-monitoring efforts.

“Wastewater-based disease surveillance is being done worldwide through monitoring of viral RNA,” says lead scientist Diana Aga, PhD, director of the UB RENEW Institute and Henry M. Woodburn Professor of Chemistry in the UB College of Arts and Sciences. “The potential of complementing existing efforts with detection of pharmaceuticals is exciting. There are a lot of opportunities here, though more research is needed.”

One interesting discovery in the new study involves acetaminophen, a pain reliever and fever reducer that serves as an active ingredient in over-the-counter medicines such as Tylenol, Theraflu and other brands.

At all four wastewater treatment plants included in the project, the research found that acetaminophen concentrations in wastewater spiked before other measures of COVID-19 in the community in early 2021, including concentrations of COVID-19 viral RNA in wastewater and the estimated number of confirmed COVID-19 cases.

For example, at the Bird Island Wastewater Treatment Plant, which serves Buffalo and some surrounding suburbs, acetaminophen levels in wastewater spiked about two weeks earlier than levels of SARS-CoV-2 RNA in wastewater. The spike in viral RNA, in turn, preceded the spike in the estimated number of confirmed cases of COVID-19 by about a week, scientists say.

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