A gut feeling about wastewater

The ideas and innovators shaping health care

Mar 06, 2023 View in browser   By Erin Schumaker, Ruth Reader and Ben Leonard THE LAB Mariana Matus sees great promise in sewage analysis. | Biobot Analytics Wastewater epidemiology became a useful tool during the Covid pandemic. It could become big business if companies can track disease outbreaks and drug-use spikes — and one day predict them. Mariana Matus is co-founder and CEO of Biobot Analytics, a Cambridge, Mass.-based start-up trying to figure out how to make money analyzing sewage. Erin spoke with Matus about Biobot’s technology. The interview is edited for length and clarity. You were analyzing sewage in 2017, before it was popular. Tell me about how you got started. At the time, the number-one public health priority for the U.S. was tackling the opioid epidemic. We decided to create a product to look at prescription opioids and illicit substances, as well as medication-assisted treatments like buprenorphine or suboxone as a way to surface intelligence as to the type of supply or problem that a community has, as well as the level of treatment it already has. Then Covid-19 hit. We saw the opportunity to demonstrate that our wastewater platform is quick and versatile and can adapt to public health priorities. In February 2020, we decided to build a Covid-19 product. And then it exploded. People embraced the concept that there’s value in waste. It’s one thing to pinpoint an outbreak that’s already happened. But what about predicting outbreaks? It’s still early days, but I think that’s where we’re going. The first positive detections of SARS-CoV-2 in Massachusetts in Boston-area wastewater happened before the first clinical case of Covid was confirmed in the states. With mpox, we’re already seeing detections in wastewater in areas that may have a single clinical case of mpox. It has that sensitivity, which means that we can begin to look at it as a leading indicator. The substance-use side is a different type of technical challenge. On the bio side, there are very robust databases of genomes. On the chemistry side, even though you can create a library of all of the chemistry present in wastewater you don't have the names of them — that doesn't exist. Can we create a panel of detectible substances that we’re concerned about and that shouldn't be here? How do people’s concerns about health data privacy fit into this picture?  I don’t want to minimize it. It’s central to our company, mission and strategy to have that front and center. Fortunately, many aspects of the technology make wastewater epidemiology quite safe. It’s naturally mixed and aggregated data. At Biobot, our roadmap is to look for infectious diseases or substances. We’re not looking for human DNA. We don’t have any sort of objective or product idea about human DNA or identifying people. What would you say to people who are worried about their health data being sold in the future? It’s already been sold. We have customers. The CDC pays, many government agencies pay to get the wastewater analyzed, and to get that data. To us, what that means is that transparency is important with the public. We have a public dashboard through which we try to share data directly with the public. At the moment, it only has Covid and Covid variant data. But it’s our vision that we can really give back to the public by also sharing data with them.   DOWNLOAD THE POLITICO MOBILE APP: Stay up to speed with the newly updated POLITICO mobile app, featuring timely political news, insights and analysis from the best journalists in the business. The sleek and navigable design offers a convenient way to access POLITICO's scoops and groundbreaking reporting. Don’t miss out on the app you can rely on for the news you need, reimagined. DOWNLOAD FOR iOS– DOWNLOAD FOR ANDROID.     WELCOME TO FUTURE PULSE Hershey, Pa. | Shawn Zeller This is where we explore the ideas and innovators shaping health care. A French bulldog that one shelter called “a fire-breathing demon” is reportedly making strides in a six-week intensive training program. There’s always room for growth! Share any thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, host Katherine Ellen Foley talks with Krista Mahr about the new law that makes it easier for doctors to prescribe a lifesaving drug — buprenorphine — to treat opioid use disorder. The catch: The DEA subjects the drug to such strict regulation that many doctors are reluctant to dispense it. PANDEMIC WHO officials haven't gotten much cooperation from China, or the U.S. Department of Energy. | Ng Han Guan, File/AP Photo Everyone, including the World Health Organization, wants to know what prompted the Department of Energy to say late last month that it believes the coronavirus leaked from a lab in Wuhan, China, in 2019. But the DOE, which investigates biological threats, said it made the determination with “low confidence.” It also declined to reveal what new evidence it has. The WHO’s technical lead for Covid, Maria Van Kerkhove, said the WHO has asked for a look and gotten no response, reports POLITICO’s Ashleigh Furlong. “As of right now, we don’t have access to those reports or the data that is underlying how those reports were generated,” said Van Kerkhove. The lack of transparency is not sitting well. WHO Director-General Tedros Adhanom Ghebreyesus called on countries to share any information about Covid’s origins with the WHO and the international scientific community “not so as to apportion blame, but to advance our understanding of how this pandemic started, so we can prevent, prepare for and respond to future epidemics and pandemics.”   LISTEN TO POLITICO'S ENERGY PODCAST: Check out our daily five-minute brief on the latest energy and environmental politics and policy news. Don't miss out on the must-know stories, candid insights, and analysis from POLITICO's energy team. Listen today.     THE REGULATORS The FTC signed off on Amazon's purchase of One Medical, but says Congress needs to make sure tech firms protect patients' privacy. | Getty Images FTC Commissioners want more privacy laws. The Federal Trade Commission decided to let Amazon buy primary care provider One Medical. Now, antitrust regulators cite the deal as reason for Congress to enhance privacy laws. In a statement, FTC Commissioners Alvaro Bedoya and Rebecca Kelly Slaughter outline how holes in the Health Insurance Portability and Accountability Act, or HIPAA, could allow Amazon to access One Medical patient data. When HHS wrote the rules implementing HIPAA, “I doubt that it had reason to anticipate that one day the world’s largest retailer — a company of profound technological sophistication — would amass people’s health information on this scale,” Bedoya and Slaughter wrote, while asking Congress and HHS to consider updating privacy laws to account for the changed climate. A second statement by Bedoya and Slaughter, as well as FTC Chair Lina Khan and Commissioner Christine Wilson, is more of a warning shot. It reminds Amazon and One Medical that both companies have promised not to share personal health data for marketing purposes without explicit consent. It warns both companies that the FTC will enforce that promise. The statements follow an agency settlement with telehealth provider GoodRx, which paid a fine for allegedly misleading customers about personal data it shared with marketers. The agency has signaled more actions along those lines to come.   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun Erin Schumaker @erinlschumaker   Follow us

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