'The future belongs to those who PREPARE for it'

RALPH WALDO EMERSON

LESSONS FROM EBOLA

Were not ready for the next epidemic

We're not ready for it. But we can there. get

Bill Gates

March 18, 2015

US. Experts say we're really not prepared.

We've a bad habit of paying attention to pandemics only when it's too late got

By Sigal Samuel

Disease X couldbe the worlds worst nightmare

By Eileen AJ Connelly

An Undeniable Truth

COVID-19 is not the last pandemic of our lifetimes.

We had since 2011 after the MERS outbreak to anticipate and prepare. We failed to do both, and it has cost us dearly.

Though we can't prevent or foresee the next big pandemic, we can set up surveillance networks to track it effectively.

The big question: What infrastructure is needed to track the next big pandemic? What are the ideal characteristics of such a system?

The Future of Pandemic Surveillance

The Ideal Surveillance Network

• Near-real-time feedback and data analysis
• Reusable , replicate its success for future pandemics
• Community-focused , non-invasive monitoring
• IoT Integration into existing surveillance networks
• Sustainable ,The 3 E's: Eco-friendly, Economical, Ethical

We can achieve all the above!

WASTE-WATER BIOSENSORS AS AN EARLY WARNING SYSTEM FOR PANDEMIC SURVEILLANCE

Wastewater Testing Complements Swab Tests



Fecal samples are best suited for large-scale community surveillance

Viral RNA is observed for much longer in fecal samples than throat swabs.

RT-PCR Swab Test

Wastewater Monitoring

• Individual test
• One-time use
• Scarce, costly
• Community-based
• Reusable
• Low-cost at scale
Wastewater Testing : Biosensor vs RT-PCR



Human Intervention

Risk of Contamination

Data Collection and Analysis

Start-up costs and Overhead expenses

No man power needed after the initial setup

Need to gather volunteers for testing everyday



Virus is never exposed to the surroundings

Risk of leaks before/during transportation



Data collected and analyzed in near-real-time

Delay in getting the test results (upto 24 hours)



Initial setup cost and low long term running costs



Scarce resource and expensive during pandemic

LSPR Biosensor: A Schematic



Cost Estimate

Time of Use

50-80 US$ (at global scale)

45-60 Days before LSPR chip replacement

USP

Reusable for all future pandemics!

Automated Wastewater Biosensor: A Schematic


Wastewater Biosensor Network At National Scale


• We place biosensors in sewage plants of local communities
• Data analyses from all communities in a region are aggregated
• Classify regions, states as low/high risk zones based on intensity of RNA vs time curve
LIMITATIONS OF OUR METHOD

PER-CAPITA RNA ESTIMATE

Yet to estimate magnitude of RNA particles excreted by individuals.

SEVERITY OF INFECTION

Severity of infection cannot be estimated with our approach

QUANTITATIVE PREDICTION

A quantitative assessment of virus spread is not currently possible!

We have an answer!

AN EARLY WARNING SYSTEM

• Classifying areas as low/high risk zones , even before infected people are tested Better resource allocation : healthcare
• providers, RT-PCR tests, PPE and more

SHAPING PUBLIC POLICY

• Smart lock-downs , informed public policy decisions , bold leadership
• Predicting future waves of outbreak

The Qualitative Approach WASTEWATER MONITORING COVID-19

Salient Features

SUSTAINABLE SURVEILLANCE

• moderate start-up costs
• low overhead costs
• minimal energy usage
• all materials are recyclable

REUSABLE FOR FUTURE PANDEMICS

• Only LSPR chip + DNA needs to be changed for future use
• Easy to install and can be reused repeatedly

REAL-TIME FEEDBACK FOR COMMUNITY TRACKING

• Near-real-time data collection
• Community-based surveillance
• Scalable, local to global
• Saves thousands of lives!
Proposed Strategy

PHASE 1

Find useful biomarkers in genome of pathogen; Design the LSPR chip

PHASE 2

Install sensors in areas with large population & less reported cases

PHASE 3

Use sensor readings to promote smart public policy decisions

PHASE 4

Periodic wastewater monitoring to prepare for future waves

The Next Big Pandemic

Our lack of pandemic preparedness has caused irreparable damages to our communities.

Our systems must change to adapt to the new reality.

We need reliable, accurate, and sustainable surveillance to combat the next big pandemic.

Every life saved is valuable. Our efforts today will ensure us tomorrow!

References

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