Poop in the Age of COVID-19

How human waste management is essential for global recovery and disease prevention

Unprecedented. The unofficially official 2020 Word of the Year. We have all seen the way that the ‘unprecedented’ COVID-19 has changed the way we do things, affecting everything from business operations to travel to interpersonal relationships to…poop? Yes, that’s right. Poop.

Here are some of the things that the scientific community has observed with regards to poop x COVID-19:

     1. COVID-19: dry cough, fever, and…diarrhea?

While we have been advised to look out for fevers, dry coughs and other respiratory symptoms in the wake of coronavirus, many COVID-19 patients have also suffered gastrointestinal symptoms. A significant portion (in some studies as high as 50%) of coronavirus patients experience diarrhea, nausea, vomiting, and/or abdominal discomfort before the onset, or in absence of, respiratory symptoms. In fact, some COVID-19 patients that were admitted to surgical wards in Wuhan were thought to have abdominal emergencies.

Further research has indicated that these symptoms can be understood by the replication of the virus in parts of the digestive system, like the small intestine. SARS-CoV-2 was seen to readily produce infective virus particles in enterocytes, a kind of cell that is abundant in the lining of the gut.

Gu and co-authors wrote, “Altogether, many efforts should be made to be alert [to] the initial digestive symptoms of COVID-19 for early detection, early diagnosis, early isolation, and early intervention.”

So don’t overlook those upset tummies folks.

     2. You can get COVID-19 through poop.

Several case studies have reported that viral RNA and/or live virus has been found in COVID-19 positive patients’ feces. This suggests that it may be possible to get coronavirus through fecal – oral transmission, not just through respiratory droplets or environmental contact.

This transmission path can be a problem if an infected person goes to the bathroom, doesn’t wash their hands, and then handles food or comes in direct contact with other people (gross!).

Scientists are performing additional research to further understand this transmission pathway and the extent of its risks.

Wash. Your. Hands.

     3. Our poop might test positive even after our nose swabs test negative.

In a study that performed both nasopharyngeal and rectal swabs of COVID-19 patients, not only was the virus consistently detected in the rectal swabs, but those butt swabs also continued to test positive for days after the nose swabs had come back negative. Kang Zhang, a co-author of the study, stated that the findings suggest the need to use rectal swabs in the diagnosis of COVID-19.

Mary Estes at Baylor College of Medicine, Texas said, “Asymptomatic children and adults may be shedding infectious virus and they could transmit it… Physicians and caretakers of potentially-infected children need to be aware that stools might be infectious.”

 Even when the snot is virus free, watch out for the other end.

Photo Credit: Teva Todd

Torres Del Paine, Chile

Here are some of the implications of poop’s involvement in the pandemic:

     1. You should wash your hands. And clean your bathroom. A lot.

Hand-washing is essential to prevent the spread of disease. In the light of asymptomatic fecal – oral transmission of coronavirus, Estes also stressed, “This is another reason to emphasize good personal hygiene.”

One study examined how viral shedding in poop might affect environmental contamination of bathrooms. Samples were found positive from the bathroom sink and toilet of infected patients. However, the good news is that the post-cleaning samples came back negative.

Wash your hands, clean your bathroom, try to avoid public restrooms, and you will be safer from infected poop.

     2. Poop could be key for testing and monitoring.

All of this poop talk opens up the opportunity for sewage surveillance to help with the tracking of infection, spread, and re-emergence of COVID-19. Wastewater and sewage have historically been used to track public health data points in communities, from opioid use to antibiotic drug resistance, and the emergence of novel or known diseases. This tactic looks promising for the current COVID-19 pandemic as well.

Individual human testing for COVID-19 has been challenging due to access, expense, and limited supplies. One study in Massachusetts found that an analysis of wastewater indicated an infection rate significantly higher than what tests had estimated. Similarly, The Netherlands was able to detect the presence of COVID-19 in one city’s sewage system before any cases were officially reported from human testing.

With promising collaborations happening between biotech startups and academia, hopefully we can use the shedding of coronavirus in our poop to our advantage for tracking its impact.

     3. Have you ever heard of fecal plume?

Fecal plume essentially refers to the poop particles that are released into the air when you flush the toilet. Disturbingly, the turbulence of a toilet flush can rocket these particles into the air at a speed of 5 m/s, sending 40-60% of particles well above the toilet seat, up to three feet in the air.

The risk of toilet aerosols isn’t new to us, but it is something we seem to have taken for granted. In March 2003, more than 300 people living in an apartment complex in Hong Kong were infected with the original SARS coronavirus through unsafe plumbing and ventilation systems.

Clearly, some innovation is needed here. Qingyan Yan Chen, an engineering professor at Purdue, is researching the development of ventilation systems for buildings that could help prevent the spread of pathogens.

In the meantime, you can close the lid before you flush, keep your mask on in the bathroom, and, as always, wash your hands!

Photo Credit: Mitchell Gilbert

Ciénaga Grande, Colombia

Here are some of our thoughts on poop in the age of COVID:

     1. Equitable WASH (water and sanitation) is more important than ever.

The United Nations Sustainable Development Goal 6 is to ensure access to water and sanitation for all by 2030. However, the WHO and UNICEF estimate only a 3% increase in safe sanitation over the last 5 years, putting the goal alarmingly off track.

“COVID-19 makes us acutely aware of our shared vulnerability. The consequences of chronic underinvestment in water and sanitation services for billions of people are becoming abundantly clear, ” stated the Chair of UN-Water and President of the International Fund for Agricultural Development, Gilbert F. Houngbo. 

Luckily, this has inspired the development of a new framework to speed up progress: “Yet the extraordinary global disruption offers a unique opportunity to use the framework and get the world on track to deliver SDG 6,” said Houngbo.

Do Good Shit is on a mission to help implement solutions that get us closer to accomplishing these goals.

     2. If we want clean water, we need safe toilets.

While researchers around the world are hurrying to understand the SARS-CoV-2 virus, it is highlighting many of the inequities in our global society; one of these being access to clean drinking water and safe sanitation. 

The CDC eases worries that COVID-19 has not been detected in treated drinking water. However, it has been detected in untreated wastewater. In a world where 673 million people still practice open defecation, this leaves room for concern. While modern sewage systems and wastewater treatment facilities may kill the virus, we can’t help but wonder what the spread of disease might look like in places without this infrastructure. 

As Stanford professor Alexandria Boehm explained, “We usually only worry about viruses in water if they are excreted by humans in their feces and urine. Most enveloped viruses aren’t…so they aren’t usually on our minds when it comes to our water sources. There is increasing evidence that the SARS-CoV-2 viruses, or at least their genomes, are excreted in feces. If infective viruses are excreted, then fecal exposure could be a route of transmission. It’s unlikely this could be a major transmission route, but a person could potentially be exposed by interacting with water contaminated with untreated fecal matter.”

If contaminated water makes its way back into the system for use in cooking, farming, or hygiene practices, it presents a risk of infection. This threat highlights the need to address human waste concurrently with efforts to improve access to clean drinking water, approaching the solution from the source of the problem.

     3. Just wear a damn mask.

At Do Good Shit, our mission is to implement and maintain sanitation solutions that improve the health of communities and the ecosystem. However, our vision goes far beyond that. We believe in a world of positivity where people hold themselves accountable for their impacts, are good to the Earth and to each other.

So please, put on a face covering. It’s really the least you can do.

(And if you or someone you know needs PPE, see below and contact us for a donation.)

Here’s how you can help our efforts as we strive for global recovery and future disease prevention:

  1. Share the Do Good Shit message. Spread the word about our mission, sign up for our newsletter, tag us in your good news stories and photos in our merchandise to be featured on #goodshitdaily
  2. Buy One, Give One mask campaign. Certain populations – including BIPOC and the incarcerated community – have been hit by the ramifications of COVID-19 harder than others. We are working to distribute much needed PPE. When you buy a DGS mask, we give one to our partners at A New Way of Life Reentry Project, Navajo & Hopi COVID-19 Relief, and more.
  3. Donate to our cause. In these times of uncertainty, every contribution makes a difference. As we move forward, our organization is committed to projects that move us closer to equitable sanitation that protects both communities and the environment. 
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