UofL detected the variant, a Brazilian strain known as P.1, early in April in a wastewater sample from western Jefferson County. Once researchers received the results, they alerted the Louisville Metro Department of Health and Wellness as well as the state, which confirmed a positive case in the same zip codes with different testing methods a week later.

“The ability to detect viruses early, such as in this case, gives officials more time to take precautions and contain their spread,” said Aruni Bhatnagar, professor of medicine and director of , which leads the wastewater research. “With pandemics, every second counts. In as little as one week, the virus can spread significantly, and then it becomes much harder to contain. This work gives us more time and an opportunity for targeted testing.”

UofL researchers began testing wastewater last year as part of the , a groundbreaking partnership to track COVID-19 in Louisville Metro.

The Louisville/Jefferson County Metropolitan Sewer District has sent weekly samples from 12 sites representing multiple neighborhoods and five wastewater treatment facilities that aggregate the entire county.

Those samples are taken to the , where pharmacology and toxicology assistant professor Josh Fuqua and his team process the samples and isolate viral RNA, and to the UofL Genomics and Bioinformatics Core facilities, where computer science and engineering professor Eric Rouchka analyzes the virus sequences to detect variants.

UofL recently announced the expansion of this work, backed by an . That expansion goes one step further than previous work — from identifying whether disease exists in a neighborhood to estimating how prevalent it is there.

Bhatnagar said understanding that connection could “revolutionize the way we track and contain pandemics, and not just COVID-19.”

Rather than rely solely on direct testing, such as with nasal swabs, wastewater testing can give health departments another tool to gauge the severity of community infection and to identify areas where the infection is prevalent. The tool also is faster, more efficient and less invasive.

“This is cutting-edge work – and the fact that it’s being done right here in Louisville – right here at UofL – places us at the forefront of public health innovation,” said Louisville Mayor Greg Fischer. “It shows we’re doing the work to keep our city and cities around the world safe.”

Since the beginning of the pandemic, the Co-Immunity Project has conducted ongoing testing and surveys to better understand the spread of the coronavirus and COVID-19. In the past year, UofL researchers have tested more than 12,000 people for COVID-19 infection and antibodies, beginning with frontline health care workers. They also have worked to gauge how local citizens feel about COVID-19 vaccines, with 91% of Jefferson County residents in a recent poll saying they would like to be vaccinated.

“This is one more example of how UofL has led the charge in finding new and innovative ways to detect, contain and fight COVID-19,” said Kevin Gardner, UofL’s executive vice president for research and innovation. “Developing these new, more efficient tools for tracking pandemics, such as wastewater monitoring, is a big step in advancing health for our community and beyond.”

The Co-Immunity Project needs 2,000 residents to undergo random testing for COVID-19 infection and antibodies the week of May 17-23 as part of this ongoing research. To learn more, , call 833-313-0502 or email covidsupport@louisville.edu.

Throughout May, Phase I of the tested 1,372 health care workers at hospitals in the system. Samples were collected by UofL’s and tested at  at the Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases.

The study found just two participants had an active infection of SARS-CoV-2, the virus that causes COVID-19. An additional 14 workers tested positive for antibodies, suggesting that they have been exposed to the virus. Unfortunately, due to low amounts of blood in some samples, antibody levels could not be tested in 128 workers.

The Co-Immunity Project, launched in April with an announcement by Kentucky Gov. Andy Beshear, is a collaboration between the and the Brown Envirome Institute. The purpose of Phase I of the project was to test health care workers at the , and UofL Health systems to identify those who have been exposed to COVID-19 and to determine how their body produced a response, or antibodies, to such infection. This information will help identify potential donors of high-quality plasma for treatment of patients with severe COVID-19 symptoms.

Interested health care workers collected their own blood and plasma samples and delivered them to researchers with the Brown Envirome Institute. The samples were then tested at the RBL, one of only 12 such NIH-funded laboratories in the nation and the only one in Kentucky. Results from Baptist Health and Norton Healthcare will be provided at a later date, but researchers say the results from workers at UofL Health facilities provide data that can be used to provide information about the pandemic and its effects.

UofL Health consists of five hospitals, four medical centers, nearly 250 physician practice locations, the UofL Health – Frazier Rehab Center and the UofL Health – James Graham Brown Cancer Center.

“The rates of infection and exposure among our health care workers is surprisingly low,” said CPM/RBL Director Kenneth Palmer, a co-investigator of the project. “Even though the number of individuals who tested positive for the antibody is more than those who had the active virus, this is still a low number, especially for those who are working in high-risk environments such as hospitals.”

“This is good news,” said UofL Assistant Professor of Medicine Rachel Keith, who conducted the study, “It shows that the precautionary measures adopted by our hospitals are working, and that patients seeking care in our hospitals are at a low risk of being infected by their health care providers. 

“These results show the need for appropriate precautions, indicating that with proper PPE and social distancing, we can minimize the threat posed by the virus to our health care community.”

Researchers advised, however, that because so little is known about the novel coronavirus SARS-CoV-2 and the disease it causes, COVID-19, much more research is necessary.

“The rates of infection among health care workers nationwide remains unknown. A recent study of health care workers in Germany who had direct contact with COVID-19 patients did find that only 1.6% tested positive for SARS-CoV-2 antibodies. This is within range of the 1% of antibody-positive health care workers our study found in Louisville,” said Brown Envirome Institute Director Aruni Bhatnagar, a co-investigator with the project.

“However, fewer individuals with antibodies against the virus also could mean that few individuals have acquired immunity, and therefore many of our health care workers may be vulnerable to the virus still lingering in our community. They may remain susceptible should infections increase again, either in the fall or some other time.”

Individuals who have recovered from COVID-19 and have antibodies against the virus are being asked by Norton Healthcare to donate plasma to help treat high-risk patients. More information is available on the .

opened earlier this month to the community to sample 2,400 participants who reside in different parts of Jefferson County to determine the existing prevalence of COVID-19 infection and immunity in the general population.

The project also will re-test health care workers across UofL Health in July to see whether the rates of infection and immunity have changed since May. The results from this second survey will be critical in monitoring how an increase in non-critical care activities in UofL hospitals has affected SARS-CoV-2 infections and see what changes occur to the levels of antibodies in those who showed a positive antibody response in Phase I testing.