Combating the “Tripledemic” on Campus

Coming this fall to a college campus near you, but it’s not a scary movie. The “tripledemic” is a dangerous combination of COVID-19, influenza, and RSV, and it has the potential to wreak havoc on campuses and communities this winter season. What can we do about it? The answer can be found in our sewage. Wastewater intelligence holds the keys to predicting, tracking, and staying a step ahead of this respiratory virus triple threat.

The problem: Respiratory viruses take a heavy toll

Influenza, RSV, and COVID-19 are a drain on the U.S. economy, a burden on the healthcare system, and a strain on college campuses and universities. The first year of the COVID-19 pandemic alone cost colleges and universities $183 billion, according to the Chronicle of Higher Education. How much do respiratory viruses cost the U.S. economy?

• RSV – $1.3 billion per year in direct and indirect costs 
• Flu – $11.2 billion per year in direct and indirect costs
• COVID-19 – an estimated $14 trillion across the pandemic by end of 2023

In addition to these staggering financial costs, RSV, influenza, and COVID-19 also cause millions of medical visits, hundreds of thousands of hospitalizations and deaths, and untold lost work and school time. Colleges and universities have been forced to grapple with decisions about campus closures and transitions to online learning, and students have paid the price. Students impacted by a college closure were 71% less likely to re-enroll within one month, and 50% less likely to earn any credential post-closure compared with students who did not experience a closure. Students also suffered from adverse mental health effects, with 30% reporting elevated traumatic stress symptoms resulting from campus closures.

Filling the data gap with wastewater

The COVID-19 pandemic taught us that data is power, and accurate and timely data can help individuals, colleges, and communities to make informed decisions about disease mitigation measures and communication. However, the complex, fractured nature of public health monitoring in the U.S., along with the proliferation of at-home COVID-19 testing, means that case counts were, and continue to be, inaccurate and incomplete. Leaders and administrators have been forced to make decisions without the benefit of good data.

Enter wastewater intelligence. Unlike most viral testing programs, which can be costly and must be administered patient-by-patient, wastewater testing makes it possible to test an entire campus community equitably down to the dormitory level. This is because wastewater captures everyone who uses a toilet. With the comprehensive, granular data provided by wastewater monitoring, university officials can target messaging and resources directly where they need to go and make public health decisions that are truly informed. Campus clinics can better prepare, individuals can take precautions based on their personal risk levels and tolerance, and communities can truly understand the circulation of respiratory disease locally. Biobot partners have used wastewater intelligence to direct pop-up clinical testing to specific campus buildings, issue mask advisories, and close specific buildings experiencing spikes in infections.

The bottom line? Passive monitoring through wastewater analysis is a cost-effective, equitable, and anonymous way to track COVID-19, influenza, and RSV within a campus community without the resources required to conduct individual case testing. It serves as an early warning system to detect an increase in viral prevalence before other monitoring systems, allowing campus officials to respond as soon as viral levels begin to rise. Wastewater captures all infections, including asymptomatic and undiagnosed infections, giving you a comprehensive picture of viral prevalence on campus. Wastewater testing is an opportunity to stop the spread of not just one, but three costly, disruptive – and sometimes deadly – diseases.