Managing Omicron With Data From Wastewater? — With Newsha Ghaeli and Mariana Matus of Biobot Analytics

As companies head back to the office, and communities try to figure out the right Covid mitigation measures, data from sewage can help them get it right. Newsha Ghaeli and Mariana Matus are the co-founders of Biobot Analytics. Their company uses data from wastewater to alert companies and communities when they’re in the early stages of Covid outbreaks. Then they can adjust appropriately. Founded out of MIT, Biobot initially took on the Opioid epidemic, helping communities figure out the right way to respond, then it expanded to Covid as the pandemic set in. Learn more about your ad choices. Visit megaphone.fm/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Alex Kantrowitz?

  This episode is brought to you by Genesis. What does it actually take to put Agentic AI to work across an entire enterprise? I recently spoke with Genesis chairman and CEO Tony Bates about why orchestration is emerging as a competitive advantage in customer experience and what companies need to get right in the AI era. Then I sat down with Adam Mitchell, head of enterprise business solutions at Voya Financial, to go inside a large-scale Agentic CX transformation, including the business decisions, trade-offs, and lessons along the way. You can watch both conversations now on my YouTube channel today. It's never been more challenging to get frontier compute. How do you know where to look, who to trust, or how much to pay?

• 0:43Alex Kantrowitz?

  Akash is an open cloud that provides easy access, flexibility, and peace of mind. That's how companies like Razer were able to cut their inference cost by 15 times. Visit akash.network/alex for a free consultation. That's akash.network/alex for a free consultation.

• 1:17Alex Kantrowitz?

  Hello and welcome to the Big Technology Podcast, a show for cool-headed nuanced conversation of the tech world and beyond. Well, it's December 1st, Wednesday, as we come to you typically. And here we are in 2021, about to go into 2022. There's another coronavirus variant. Everybody seems like they have no idea what's going on, how we're going to handle this. And it just seems like we're stuck in this endless purgatory of being dictated to by a virus. And you have to think, we have such great technology. Maybe technology can help us not solve these problems, at least get a grip on them, get a rap on them, and start to make progress in our ability to fight them.

• 1:59Alex Kantrowitz?

  So why don't we speak with people working on the forefront of this technology today? They don't just do coronavirus stuff, but it's fascinating technology. It's called wastewater epidemiology, which actually looks into our sewage and tries to help figure out what's going on with our health. It's going to be a fascinating conversation. Our guests today are Mariana Matus, Anusha Galy. They are the founders of Biobot Analytics. Mariana, Anusha, welcome to the show.

• 2:26Speaker 01

  Thank you. Thank you. Thank you, Alex.

• 2:28Alex Kantrowitz?

  So, we're going to get into your product, which is fascinating. It came out of MIT. You've raised millions of dollars to help productize it. You've worked with the federal government and corporations. But before we get into the field of wastewater epidemiology, why don't we just address what's going on right now with Omicron? I think that's how you call it. I don't want to become too familiar with it because it means it's actually been as bad as people say. So, we're going to get into your technology, but I do want to talk about this because you are the experts.

• 2:58Alex Kantrowitz?

  What's your initial read on this? I know that there's been little data, but is this variant going to be as bad as, you know, some folks make it out to be? Because there is some evidence that maybe it won't. Newsha, do you want to take it?

• 3:12Speaker 02

  Sure, yeah. You know, I think we're in the same place as everybody else around the world, just eagerly, you know, attentive to see what scientists find with Omicron. You know, how will the vaccines respond to it? Early evidence shows that it's more transmissible. And so, we're paying attention just like everybody else. But it's definitely, you know, I think it's a moment for us to at least take stock of what we've learned with every single other variant that's come out, especially what we faced with the Delta variant over the summer, and implement a lot of the best practices that we learned about over the summer.

• 3:59Alex Kantrowitz?

  And so, you both study disease, right? We're going to get again to the wastewater part of it. But you study disease. So, let's just talk generally because we don't know enough about Omicron to actually get too deep into it. But generally, doesn't there come a point where viruses, you know, they spread faster, but they're weaker, right? They want to stay alive. They want to stay in the human population. And so, they actually become a little weaker and less fatal, but more transmissible. And it's a way that it spreads throughout, you know, our society without killing people, but keeping the virus viable. And I'm just going to give some context here, which is why, and again, we We're sort of shooting from the hip here, but why not? So there's a report out of Israel, which is highly vaccinated. There's a professor, Dora Mavorak.

• 4:44Alex Kantrowitz?

  He's the head of the coronavirus department at Hadassah University. And he says, so he says that the people, the condition of people infected with this new variant is encouraging. And he goes, if it continues this way, this might be a relatively mild illness compared to the Delta variant. And paradoxically, if it takes over, it will lead to lower infection rates. So is this, you know, maybe in a best case scenario, this could be, could this be what we're possibly seeing, Mariana?

• 5:13Speaker 01

  Yes, I think that the scientific community, the public health community just across the world is hoping that maybe this variant will be more transmissible, but with less adverse effects. Hopefully not increasing lethality or deaths. And hopefully something that people can recover from relatively easily, especially people who have been vaccinated already. So I think it's a moment for us to, to basically stay close to the updates that we hear from the researchers at the forefront of this pandemic. Be safe with the practices that we already know.

• 5:58Speaker 01

  Get those vaccines if we haven't, the boosters. Be able to wear masks when appropriate. And I think we will be able to ride out of this new wave. You know, it will, it will pass too. So hopefully it's something that we can get over, but with less damage as before.

• 6:19Alex Kantrowitz?

  Right, and this is how this is going to eventually end. I'm not saying this is the moment, but right, the virus becomes endemic when it's less lethal, more contagious. So potentially, you know, if something like this, whether it's this one or another variant that ends up showing up, this is how we get out of it. Or am I being overly optimistic? Okay.

• 6:36Speaker 01

  Absolutely. I think we're headed in that direction, so hopefully it will happen sooner rather than later.

• 6:43Alex Kantrowitz?

  Great. Yeah, and I, you know, I know that it's traditional to hit the panic button on Twitter, and it's definitely been warranted in many occasions over the last couple of years. But there's got to be, you know, some good news eventually on the other side of this. Before we move on to your technology, one last question about this. We always end up seeing that there's a country that discovers a new variant, right? Alpha was the British variant, then we moved to Delta, right? And now this Omicron variant was discovered in South Africa. And, you know, countries worldwide started putting on travel bans, almost thinking as if this was the, you know, initial moment where the virus was discovered in China. These bans are pretty controversial. It almost feels like, you know, we're exacting a cost on the countries

• 7:27Alex Kantrowitz?

  that actually do detection of this type of stuff. And so I wanted to ask you, because you are experts in the field, about whether this makes sense, especially in light of a new report that CBS News has put out yesterday. And they says, they say the Omicron COVID variant was in Europe before South African scientists detected and flagged to the world. So isn't this stuff moving too fast to do these like blanket travel bans? And to imagine like they're going to have, you know, a serious impact. And I know it's controversial. I know you, like as a government, you want to do as much as you can. But also I'm wondering about this and whether these things, you know, might make sense at the beginning of a pandemic, like when the, you know, coronavirus was discovered in Wuhan.

• 8:12Alex Kantrowitz?

  But at this stage, you know, especially given what we know now that this thing was actually circulating in Europe before any of these travel bans were put in. They just weren't testing for it as vigorously as the South Africans.

• 8:25Alex Kantrowitz?

  Where do you net out on this? Who should you want to chime in?

• 8:28Speaker 02

  Yeah, yeah, so you know, I think it's important for us to remember that one of the reasons why the variant was indeed detected in South Africa is because of their robust genomic sequencing infrastructure. And so they were looking for it. They were looking for things. And indeed, the variant was likely present elsewhere outside of South Africa, prior to it having been first detected in South Africa. But they were the first nation that just was able to sequence it and detect it. And so I think it's very important for us to differentiate between those two things. And I think it's important that the media tries their best to present sort of the information

• 9:12Speaker 02

  that way with that nuance. Because you know, you're right that now, I think there's, you know, the list of countries that have confirmed an Omicron case today extends well beyond just the list of countries that are mostly impacted by travel bans put in place by the United States and other countries around the world.

• 9:34Alex Kantrowitz?

  Right. Yeah, and it always, it did seem to me like, okay, like, you know, they found it, but how many were looking for it? And if you start punishing the countries that are looking for this stuff, it disincentivizes the research. And then you end up in a much worse position, like, is South Africa going to want to, you know, keep testing for this stuff if they end up having their economy tanked and their, you know, citizens' freedom of motion reined in if this is the result when they actually bring the findings to, you know, the world? It's like, all right, I'll give an example. I'm not going to name the friend because he'll kill me. But Lyft, right, if you tell Lyft that you, you know, have tested positive for coronavirus,

• 10:15Alex Kantrowitz?

  just so that they can do the testing and the contact tracing notifications necessary, they ban you from the platform for like a couple of weeks and you have to like test your way back into it. Which is like, and it's not easy to do that. And it's like, come on, guys, you're, you know, just do the contact tracing notification and don't punish the people that are acting as good citizens. But I could go on about this forever. Okay, so the reason why you're here is because we're at this moment where we're grasping for new ways to deal with endemic disease. And you know, throughout the course of the pandemic, I had heard that potentially by testing sewage, you could figure out, you know, what the COVID instance is in,

• 10:59Alex Kantrowitz?

  or the prevalence of COVID is in certain communities, in certain countries, and even in certain buildings. And, you know, it always struck me as this kind of like far out concept that like, you know, seemed pretty theoretical. But actually, you're doing it. And productizing this and bringing it to the world. And it can be a way that, you know, for instance, companies that are going back into the office could figure out whether they have a COVID outbreak without testing everybody individually each day. So I think it's really fascinating technology. We're just at the forefront, you're just at the forefront of this. And I thought it would be great to have a discussion, you know, deep discussion about where this came from, where it's going, and then how it can be

• 11:43Alex Kantrowitz?

  applied both to countries, communities, and then corporations. So, so why don't we, you know, I've done a lot of talking about it already. Now I'll take a backseat and I'd like to hear a little bit more about what the practice of wastewater epidemiology is, and how it can be useful. So, Mariana, do you want to tell us a little bit about the field, where it is right now, what it actually does, and how many errors have I made in the introduction trying to explain what you do?

• 12:14Speaker 01

  No, you got it. You got it, Alex. Thank you. Wastewater epidemiology, it's quite mouthful.

• 12:21Alex Kantrowitz?

  Yes.

• 12:22Speaker 01

  Basically, the concept is very simple. We are looking at wastewater, not as waste, but as a data asset, as a collective sample of people where we can apply a QPCR test, similar to what you would do with a nasal swab. Instead of testing one nasal swab coming from a single person, you are testing a group of people, an entire city, an entire town, an entire building, represented in that wastewater sample. So it's a, it's a method to very effectively test a large number of people.

• 13:01Speaker 01

  And be able to to understand what's happening in terms of disease in that area. You can look for infectious diseases like COVID-19 and the flu. You can look for consumption of substances like opioids and meth.

• 13:18Alex Kantrowitz?

  Uh huh.

• 13:18Speaker 01

  Um, you can look for antibiotic resistance bacteria, which are a concern not only in the U.S. but globally. You know, and the list just goes on and on, like diet, wellness, uh, mental health and stress. Um, so it's a, it's a, it's a data asset that at the moment remains largely untapped. And, uh, you know, we started as researchers at MIT. Um, this was back in two thousand and fourteen when we started the project. And back then wastewater epidemiology was an obscure niche area of science that very few people were working on, very few people have heard about it.

• 14:03Speaker 01

  And it's been wonderful that over the past year it has grown from that place into becoming one of the central pillars to tackle COVID-19.

• 14:14Alex Kantrowitz?

  Yeah. Yeah, I mean, it's, it's amazing because it can give like our testing has been limited. So, you know, PCR tests go individual by individual, time consuming, expensive, all the above, unpleasant, if you don't like stuff getting stuck up your nose. Um, and this data that you can get from sewage actually uh, seems like can give pretty accurate uh readings of uh how prevalent disease is in different communities or even, you know, I guess different uh, uh, buildings or areas attached to a single septic tank. So, you know, I don't, I'm gonna, I guess I'll have to put an explicit label on the podcast because let's get into the details a little bit about how this is done.

• 14:56Alex Kantrowitz?

  Because, you know, at first blush, um, the, the whole practice seems, I mean, very, okay, very useful, but like also disgusting, right? So, um, it's just, I, but I want to, yeah, I want to talk about it. So, um, let's just talk about what it's like physically to, it, do you go like collect samples, uh, from, from like septic tanks and sewage? And, and then what is the scientific process? Like, how are you able to say, you know, if I, if I have this sample and there's, you know, X amount of COVID or X amount of? You know, whatever disease, then you can draw conclusions. Um, if you can flush it out a little bit about like what it's like in practice. Um, then uh, I feel like that would be a really nice way for people to sort of see what this is like in a concrete way.

• 15:41Alex Kantrowitz?

  No matter how unpleasant it might be.

• 15:44Alex Kantrowitz?

  Oh, Nish, do you want to take it? Yeah.

• 15:46Speaker 02

  Yeah, um, well, you know, when we, when we were, when we first started the company and, and uh, explaining this to people who had never really heard about wastewater Epi before, we'd always start by saying, you know, everybody pees and everybody poops every day. Uh, right? It's an activity that, that we can all uh, sort of uh, agree on and, and we all share. And so if you think about it, every time you use the toilet and you flush the toilet, you're essentially sending medical grade samples down the drain and it's collecting with medical grade samples from thousands of other people, your neighbors, other folks in, in the community.

• 16:27Speaker 02

  And it's mixing and aggregating with, um, with all that information. And it eventually ends up at a wastewater treatment plant where it's processed, treated, cleaned, and sort of sent back out into our, um, our water ecosystem. And so what we do is tap into the wastewater system before sewage is actually cleaned and, you know, all these gross nasty bacteria and viruses and chemicals are, are removed from the water. And so we tap into either, you know, a manhole, so we can pull sewage directly from a manhole in a city. Or we can go to the end source, which is a wastewater treatment plant.

• 17:08Speaker 02

  Or we can start, you know, at a building level, let's say a very large building, uh, where you might have, you know, a thousand people or so, uh, think about like a tall office building skyscraper in Manhattan. Um, and we pull the sewage, uh, using an automated sampling device. It's, it's basically a peristaltic pump attached to a timer. Uh, uh, these are devices that have existed for a long time, uh, in the water wastewater, uh, field. And the samples are collected and pulled. And then they're transported back to our labs. Uh, we actually have kits designed specifically for the purpose of transporting the samples that we send out to customers.

• 17:53Speaker 02

  And, you know, we like to say sort of like a twenty-three-and-me kit, but for sewage.

• 17:58Alex Kantrowitz?

  Hmm.

• 17:58Speaker 02

  And so, once the sample is back in our lab, we have a team of, of scientists and, and people in the lab who are concentrating that sample down and essentially filtering out all of the sort of, you know, sewage stuff that we don't want to be looking at. Uh, distilling it down to, you know, essentially something that looks like a medical-grade urine or stool sample. And then from there, we can apply all sorts of different types of, um, uh, tests to look at viruses and chemicals and some of the things, uh, Mariana touched on.

• 18:32Alex Kantrowitz?

  And so you said that, um, this is medical-grade samples. So what are the type of things that you're able to learn when you, um, are able to go into, uh, you know, uh, uh, communities wastewater and, um, what are, what are some, yeah, like, what can you discern from that when you look at it in the aggregate? Um, because I think that like, you know, there, to me as a layperson, like you'd imagine that it's tough to pull out, you know, too much data in aggregate because it gets mixed up with other people's sewage and all that stuff. And so what kind of practical data have you been able to, uh, pull out of, of this wastewater? Newsha?

• 19:10Speaker 02

  Yeah, so, um, you know, we can look at what foods are people eating? Um, so what are you, uh, putting into your body that you're then excreting? So foods, pharmaceutical medications, uh, things like drugs, both licit and illicit. Uh, we can start to look at different viruses that are harbored in our bodies. So viruses that cause infectious diseases such as obviously COVID-19, uh, where most of our work is focused on today, but also viruses like the influenza A or B virus that cause the common flu or cause flu, um, during flu season. And actually, we just announced last week that we, uh, have been able to detect the

• 19:54Speaker 02

  presence of the influenza A and B virus in wastewater. Uh, and that's work that we've been doing over the past couple of months, um, of this year's flu season. And then from there, also looking at things like antimicrobial resistance bacteria. And so beginning to even move out into some more sort of cutting edge public health applications outside of infectious disease and, and let's say substance use or nutrition.

• 20:24Alex Kantrowitz?

  Yeah. And so Mariana, on the COVID front in particular, what can that data? So you get aggregate data, you know, maybe some communities don't have a lot of COVID showing up. Maybe some communities have a ton of COVID showing up. So what can you do with that data? And do you have any practical examples of how you've put it into, use that data to put it into action in terms of like specific communities or governments' policy approaches to what we're doing? Cause like I'll just use a, an example, like if, if, or, or yeah, I'll, I'll just throw it, throw a scenario out there. Maybe if a certain community doesn't have any COVID, then you can, or have minimal COVID, you, you know, they would learn to restrict their mask mandates.

• 21:07Alex Kantrowitz?

  And if someone has a lot, then you know, maybe you put them on or something like that.

• 21:11Speaker 01

  Indeed, yes. At, at the high level, when we think about our data, it enables the community leaders, it being government or like the CEO or head of HR of a company. It allows them to sort of like move how stringent a response to COVID should be and either increase the level of safety measures and social distancing and testing, or actually taper it down because we are not seeing much of the virus in that, in that community's wastewater. And so at the high level is a tool to understand how much intervention to do, if you will.

• 21:53Speaker 01

  In order to, to get there, we actually had to do a bunch of R and D just very quickly. Because when we started, it was only accepted that you could do detection or non-detection of the virus in a wastewater sample. And that's just like, it's helpful. Maybe if you have very low levels of COVID. But once COVID is basically dominating or like present in a community, it's not very helpful to continue hearing it's here, it's present, it's present, it's also present again, right? That's just not very helpful. So one of our key insights that we had last year was that you need to,

• 22:36Speaker 01

  you can quantify the virus, first of all. It doesn't have to be just a binary yes or no. You can quantify the amount of virus present in the wastewater. And most importantly, you have to correct for the amount of poop, you know, that is present in the wastewater. So we're effectively calculating how much of virus there, you know, their total amount of poop there is in the wastewater. And that's actually the number that is the important one, the one that allows you to know if their unit of people, we are seeing more or less of the virus and therefore need to ramp up

• 23:19Speaker 01

  or can wind down some of the interventions. So besides measuring the target of interest, SARS-CoV-2, we also measure this virus called, that is present in peppers and tomatoes. So that we ingest through our diet and that is present in the waste of healthy individuals. And that's our correction factor there. One final piece of work that we did was to demonstrate that people who are infected with COVID start shedding the virus before they develop symptoms. So you can actually detect a COVID-19 outbreak in a building

• 24:03Speaker 01

  or you can see a spike of cases in a community through the wastewater before you see it in the clinic. Because people will shed it in their. Biofluids before they develop symptoms and therefore before they look for a clinical test and get a confirmation out of that. So there's a leading indicator aspect, the wastewater data that is very unique to these data sets and a great complement to what we see in the clinic.

• 24:34Alex Kantrowitz?

  Yeah, I was just gonna ask, you know, why is your approach better than, you know, taking the data that you get from PCRs in a community and sort of take doing statistical averages of that. But I think you answered that, right? Because you're able to see these outbreaks before they happen by looking at the wastewater because you'll basically see it before people are symptomatic. You know, I'd like, yeah, go ahead.

• 24:58Speaker 02

  Well, I was gonna say, and another reason, you know, in addition to that, that makes wastewater so compelling as a, you know, when comparing it to clinical testing is clinical data is only going to be as good as the individuals who contribute to that data. So you have to, as somebody who is infected with COVID-19, you need to be symptomatic. And then, once you're symptomatic, you have to choose to go get a test, or you have to choose to go to a clinic and report, you know, get a test that's reported. There's a lot of people who don't necessarily interact with the healthcare system nearly as frequently as others do, you know, merely because they don't have health insurance, for example.

• 25:43Speaker 02

  And so clinical data has its own biases. And so we really believe that when it's complemented with wastewater data, it can help fill some of these gaps that might exist when only looking at clinical data. Everybody contributes to our sewer systems, and we all contribute, you know, pretty much equally. And so it doesn't take into account whether you have health insurance status, whether or not you happen to be somebody who chooses to go to the doctors more frequently. And so that's another reason why, you know, the wastewater data is impactful for communities.

• 26:18Alex Kantrowitz?

  Did you have a moment where you told like a community administrator or a government official that, hey, you have an outbreak coming? And they were kind of skeptical? And then it happened?

• 26:27Speaker 01

  Yeah, absolutely.

• 26:32Speaker 01

  The data from wastewater has like a it's noisy like you know as a as a the base level of noise or variation in the wastewater data is high. It's a noisy type of data set. So it's happened several times where basically the based on the latest result, which saw a very large spike in the amount of virus in the wastewater. We get asked to jump on the phone with basically leaders, administrators wanting to know, hey, could this be a technical artifact? Or do you think that, you know, I'm just skeptical about seeing such a big jump between the last sample and the new one, right?

• 27:14Speaker 01

  So by far, the most common situation has been where the wastewater actually has tracked and continued to go up over the next few samples. And I think by now, because we've been through this process several times, the the people on the other end of our service, right, those leaders and those administrators are are believing more the data and acting on it, you know, quickly versus I think in the beginning, there was more that hesitation to get on the phone with us and want to hear more if we trust the data, if we can rerun the sample in the lab, you know, things like that.

• 27:53Alex Kantrowitz?

  Right. So you're like, okay. Yeah, go ahead, go ahead.

• 27:56Speaker 01

  I think it's been part of the education for this new type of data and building trust and credibility. And I wouldn't expect less when wanting to make such high stakes decisions.

• 28:07Alex Kantrowitz?

  Yeah, it's it's totally wild where you can be like, you know, okay, you know, Mr. or Mrs. Mayor, you got an outbreak on your hands and indeed, there's an outbreak. I want to hear a little bit about how, you know, we're we're in this moment where like companies are deciding whether or not to go back to the office and. You know, maybe there's a way where they could use this data to decide whether or not like they should keep people in office or not and rely on it company specific versus, you know, just kind of trusting the population level statistics. Maybe you can help them. Maybe you already are. So let's take a break and then I want to get to the commercial applications

• 28:48Alex Kantrowitz?

  of this technology on the other side. So we'll be back right after this with Mariana Matous, Nusha Galy. They are the co-founders of Biobot Analytics and telling us some amazing stories about how sewage can be used to treat disease and mitigate some of the outbreaks. So we'll be back in just a minute. Stick with us here on Big Technology Podcast. This episode is brought to you by App Point. Everyone's racing to roll out AI right now. Co-pilots, chatbots, agents doing real work. But here's the part nobody loves talking about. All that AI runs on your data and most teams have no single way to see it, secure it, and prove it's under control. That's exactly what App Point does. For 25 years,

• 29:30Alex Kantrowitz?

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• 30:10Alex Kantrowitz?

  And we're back on Big Technology Podcast here with Mariana Matus and Newsha Galy. They are the co-founders. Biobot Analytics, fascinating company. I've loved where our conversation has gone up until now. Actually, before we start the second segment, I have to ask you a question. So there's been this rumor that Kim Jong-un doesn't want to travel. He travels with his own toilet because he doesn't want the countries that he's visiting to to figure out what his health is like. And it always seemed like the most ridiculous authoritarian dictator thing, like, haha, he travels with his own toilet. Are you telling me that like, actually, that's a good idea?

• 30:48Alex Kantrowitz?

  I was impressed.

• 30:50Speaker 01

  Yeah.

• 30:51Alex Kantrowitz?

  He knows what's going on.

• 30:53Speaker 02

  He was ahead of the curve.

• 30:55Alex Kantrowitz?

  Yeah, maybe that's a put that on the brochure. Just kidding, but maybe. Okay, so so how are companies using this stuff? Because I would imagine if we're in the back to the office moment, you know, that they'd be able to see, you know, okay, we're having people back in the building. Maybe monitor the wastewater to decide whether or not it's safe for all of our employees to be, you know, in person together as we're, you know, going through this Omicron variant or whatever other, you know, coronavirus disease or other diseases we might have. Is that something that you're you're working on?

• 31:32Alex Kantrowitz?

  Newsha?

• 31:32Speaker 02

  Yeah, so, you know, early in the pandemic, we actually had a number of building level environments or settings reach out to us, curious to lean to learn more about wastewater Epi and whether or not it could be used at the building level. And so we started relatively early working in office buildings, places of work, correctional settings, congregate care settings, as well as university campuses and schools. And, you know, one of the reasons why wastewater Epi is so can be so impactful at the building level is because buildings by design are not optimized for controlling the spread of disease.

• 32:17Speaker 02

  Right, it's what is kind of fundamentally also making back to work such a challenge for so many employers is we're sorry about the noise outside. But we're we're, you know, getting employees to come back into an office building where obviously the purpose is to to recreate some of the, you know, interpersonal dynamics that are so valuable in a workplace setting. But those interpersonal dynamics are exactly the types of sort of interactions that create the spread of disease. Right, it's talking to one another. It's being in close quarters and physically sort of present with each other. And so what we found is that wastewater Epi can

• 33:00Speaker 02

  and data from sewage can really help employers or building administrators. Navigate a lot of the complex, sort of this complex web of mitigation strategies that exist out there for COVID-19. You know, we hear a lot from employers that there are so many solutions and they don't really know exactly what to implement. Should they be disinfecting their building and at what cadence? Should they be clinically testing everybody, you know, once every two weeks? Should they be temperature screening or tracking symptoms and vaccination status? And so, one of the things that wastewater data can really help decision makers and

• 33:42Speaker 02

  building administrators do is essentially figure out when to launch what types of COVID-19 mitigation strategies. So, based on the wastewater signal, if we see, you know, if no COVID is detected or very little levels of COVID are detected, certain strategies are implemented for sort of back to work and building safety. If very high levels of COVID are detected and we're confident or comfortable saying there's an outbreak, then you can trigger sort of, you know, expensive clinical testing or types of solutions that might have a pretty high administrative burden.

• 34:25Alex Kantrowitz?

  Right, and so, you know, some of the back to the office stuff has been a little ridiculous, like it's been, I mean, companies are so bad at this. You know, there's been, you know, people can come in, but they only can be in their own conference room, or everyone's there, but, you know, they have to wear a mask and they can't talk to their coworkers. It's like, companies are like, "We want to be in person, but we're trying to be as safe as we can," and you end up with something that's, you know, totally unworkable. So, Mariana, can you describe like, what it's like when a company works with Biobot? Like, and do you have any names of companies that have worked with you that you can share, like what their experience has been like?

• 35:01Speaker 02

  Yeah, so...

• 35:03Alex Kantrowitz?

  And like, you know, can they just go full, sorry, one last part of it, can they just go full no mask if, you know, you're not seeing any COVID in that building?

• 35:10Speaker 01

  Yeah, so basically, our vision for this product for companies is that the wastewater can be sort of like that, that first intervention that it's deployed just everywhere, in every building that is housing offices across the country. And that, based on that data, an employer can know if the building basically remains COVID free, if we are seeing some COVID, how high is the risk that they have an active outbreak versus like some residual shedding from people who are already recovering and

• 35:53Speaker 01

  are not infectious anymore. That's the type of questions that we can answer for them. And then based on that data, they can then decide how to deploy the other mitigation tools that they have available. It's much cheaper than clinically testing everybody. It's obviously non-intrusive because people who come into the office space don't need to change any behavior. They just come into the office space, they work, they use the restroom when they need it, and they go home. That's all that needs to happen. There's no need to do any sort of behavior change for their employees. And it could really

• 36:34Speaker 01

  enable and empower companies to have, to bring people back and foster the right culture and the right dynamic, but still knowing from data that they are safe, rather. So Fidelity Bank is one of our first early adopters here for this product, and they are one of our best customers. So we have seen firsthand how they've benefited from testing now, I believe, five of their campuses, not only within Massachusetts, but in other states.

• 37:10Alex Kantrowitz?

  Yeah, have they used that data to, you know, change the way that their employees can come into the office?

• 37:16Speaker 02

  Yeah, so, so they use the information, I mean, similar to other buildings that we work with, they use it to essentially be able to understand whether or not there's an active outbreak in the absence of, you know, regular clinical testing. And so as more and more people become vaccinated, companies are sort of scaling back, or have, most of them have already scaled back regular clinical testing, uh, because, you know, most of their staff is vaccinated. But we know that breakthrough infections happen. And so at the same time, companies don't want to do nothing. Uh, and so the wastewater data really comes into play as sort of this like insurance

• 37:58Speaker 02

  policy or sort of background surveillance that we're still monitoring just in case there's a breakthrough infection. And then, once there is, we recommend everybody gets clinically tested, an outbreak is identified and contained, hopefully, much earlier than, than people are symptomatic and before it turns into a, a larger outbreak.

• 38:19Alex Kantrowitz?

  It's amazing because it feels like it's just a way to make everyone feel so much more comfortable working in the office, like, if you know that, like, this stuff is, um, running in the background. And, and so like, like the community example, you can detect an outbreak in the building before, like, the PCR test will necessarily.

• 38:35Speaker 01

  Indeed. I think that it's going to be a, a huge win for employers who want to create that sense of not, not only physical, but psychological safety and encourage their teams to come back into the office. Uh, and it's all, it's data, it's real data, and, and we have demonstrated that we can detect as little as like one infected person in hundreds of people attending the building.

• 39:02Alex Kantrowitz?

  Wow.

• 39:03Speaker 01

  So it's incredibly powerful.

• 39:04Alex Kantrowitz?

  Employees don't push back a little bit. I mean, you know, we, we're in the age of worker empowerment. I can imagine there would be a, some segment of the, uh, employee base, uh, you know, in companies that you're working with that say, hey, don't touch my poop. What's your experience been?

• 39:19Speaker 02

  Yeah, I mean, I think it's really important to remember that

• 39:25Speaker 02

  when a sample is deposited into a wastewater system, whether it's within a building or in a city, it's so naturally aggregated and mixed in with with waste from so many people that it's impossible to sort of link what we're seeing, let's say the SARS-CoV-2 virus back to an individual person.

• 39:47Alex Kantrowitz?

  But don't tell that to Kim Jong-un.

• 39:52Speaker 02

  Yeah, and so, you know, at at best, what we're able to tell an employer or a building administrator is one person or we estimate that there could potentially be three infected individuals in this building of X number of people. And so I think it's very important that it's communicated, obviously, in in the right sort of nuanced way. And that's something that our team works directly with with our customers on is how do you, how should this be communicated? How should this be messaged so that we make sure the right information is put forward?

• 40:29Alex Kantrowitz?

  And you haven't had any like protests or anything like that?

• 40:32Speaker 01

  No, not not with

• 40:36Speaker 01

  that sort of like building level or like with government. I think it's actually been on the contrary.

• 40:42Alex Kantrowitz?

  People love it.

• 40:43Speaker 01

  And when we, I remember when we founded the company, some of our more experienced advisors would always flag this for us as a, you know, as a main risk for the company. What is going to be the public perception for what you do? We've been very lucky that so far people like it. People find it interesting, engaging. They have questions because people are smart and they are educated and they read the news and they, you know, all of that. So so they are aware, they ask questions about how it works, what it can do, what it cannot do. And then, you know, that's part of our job to do that level of education and raising awareness for this new technology.

• 41:26Speaker 01

  But so far, the acceptance for it has been, yeah, has just been beyond our expectations.

• 41:33Alex Kantrowitz?

  OK, and now quickly, before we go to break, another commercial application of your technology can be with drug makers. Who, you know, I don't know exactly what the application might be, but maybe they are able to be like, all right, there's a outbreak of X disease in a community and, you know, maybe we like speak to doctors there and try to get our drug in front of them. So can you talk about the commercial application of how that might be useful to them and then the ethics involved with it? Why don't we start with Newsha and then we move to Mariana?

• 42:04Speaker 02

  You know, you could think about how there are some infectious disease, let's say, for example, some infectious disease applications where if we detect clusters of it, then that could be a nod to, you know, folks that are building treatments or therapies for those infectious diseases to come in and essentially kind of create greater access to the therapy. I mean, we can even think about it in the context of COVID-19, right? Where do we see higher, you know, virus concentrations of SARS-CoV-2? Could those be targets for us

• 42:46Speaker 02

  to get vaccinations out into those communities? And so beyond COVID, there could also in the future, kind of create this wastewater data could serve as an additional data set alongside clinical data that's used and looked at in order to understand like where do we want to bring different types of therapies and medication? We can also look at wastewater data as a way to do that and create greater access to care, essentially.

• 43:14Alex Kantrowitz?

  Yeah, I remember that when we had limited vaccines and there was this idea that we could potentially like flood the zone with vaccines in areas with outbreaks. So potentially this data could be useful, you know, if we end up in that situation again, for instance, let's say Omicron does become bad and there's limited vaccine access to prevent it, maybe we could use some of this data to figure out which communities to get it into. What about the ethics of it, Mariana? I mean, do we want to have, you know, drug companies with access to our wastewater data and, you know, they're already such controversial businesses to begin with. So is this something that we want to provide them with?

• 43:52Speaker 01

  I was going to say that, yeah, I find this question fascinating because I feel like we're in such uncharted territory when it comes to just the data rights, data access, data sharing, or the data coming out of wastewater. It's early days. What we hope and our vision is that the data coming from wastewater, that human health data coming from wastewater, can be seen more of as weather data. You know, where you can access it, just everyone can access it and it's widely available.

• 44:31Speaker 01

  And, you know, there are probably like so many, so many uses for the data that we cannot even imagine today within the healthcare system, for pharma companies, for hospital systems, right? Like, probably there are so many applications to having this type of data available, but it's just something that we haven't really, there aren't that many precedents. And I think it's a little bit hard to imagine, because so far, the only population level data available is the one coming from hospitals. And that data, to begin with, has personal identifiable information that needs to be scraped off.

• 45:14Speaker 01

  It's data that is super highly regulated. It sits behind a lot of red tape. Even within government agencies that have a public health mandate, it's difficult to access this data. Like, a person within a public health department may have the credentials and the access to the data, and they may have a team of five people, you know, analysts or epidemiologists that just don't have it. You can be the mayor of a, you know, city here in Massachusetts that hears about overdose deaths from the news.

• 45:55Speaker 01

  First, before you see it from your actual data, because you just don't have access to these data. So, so I think that to me, like, again, like, the, the ethics questions here is, how do we make sure that this data that is more naturally aggregated and de-anonymized is widely available to everybody involved in public health response, which is not just a single person sitting within a public department.

• 46:25Alex Kantrowitz?

  Right.

• 46:25Speaker 01

  This is entire teams, different departments within government, different levels of government, from municipality, county, state to federal. How do we make sure that this data is widely available to people to use it for the public good versus it being, it becoming the same as the hospital data, highly regulated and like sitting behind a lot of red tape. To me, I think like that's the challenge. And if we can figure that out, then downstream from there, there will be also benefit to the entire healthcare system.

• 47:01Alex Kantrowitz?

  Right. Yeah, I guess the fear is that it becomes ad tech. So as long as this doesn't end up, because weather data also is useful for everyone, but eventually weather data became ad tech too. Like in Atlanta, they knew that, you know, if the temperature drops, you know, X degrees in the summer, you know, for a certain amount of days, then people buy more Budweiser and they sold that data to Budweiser advertisers. So I think there would be a concern if this stuff, you know, ends up in the hands of, of, you know, like, if, if the most commercialized aspect of this is that, you know, it goes to like Pfizer or some other drug maker. So what's, what's the thought on that, on that front?

• 47:38Speaker 02

  Yeah, I mean, it's, again, I think just underscoring what, what Mariana said, that we are in uncharted territory and I think it's important for us to map out, and us, government agencies, sort of other companies that work in the space of wastewater, Epi, academics, I think it's important for us to be mapping out, you know, what are the possible uses of this data? Who are all the stakeholders around the table? Who can benefit from this data? And, and essentially, you know, create a, a plan for

• 48:14Speaker 02

  How we want this data to be used. And of course, we have our vision and our mission. And for us, it's very much about promoting public health and leveraging, you know, our data to actually advance community health and public health in cities. And so that dictates who we want to work with and the uses of the data. And I think it's important for communities and government agencies that are using this data to have their own sort of mission and guiding North Star of what they want from the information.

• 48:48Speaker 01

  I think just a small thought there that, you know, right now, this industry is not regulated, right? There are no rules as to what we can do or not with the data, or what, who can see it or not. But I think that's going to quickly change over the next, you know, three, five years. So I think what would be great is if the different stakeholders indeed come together and can take a very proactive approach to creating regulation that allows the data to be used in a way that promotes the overall like well being

• 49:27Speaker 01

  of people without making it incredibly regulated. I think like that would be a lost opportunity if it gets behind red tape, similar to the hospital.

• 49:38Alex Kantrowitz?

  Yeah, yeah, I agree. I think that like, you know, this stuff is so valuable. And there's got to be a way to find that Goldilocks zone where like you end up using it for the most public good, but also like find a way to mitigate some of the downsides. And that's what makes it exciting. All right, let's let's head to break. We're going to have a few minutes on the other side of this to talk a little bit about the public health cause that got you started on this. Not COVID-19. It's actually something very different. And then maybe we have a minute or two to get into the founding story and then we will say our farewell. So we'll be back on the other side of this break here on Big Technology Podcast. So we'll see you right after this.

• 50:17Speaker 03

  Now, more than ever, we need someone on our side. But Rob Whitman? Whitman's votes drove up costs, cut Medicaid, and risked 350,000 Virginians' health care to pay for tax breaks for himself and his donors. He's not on our side. Shannon Taylor will fight corruption, cut taxes, and bring down costs. This November, vote for Shannon Taylor. She's for us. Paid for by HMP, the HouseMajorityPac.com. Not authorized by any candidate or candidates committee.

• 50:48Alex Kantrowitz?

  And we're back for one final segment here on the Big Technology Podcast with Mariana Matus, Nushia Galy. They're the co-founders of Biobot Analytics. We've actually danced around it a couple of times, but I want to talk about opioids because that was the... As far as I'm aware, the founding mission of the company was to help communities get that under wraps and figure out a way to address that in their communities and see how prevalent it was. So, Mariana, can you talk a little bit about that? And, you know, Nushia, I'd love to hear your thoughts also about like... You know, you talk about the public health benefits of wastewater epidemiology. It seems like it can help a lot with the opioid situation.

• 51:33Speaker 01

  Yeah.

• 51:35Alex Kantrowitz?

  I'd love to hear how that was involved in the founding as well.

• 51:38Speaker 01

  Absolutely. You know, I remember when Nushia and I founded the company back in 2017. One of the very first things that we did together was to make a list of all of the different types of data that we could get out of wastewater. It was a long list. So then we're like, okay, we probably need a different approach to understand what to build first. So we started talking through our networks to as many people working within government, public health, mayor's offices, to understand, okay, what are your public health problems? What are your public health concerns?

• 52:20Speaker 01

  The opioid epidemic came back just across the board as the number one public health priority for the US. So we decided to go out and build a product to tackle the opioid epidemic.

• 52:37Speaker 01

  And what we discovered is that the opioid epidemic has been a problem that is not new. It really has been around for several decades, just constantly growing, unfortunately. And one of the problems that we saw is that the best data available to make decisions on how to help people is counting how many people have died, basically overdose deaths. That's the best data available, that's a gold standard. And that just seems wrong, because you know, that data is very reactive and it's letting you know about the people that you cannot help anymore.

• 53:18Speaker 01

  In contrast to that, our wastewater data, we realized that we could bring data on how many, yeah, how much opioids is being consumed today? What types of opioids, if it's mostly a prescription opioid problem or a street drug, like heroin problem? If people are using medications like naloxone to reverse overdoses or like buprenorphine in order to combat opioid use disorder. And all of this data can inform in more real time

• 53:58Speaker 01

  how to create the right program for a specific community, a specific city, a specific town. This is important because there isn't just one opioid epidemic. There are many types of opioids and community to community, the types of substances that dominate can vary quite a lot. So this data is really important for government to allocate their limited resources into the right programs, the right messages. And in fact, our very first pilot customer, which was the town of Cary, North Carolina, ended up seeing a forty percent decrease in overdoses

• 54:37Speaker 01

  in the first year of working with Biobot, really demonstrating that the data is effective and driving results for them.

• 54:44Speaker 02

  Yeah, and I'll, well, I'll add quickly that, you know, what they found and really why they were able to drive that impact was they found it was a data, data problem, right? They were, they were seeing overdoses, an increase in overdoses year over year. However, in their programming, you know, they were targeting heroin and and talking about illicit drugs and overdoses. And so there wasn't a lot of engagement or acceptance by the community that this is my problem. It very much, the reaction was very much, this is not my problem. This is somebody else's problem. After having worked with Biobot for only a few months, we were able to show them that the majority of the consumption

• 55:29Speaker 02

  in the town was actually prescription opioids. And so they completely changed their approach to, you know, their epidemic and changed the language that they use to talk about prescription medications, you know, installing medication drop off units, and the engagement just completely skyrocketed amongst the citizens and amongst the community.

• 55:52Alex Kantrowitz?

  Amazing. And so like, yeah, that must have been the moment where you saw, hey, we have something here. And then this COVID situation where data was really so precious and helpful to fight, fight what we were seeing in the communities ended up being the takeoff moment, I imagine. Newsha?

• 56:09Speaker 01

  Yeah, absolutely.

• 56:10Alex Kantrowitz?

  Oh, Mariana, yeah?

• 56:13Speaker 01

  Yes, it was, you know, that that first pilot converted into a contract, which was great. We had just signed additional pilots to continue demonstrating the the technology for for government customers. And then COVID nineteen hit, and we saw it as an opportunity to demonstrate that wastewater is a platform that is versatile and it can adapt quickly to to tackle any new threat that that our cities and our country finds. So in less than four weeks, we were ready out there, like we're testing for for the virus that causes COVID.

• 56:53Alex Kantrowitz?

  Yeah. And I think that what what you're what you've shown, like, you know, through your work and over the course of the conversation is that, you know, data is at a premium, and we can do a lot with data if we just know we're fighting. And in this past couple of years, I think that everyone has felt like Sort of amiss and, you know, thrown into this turbulent state where we don't know what's hitting us, you know, moment to moment, especially, you know, given what we spoke about at the beginning with this new variant and stuff. And we need better ways to manage it. And this seems like a really good way. So Newsha, Mariana, I really appreciate you coming on and sharing the story and wishing you best of luck. I know you've got some interesting stuff in the pipeline and I'm really excited to continue to follow your progress.

• 57:37Speaker 01

  Thank you. Thank you for having us. It was great.

• 57:41Alex Kantrowitz?

  My pleasure. Really appreciate it. Okay, so we'll stop here. I just want to say thank you to Nick Watney for doing the mastering of the audio, Red Circle for hosting and selling the ads, and you all, the listeners, for coming back each Wednesday. Appreciate you very much. Thank you for being here for the pod. We're seeing some great numbers through November. We hope we have another strong month in December as well. And you're the one that makes it happen. So I want to say thank you. We'll have some really good stuff coming up later this month in appreciation. Well, that'll do it for us here on Big Technology Podcast. If you liked it, please give it a rating. If you're here for the first time, please subscribe and we hope to see you next week. We have an amazing conversation with two incredible scientists talking about behavioral health, I'm sorry, behavioral economics

• 58:24Alex Kantrowitz?

  and artificial intelligence. You won't want to miss it. Until then, have a great week and we'll see you next time on the Big Technology Podcast.

• 58:42Speaker 03

  Now, more than ever, we need someone on our side. But Rob Whitman? Whitman's votes drove up costs, cut Medicaid, and risked 350,000 Virginians' healthcare to pay for tax breaks for himself and his donors. He's not on our side. Shannon Taylor will fight corruption, cut taxes, and bring down costs. This November, vote for Shannon Taylor. She's for us. Paid for by HMP, the HouseMajorityPac.com, not authorized by any candidate or candidate's committee.