COVID WASTEWATER IN EUROPE, a thread 🧵

Covid prevalence is rising fast in England.

Our Covid wave is only just beginning, but other European countries are further along the curve.

In this thread, I take you on a whistlestop tour through Europe to see what’s been happening...
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It’s important to note that Covid waves impact different countries in different ways, depending on many factors, including:

📍length of time since last big wave
📍% of population recently vaccinated
📍mitigation measures taken by government
📍population density

…and many more.
So, with that in mind, let’s take a little tour around Europe:

1. THE NETHERLANDS 🇳🇱

In the Netherlands, they’re currently seeing the highest EVER Covid wastewater signal.

And it’s not just a bit higher than the previous max - it’s a LOT higher!

coronadashboard.government.nl/landelijk/rioo…
Image
2. AUSTRIA 🇦🇹

In Austria, it’s a similar story. They’ve just seen the Covid wastewater signal rocketing to a new record high.

It’s possible that the Austrian wave has just peaked but it’s still too early to be sure - it may just be a little blip.

abwassermonitoring.at/dashboard/
Image
3. GERMANY 🇩🇪

Likewise, in Germany, they’re seeing the viral load of SARS-CoV-2 in wastewater across the country soaring to new record highs with each passing week.

corona-pandemieradar.de/en/sewage
Image
4. BELGIUM 🇧🇪

Belgium are also seeing another big spike according to their Covid wastewater surveillance, albeit not as extreme (yet) as the waves being experienced in the Netherlands, Austria and Germany.

wastewater.sciensano.be/dashboard/covi…
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5. FRANCE 🇫🇷

In France, they are also experiencing a steep & sustained rise in the Covid wastewater signal, soaring to the highest level in well over a year.

H/t @nicolasberrod
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6. SWITZERLAND 🇨🇭

I think perhaps you’re starting to see the trend by now.

Another huge spike in the viral load of SARS-CoV-2 in the wastewater signal (purple line) which, in some areas, is the highest it’s EVER been since the start of the pandemic.

sensors-eawag.ch/sars/overview.…
Image
7. LUXEMBOURG 🇱🇺

Since September, there has been a steady and sustained rise in the SARS-CoV-2 viral load in their wastewater surveillance, once again reaching levels that are as high, if not higher, than the previous record high.

list.lu/fileadmin/file…
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8. DENMARK 🇩🇰

The concentration of SARS-CoV-2 in Denmark’s wastewater is again at the highest levels they’ve seen in over a year…

en.ssi.dk/covid-19/natio…
Image
9. FINLAND 🇫🇮

Another similar story. Another massive spike in the Covid wastewater signal.

koronatilastot.fi/fi/jatevesi/
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10. CANADA 🇨🇦

I know I said this thread was all about Europe, but this trend is not unique to Europe.

Let’s look further afield and see what’s been happening in Ontario, Canada… 👀

Their Covid wastewater signal has been rising & rising too.

publichealthontario.ca/en/Data-and-An…
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11. USA 🇺🇸

The USA are also seeing signs of a big incoming wave.

biobot.io/data/
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11. USA 🇺🇸 (continued)

@michael_hoerger has been keeping a close eye on the data and predicts that this has the potential to be the 2nd largest COVID surge of all-time in the U.S.

His thread 🧵 below is well worth a read.
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12. ENGLAND 🏴󠁧󠁢󠁥󠁮󠁧󠁿

Now you might be wondering what the England wastewater surveillance data looks like…

Well, I’d love to be able to tell you, but sadly England’s wastewater surveillance was axed nearly two years ago, back in March 2022. Image
13. SCOTLAND 🏴󠁧󠁢󠁳󠁣󠁴󠁿

Meanwhile, Scotland have continued to monitor their Covid wastewater signal since 2020.

There was a fairly big double spike towards the end of the summer in August/September. The signal then dropped but has just started to rise again.

scotland.shinyapps.io/phs-respirator…
Image
14. WALES 🏴󠁧󠁢󠁷󠁬󠁳󠁿

Wales recently restarted their wastewater surveillance after a 4 month hiatus when their budget was suddenly axed back in August.

The first report since surveillance restarted has just been published. Image
15. IRELAND 🇮🇪

Ireland also keep close tabs on the Covid viral load in their wastewater.

There’s not any sign of an uplift in their signal just yet.

hpsc.ie/a-z/nationalwa…
Image
So that concludes our whistlestop tour of the Covid wastewater surveillance in Europe (& beyond).

Two key questions arise from my research:

1️⃣ Given that practically every developed nation in the world is conducting Covid wastewater surveillance, why did England stop theirs? Image
As explained in this briefing note for SAGE back in Nov 2020, “wastewater surveillance is a reliable, timely & cost-effective method” of keeping track of Covid prevalence in the community.

So why was the budget for wastewater monitoring axed in England?

assets.publishing.service.gov.uk/media/5fc8d6a2…
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A recent Freedom of Information request revealed that the cost for Wales to resume their wastewater programme was just £621k.

This is a tiny cost in the greater scheme of things, especially when compared to the £billions written off in the PPE scandal.

llyw.cymru/sites/default/…
Image
2️⃣ My second question is, given the huge surges in Covid prevalence across Europe, when are our government going to take action to reduce transmission here?

The WHO, BMA & RCN have called for improved infection control in health facilities - this would be a good place to start.
Millions of Covid vaccine doses have been stockpiled for a potential “surge” campaign this Winter.

Perhaps now would be a good time to release those vaccine doses to protect people in the coming weeks, rather than just leaving them until they expire & need to be destroyed?
Image
Perhaps the gov could also consider bringing back free Covid tests.

In the US 🇺🇸, free Covid tests can be ordered by all households and are sent out by mail:



Here in England 🏴󠁧󠁢󠁥󠁮󠁧󠁿, tests are no longer free for most people. A pack of 6 tests costs ~£10. axios.com/2023/09/20/cov…
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Another thing on my wishlist would be for some decent public health messaging, advising people in England to wear high quality masks (FFP2/3) in public indoor spaces and crowded places…

…like this recent public health campaign from New York. 👇🏻
There will be a huge amount of inter-generational mixing taking place over the next few days, so a public health message reminding people of the importance of VENTILATION could also make a huge difference right now.

Perhaps they could even re-release this video from 2 years ago?
Schools have broken up for the Christmas holidays now - but, by the time they return in a few weeks, Covid prevalence will be almost certainly be far higher.

We desperately need mitigation measures to reduce transmission - especially via improved ventilation & air filtration.

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More from @_CatintheHat

May 11
HANTAVIRUS OUTBREAK:

I’ve just listened to the health update from the US Nebraska Health Officials 🇺🇸

A few points of interest:

1/ in addition to the US passenger who tested positive & the one showing symptoms, it seems there is ANOTHER passenger who may have tested positive.
2/ Passengers currently in the Nebraska quarantine unit will spend a few days there being assessed.

If they remain symptom free & have support available at home to isolate safely, they’ll have the choice to complete the 42-day isolation either at home or in the quarantine unit.
3/ When asked about the US passengers who left the ship in St Helena on 24 Apr (at the same time at the Dutch woman who was symptomatic & sadly died on 26 Apr), they confirmed that these passengers have all been traced & are being monitored - but seems they’re NOT self-isolating.
Read 10 tweets
May 10
HANTAVIRUS OUTBREAK

Following my thread yesterday which criticised aspects of the WHO’s strategy, I’m pleased to see they’ve done a 180° turn in the updated guidance published today:

who.int/docs/default-s…

EVERYONE from the ship will now be treated as HIGH-RISK contacts…

🧵 x.com/_catinthehat/s…Image
…and ALL high-risk contacts will now be required to ISOLATE in a designated facility or at home (depending on each country’s capabilities) for 42 days from last known exposure…

…and for the MV Hondius passengers & crew, the last day of exposure is the date of disembarkation. Image
So for the passengers & crew leaving the ship today, the clock for their 42 days in isolation starts ticking TODAY…

…and their isolation & monitoring will end on 21 June. Image
Read 7 tweets
May 9
HANTAVIRUS OUTBREAK 🧵

Following the WHO press briefing, I wanted to compile a thread with the key points.

1/ ISOLATION OF PASSENGERS

Concerningly, it seems the WHO are NOT recommending to isolate cruise ship passengers (even high-risk contacts) UNLESS they develop symptoms.
Just to quickly recap, it has been confirmed that the passengers & crew (including the 30 who disembarked on 24 April in St Helena) come from a total of 28 different countries.

The full breakdown of countries for both passengers 🟥 & crew 🟦 is detailed below ⬇️ Image
When the 146 people remaining on the ship are repatriated to their home countries, each country will adopt their own local protocols.

However, the WHO are only recommending:

▪️SYMPTOMATIC cases ➡️ isolation
▪️ASYMPTOMATIC cases ➡️ monitoring
Read 41 tweets
May 5
HANTAVIRUS OUTBREAK ON CRUISE

“Human-to-human transmission suspected on board hantavirus cruise ship, WHO says”

▪️7 cases identified so far.

▪️3 people (2 Dutch, 1 German) have tragically died.

▪️1 Briton is in intensive care in South Africa.

edition.cnn.com/2026/05/05/afr… x.com/cnn/status/205…Image
The exact Hantavirus has not yet been identified, but given the ship departed from Argentina, it’s a distinct possibility it’s the Andes Virus.

This strain is known to be transmissible between humans & previously caused superspreader events in Argentina.

nejm.org/doi/pdf/10.105…Image
Below are further details about the Andes Virus superspreader events in Argentina (in 2018):

▪️ Transmission event: Birthday Party
5 guests infected
Symptom onset 17-24 days later

▪️ Transmission event: Funeral/Wake
10 guests infected
Symptom onset 14-40 days later Image
Read 50 tweets
Mar 22
MENINGITIS B TRANSMISSION

There’s been a lot of discussion online and in the media about how exactly Meningitis B spreads.

A lot of it is conflicting & confusing.

So let’s put opinions & hearsay aside and take a proper look at what the latest science actually tells us…

🧵 Image
The UK National Institute for Health & Care Excellence (NICE) states that bacterial meningitis and meningococcal disease is transmitted by the following 3 modes:

▪️ aerosol
▪️droplets
▪️direct contact

cks.nice.org.uk/topics/meningi…Image
The first of these modes of transmission, AEROSOL, has been the subject of heated debate.

Let’s look at why…

Notice the second line:

“Transmission usually requires either frequent or prolonged close contact.”

At first, this may seem contradictory with aerosol transmission… Image
Read 22 tweets
Mar 19
COVID INQUIRY: MODULE 3 REPORT

“Fundamental flaws in the UK’s approach to IPC [infection prevention & control] guidance, for example in relation to the use of PPE, put patients and healthcare workers at risk.”

— Baroness Hallett, Chair of the Covid Inquiry

Read more here… ⬇️
These are the words we were all hoping to hear:

“Initial guidance on preventing the spread of infection was flawed. It assumed the virus was spread by contact transmission, failing properly to consider the extent to which it was also spread by AIRBORNE transmission.” Image
But it wasn’t just the “initial guidance” that was flawed!

To this very day, the IPC guidance STILL does not reflect the latest science on AIRBORNE transmission.
Read 4 tweets

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