Can Your Poop Predict The Next Pandemic?

Quinn: [00:00:00] Can your poop predict the next pandemic? That's today's big question, and my guest is Newsha Ghaeli. Newsha is the president and co-founder at Biobot Analytics. If you read our newsletter, you'll have heard me go on and on about Biobot, whose mission it is to transform wastewater infrastructure into public health observatories.

As an architect turned Urban Studies researcher, Newsha met her co-founder, Dr. Mariana Matus, at MIT almost a decade ago. Their work on the MIT Underworlds project led to a dissertation, scientific publications and coverage by dozens of local and national media outlets and places in the DeltaV, DesignX, and Y Combinator accelerators.

And now just in time, they're extending their groundbreaking wastewater epidemiology platform across the globe. Real talk. From opioids to COVID, to polio. There's so much we can glean from your poop and my poop altogether, so you and me and our [00:01:00] neighbors can be healthier and more prepared for better today and tomorrow.

Welcome to Important, Not Important. My name is Quinn Emmett, and this is Science for People Who Give a Shit. Quite literally. In our weekly conversations, I take a deep dive with an incredible human who's working on the front lines of the future to build a radically better today and tomorrow for everyone.

Along the way, we'll discover the tips, strategies, and stories you can use to get involved and become more effective for yourself and your family, your city, your company, and in our world.

Obviously Biobot’s work couldn't have come along at a better time. Public health data in the US is fractured and difficult to aggregate much less on the fly.

It requires a lot from us and all these institutions. Three years into the pandemic, most COVID testing is done at home and thus unreported. Most states have stopped reporting the data they do get. That's where poop comes in. Building a baseline understanding of what's quite [00:02:00] literally floating around in our towns and cities will help us be better prepared when new threats like COVID or old threats like polio come to town.

Like a weather report, wastewater data can make our day-to-day lives safer and leave us less surprised when things go to shit.

Newsha, welcome to the show. 

Newsha Ghaeli: Thank you for having me Quinn.

Quinn: You're very welcome. Uh, hopefully this is not one of those hours on your deathbed where you're like, I'd like to have that back now. Newsha, we'd like to start with one important question to set the tone for today's conversation, and that is why are you vital to the survival of the species?

It's a little ridiculous, but that's kind of the tone of the conversation, so let's do it. 

Newsha Ghaeli: That's a great question. I am one of two co-founders and president at Biobot Analytics, and what we do at Biobot is basically look at your shit, and not just yours, but your neighbors and everybody else who lives in your [00:03:00] community because your waste contains a ton of valuable information on your health and the health of every single person who lives in that community.

We are mining that information. We're mining that data. We're making sense of that data, and we're organizing it, presenting it, visualizing it for our government officials and public health officials so that they can make better decisions that can ultimately promote your health. 

Quinn: That's sounds super vital. We'll, we'll take it.

I mean, that's the whole point of having you on the show. Uh, thank you for explaining it so clearly and for what you do. So what I wanna help folks understand, and I'm trying to do a better job with this lately when we get into the nitty gritty of things, is let's really try to, if we can paint a picture for folks of the journey from their shit to Biobot. How this actually works generally, and I know the setup I imagine can differ [00:04:00] from county to county. Um, how that really works, so that eventually a city council, a public health department, however underfunded it might be, can eventually have a baseline. It can say is covid or opioids or whatever it might be going up for us, or are we in a pretty safe space so we can have better messaging?

But before we get to that, let's really try to paint that picture. Somebody goes to the bathroom, nothing changes. They just have to do what they do. What we all do.  The water - hopefully they flush - if they're my children, I have to beg them. because apparently that's just not something that gets through to them.

It flushes leaves their house goes out into the street where you guys start to get involved basically.

Newsha Ghaeli: Yeah. So we are collecting the wastewater, um, once it's already in our sewer systems. Um, so it's in the network of pipes that are underneath our streets and, and almost, almost every single city, let's say in the country, in the US.

We collect that [00:05:00] wastewater either at the wastewater treatment plant, which is sort of at the end of that network. Or we can also collect samples from manholes within a city to get a smaller catchment area. Say the city of New York is massive, we want Manhattan specific data, or even more so lower Manhattan versus Midtown versus uptown.

So we'll actually collect the samples from a manhole. Once that sample's collected, whether it's a manhole or a wastewater treatment plant, it's a small, little sample of sewage. It gets packaged into a kit that we provide the wastewater folks in the city. They pour that sample into the kit, sort of like a 23andme kit, but for sewage, these kits are flying all around the country.

Uh, that gets packaged into that kit and sent back to our labs, our headquarters, which are in Cambridge, Massachusetts. And that's really where the magic begins, and that's where we have a [00:06:00] team of scientists, data scientists, that are analyzing what is in that sample, what is in that small sewage sample.

They're analyzing it to identify all sorts of human viruses, bacteria, chemicals, really anything that we are consuming or that's in our bodies, we can actually then detect in that sample in an aggregated fashion.

Quinn: That's super helpful. Thank you. So I have 7 million questions. Let's start with, I hesitate with sewage to use the word sexy, but we should make this more attractive to people so they get more excited about it.

Is it better to ask you for a list of things that we can find from sewage, or is it so wide and varied that it's better to say what are the things we can't find?

Newsha Ghaeli: Yeah, I would say that our approach to it is actually slightly different in that we identify, you know, what are the priorities when it comes to public health and public [00:07:00] safety in our communities.

Today it's covid, it's covid variants. A couple months ago, monkeypox topped that list. More recently, influenza and RSV are topping that list. Three years ago it was opioids and other substances that were driving the overdose epidemic in the country. We try and identify working with public health officials and government officials, what is it that you are trying to address right now? What are the human health issues that you're trying to improve and how can we equip you with better data that can help your job? And then we can design an assay in the analytics for that on our side. And I'd say the reason why we take that approach is because it is so varied and so vast, what we can find in wastewater.

So rather than finding a solution and going out in search of the problem, we'll identify the problem first and then develop the [00:08:00] solution. 

Quinn: That seems very prudent as opposed to like, here's the 45 things. Go, go get 'em. Imagine for a moment, that we stopped killing people with opioids and that we start to get, uh, this particular virus in all of its many sub-variants under relative control.

So a normal time. What are sort of the typical things that a county might have their eye on? Flu season, RSV, things like that, or is, what else am I missing that we could actually try to get a step ahead on?

Newsha Ghaeli: Definitely, infectious disease is top of mind and has been top of mind the last couple years. Um, so covid, covid variants, monkeypox, but then also more broadly, respiratory illnesses like influenza and RSV, other gastrointestinal viruses like neuro virus.

We also are developing panels around sexually transmitted infections. So things like gonorrhea or chlamydia are excellent candidates to look in the wastewater for and [00:09:00] can really directly tie to actions that a public health agency can take. But then also expanding even more broadly beyond that into things that you don't really wanna see in our communities circulating.

So we can also leverage wastewater as a tool to just make sure that some of the scarier viruses are not present, so things like Ebola or Zika virus. And so we can start to also use this as a way for pandemic monitoring and prevention. 

Quinn: That makes sense. Is whooping cough on the list? 

Newsha Ghaeli: Oh, whooping cough. I mean, we could.

We likely could yeah.  

Quinn: I just think back to my children were all very close in age and when my middle child, my daughter was one and a half, maybe ish, we had our third child, and my one and a half year old daughter, somehow, despite having her shots, came out with whooping cough and this is pre Covid. Again, I remember the CDC being like, you need to split your house in half, and if this baby gets it, he's a [00:10:00] goner, and also your daughter might not do - and they called every day and all this type of stuff.

Obviously, Los Angeles has had a history of issues of people thinking they're smarter than doctors and waivers for vaccines and this and that. But again, and now we've seen, uh, obviously huge segments across the world and in the US children are behind on shots and things like that. I guess what I'm getting at is, it's very easy to feel like you were saying some of these more dangerous things where these more exotic, quote-unquote, exotic things are back of mind at best. When in reality we really need just a better picture of what is circulating most of the time or not, so that we can, again, better prepare ourselves. And that probably goes also to, Hey, we need to fund public health more in this area, or we need to build more clinics or community centers, or whatever it might be.

Does that make sense? It's, it's almost like an edit.

Newsha Ghaeli: Yeah. It's to help fund clinics and educational programming, but it's also to help raise awareness. So [00:11:00] very sort of publicly, I'd say over the last few months, the state of New York has looked for poliovirus in wastewater, and they have found poliovirus in wastewater in a few counties here in the state.

I'm based in New York City. They've made announcements about that. They've shared that information publicly. They've shared that data publicly, and that's really helped individuals as well as healthcare systems just prepare and be vigilant, especially if they're unvaccinated or their children are unvaccinated.

Quinn: Sure. Let's go back to painting this picture for folks for a while and then I'll go off on another tangent. It doesn't seem like there's some machine you guys come and install, that there's some infrastructure that the city or county has to pay for, or university. You know, some of these things are the size of small cities or large cities have to pay for it to install and then maintain it.

This, it seems, correct me if I'm wrong, that it's like the little tube, you take the sewage and we ship it off. Is that correct?

Newsha Ghaeli: [00:12:00] That's correct. And that's the beauty of this technology and this platform is that it's tapping into an existing infrastructure that we have. It's minimally operationally intensive or invasive.

If you take wastewater treatment plants across the country, there's 16,000 wastewater treatment plants that service almost 80% of the US population. Those wastewater treatment plants are already collecting wastewater samples, sewage samples on a weekly basis, many of them even on a daily basis, and they're collecting that sewage because they need to analyze it for all sorts of other environmental contaminants.

Things that help them operationally improve their processes, or just environmental reporting. All we need is a sub-sample of that sample that they're already collecting, so they're already doing the work and we're just telling them in that flow. Hey, that two liters of sewage that you collected today, can you just [00:13:00] send 150 milliliters back to our lab?

So fill these three tubes in our kit, ship it back to our lab. That really exemplifies the power and also the beauty of this platform. That 150 mills then that comes back to us, can be analyzed for all sorts of things and create this like tremendously powerful amount of data that can help inform the work that we do on the public health side.

Quinn: They're already doing the work. They don't have to install anything new. They don't have to maintain anything new. They don't have to hire somebody new to do specifically this. You guys don't necessarily have to be on-premise or performing inspections or anything like that. It's collected and ship it to you all.

Now, is there a centralized warehouse where all this shit goes? What is current capacity for testing this stuff? What is future capacity look like? How much can you all take on, what is required for you guys to scale? Cause as you have painted it, you are the ones really doing the extra work here. [00:14:00 

Newsha Ghaeli: If I can like paint a picture for you, we're headquartered in Cambridge, Massachusetts, just up the street from MIT where my co-founder and I first met. So that's where our HQ is, and that's also where our labs are. So every morning around 10 o'clock in the morning, FedEx shows up to our space sort of backed by the loading dock in the, in the parking area.

And dumps hundreds of kits. Our team is down there with these big sort of trolley bins collecting these individual kits from FedEx and taking them all upstairs into the lab to begin the work. And the analysis of one of those kits takes one working day. The following day, that community has their report and the analytics back from us. So we're giving them data that quickly. It's next business day turnaround. Currently today, we service over 600 sampling locations or sites across the United States, and as I said, there's [00:15:00] 16,000 wastewater treatment plants. That doesn't even begin to consider the number of manholes that we could be sampling.

So in a city that might be serviced by one wastewater treatment plant, we can also come in and divide up that city into 10 smaller neighborhoods and test, you know, those additional 10 smaller neighborhoods within the city. The potential to scale is massive, and that's what we're building towards.

I mean, we see this as being a permanent infrastructure layer in every single city in the country, in every single city around the world.

Quinn: How big is your loading dock? I laughed myself again at three small children. At one point it was Amazon drivers dropping off diapers at my house, and then it sounds like that literally gets FedEx to you. So the circle is complete. Scaling that up, let's say over the next year, you took on a third of those. What has to change for you all? Or is there a version two? I mean this might be version 35, but is there a version two post this [00:16:00] conversation that is more efficient than the FedEx side?

Is there more onsite stuff? Like, I'm curious sort of what the very near future looks like for the testing side. 

Newsha Ghaeli: So I would say the very near future does look like us scaling our footprint, expanding our lab, expanding our lab team, and the folks behind turning that sewage into data. We fundamentally believe it's very important for those samples to come back to our lab right today, as opposed to investing in real time sensing on the field. Because when those samples are in the lab, that's where we then have the flexibility to do R&D and try new types of assays, new analytics to detect new viruses and even hope to detect things like unknown viruses. If we are focusing on real-time sensing, we'll be building a sensor for one specific pathogen, which will then constrain the [00:17:00] data we're getting to that one specific pathogen or virus.

There is just so much value, untapped value in that sample that if we bring it back to the lab, that's where we can then split it across multiple different assays and workflows. 

Quinn: That makes sense. Um, this all seems so reasonable. Let's back it up a little bit to paint a broader picture for folks of wastewater, cuz this all seems like such a fantastic idea.

It seems so rational. It seems so, it's both curious but also such a reasonable way of looking at things going like, well, this is something we're already doing. Like why wouldn't we investigate it? And there's so much we're finding out about poop or shit or whatever you want to call it these days on the other side, right?

When we look at fecal transplants, like they actually might be incredible what we can do with those type of things to help people with their health. What is the history of wastewater? When did someone realize, wait, there's actually information here. There's data here for us to understand besides like, poop makes you sick.

How did we start to dig deeper on that? And then where did you guys come into that?

Newsha Ghaeli: There are [00:18:00] some very early examples of wastewater being used to monitor for poliovirus. In particular in areas where polio is endemic, and it was demonstrated as such a powerful and, and also like early kind of detection mechanism to understand the spread or the incidents of polio in a community that I'd say maybe 10 years ago or so, the WHO started to collect data from countries where polio is endemic, collect wastewater data, and these countries started reporting into the WHO, the prevalence of, of polio in wastewater.

The US has been largely polio free. Of course, you know, there's active like polio surveillance and outbreaks here in New York state right now, but that wasn't happening in the US again, mostly in regions where polios been endemic. And then I'd say similarly, in the past 10 years or so, there's been a lot of examples [00:19:00] of scientists looking at wastewater to understand drug consumption.

A large group, a large team in Europe had been working on this largely in the academic and research space, but a team of chemists in Europe and actually in Australia as well, looking at wastewater to understand consumption of drugs and in particular opioids. Now. That's sort of where our team came into play.

So Biobots actually founded on research that was developed at MIT. That's where my co-founder and I met. So in 2013, my co-founder was a first year PhD student in computational biology. Her name is Mariana Matus, and started a research project to see if we could identify influenza in sewage from the city of Boston.

That research question turned into a larger project that was working across her lab, but also the lab that I was in at MIT. [00:20:00] So I'm an architect. I'm not a scientist, I'm an architect. And I was in the Department of Urban Studies and Planning.

Quinn:  Like an architect, architect?

Newsha Ghaeli: I design buildings, architect.

Quinn: I love this. I'm a religious studies major who's like an atheist monster, and now I talk about poop water. So this is great. Continue.

Newsha Ghaeli: I came to MIT to expand beyond just architecture, which was my formal training. And I was curious largely in the future of our cities, so looking at how can we leverage new technologies and namely in particular, novel data streams that we're generating in our cities.

So whether that's data from our cell phones, from our cars or transportation systems, whether we could leverage these new data streams to help address some of our big urban challenges. So that was my research lens, and then I met Marianna one day. Learned about this research project that she had started around, you know, looking at sewage as a source of information on human health and human [00:21:00] behavior.

Her lab was focused on looking at the human microbiome. So this was a small leap, but a pretty profound leap going from the human microbiome and an individual's poop to community poop, essentially. Sure. And the concept just blew my mind, and I knew that one day this was gonna be implemented in every single city around the world.

I mean, it just makes sense when you think about it. We all know that there's a ton of information in our urine and stool. Our doctors look at it all the time, and so it just makes sense to look at citywide urine or citywide stool. So we started working together for about three years as research collaborators.

Running this very large project across multiple labs. Marianna finished, defended her PhD dissertation on the topic and we decided to start Biobot and, and start a company. And so when we first started Biobot, you know, we wanted our work to really reflect our mission, and our mission was to leverage data from wastewater to [00:22:00] improve and promote human health and human behavior in our cities, promote public health, promote public safety, and as such, we looked into what is the biggest public health crisis in, in our country today.

So this was in 2017. And yeah, this was before covid, so this was in 2017, and it was the opioid epidemic across the board. So that's where we built our, our first product, our first application. And really it was one of the first times that that opioid monitoring via wastewater was brought to the United States at a large scale.

We scaled that work for about a couple years, and then Covid hit and we expanded into infectious disease. Sort of here we are today, so I took you on a little bit of a detour there. 

Quinn: That’s what we’re looking for, because I think people either don't go to the doctor enough or they can't go to the doctor enough in the US for a thousand different reasons, or they're scared to go to the doctor, or they can't take time off to go to the doctor, whatever it might be. [00:23:00] Regardless. When you go, if you, if you attempt to go annually or when you do go, usually they will ask, can you go pee in this bottle? Or if you've got something going on, gastrointestinal, you might have to poop in the thing.

Or I mean, we do with pets all the time, right? The vet says, all right, they've been pooping all over the house, like put some in a thing and bring it into us within a few hours. And it's easy to think like, well then it's magic. And they tell me what's wrong with them. But that sort of perspective is so helpful, not just your journey from being an architect in the future cities to this is quite literally part of the future of our cities, hopefully. But going back further and understanding people really looking at these things going from, oh, we should wash our hands to why to wait, what can that tell us? And now can we aggregate it so we can try to get ahead of things or deal with these problems as, as Ed Yong put it early in the pandemic about, you know, sort of how Covid and I mean, opioids certainly have as well, but tested all of our assumptions. His  metaphor was like, it was the, the flood that found every crack in the sidewalk. Right. And we still really haven't funded more [00:24:00] community centers or clinics or public health agencies and state budgets and things like that.

That doesn't mean we can't look at things like this or the work that Sam's doing in the Pandemic Institute and things like that to look at and go like, no, it is 2022. You can take this very old sort of idea and really start to use the power of FedEx to use the power of labs to have great, fun, sexy dashboards that don't require, you know, a statistics degree to parse so that people can look at this and go, oh, here's our picture today from poop collected 48 hours ago.

It's meaningful. 

Newsha Ghaeli: Absolutely. And you said something that I, I want to go back to for a second is that here in the US and elsewhere as well, but really highlighted here because of our healthcare systems, people aren't always seeking out medical care, even if they need it. One thing that we always say at Biobot is that everybody has a voice in our sewer systems.

So the data that we're getting from sewage does not bias, unlike clinical data, it doesn't bias [00:25:00] towards those who are accessing clinical care. It doesn't matter if you have health insurance or you don’t. Your health is represented in that wastewater data and also our health is equally represented in that wastewater data.

That's what also makes it so powerful in informing our public health and public safety response. 

Quinn: I think if you've been working in American public health in any way or in the healthcare system, or it wasn't a surprise when cities and states were still, what are we, December, like faxing in Covid records, if they're tracking anything at all, and that the data don't talk to each other, and that we're behind on a lot of the research we need to be doing on new treatments as sub variants grow or we're behind on long covid, whatever the hell that actually ends up being.

You know, here's the most prominent things, but why and how do they interact? How do we treat them and what's the timeframe. All these things, and so much of that is because we really have such a lack of centralized data, and that is for a million [00:26:00] reasons, but it was really interesting and frustrating to see - and the system certainly isn't perfect - how the NHS was so, in the UK was so quickly able to conduct trials and get ahead to have practical understandings of we think these are how these things are coming together, who's being affected and what we might be able to do about it to try to find some meaningful signals in the noise.

And I come back to one of the things I wasn't aware of, even though I lived over there for a while, was aggregated anonymous data is actually the default when you're born in the UK as part of the NHS, you actually have to opt-out of that. Where in the US, we don't really, and I'm sure I'm mangling that in some way, and I'll put it in the show notes, but in the US we don't have anything like that.

Every time we try to run a big trial, either they're really expensive to do, or it's complicated or we can't get enough people to sign up or this and that. To come all the way back to the point you were just making is everybody poops, that's the whole thing. There's no way to really, unless a city just doesn't sign up [00:27:00] for this or a county doesn't sign up, or they decide not to use the data, there's really no way to leave people out of this.

It is our first sort of, you have to opt out type of thing, where it's easy to cut across all the data to really get the fullest picture, cuz everybody poops, right? Everyone is collected in this water and I don't think we really have much else like that. 

Newsha Ghaeli: Yeah, no, absolutely. Spot on. And I think that there's a couple of examples or anecdotes that can also make that very clear.

So if we take the, the Covid pandemic today, something that everybody can relate to. Like what do you do when you feel sick? If you have a suspicion that you have Covid -

Quinn: Cry

Newsha Ghaeli: And then once you wipe those tears, you're, you're probably gonna grab an antigen test that you have lying around your house.

You're gonna take that test. It's gonna confirm that you have Covid and you'll probably, aside from, you know, maybe calling the few folks that you [00:28:00] saw in the last few days, canceling all of your plans for this upcoming week, you're not really gonna do much else other than stay home and put on Netflix and you know, cuddle your hot water bottle or whatever makes you feel good. That's a behavior that everybody is now subscribing to when, when they get covid. Whereas if you rewind, you know, two years earlier in the pandemic, if you thought you were sick, you were immediately going to a clinic, you were getting tested, it was likely a PCR test, and that data was getting captured by your county, state, and then the CDC. So, county public health agency, state public health agency, and the CDC, were all counting that sort of like one person confirmed infection. So what's happened today is that all of those folks who are getting tested at home, confirming their illness at home, are not reported in the data, it's very unlikely that you're actually calling your county health agency to report your illness.

The data, the clinical data that we have for [00:29:00] covid is not nearly as representative of the true scale of covid infection in our communities today, unlike two years ago. And that's where wastewater data becomes super important. To pair with that the clinical data that we do get today, to pair with other data like hospitalizations that we look at, to help fill in the gaps that some of those other data sets have.

Quinn: Maybe you're familiar with this sort of framework. The map is not the territory. Right. And that was super indicative even at our most, if you wanna use the word robust or comprehensive level of testing, when we were still doing PCR and, and the government said, yep, fine, we'll pay for tests and you guys can each order four and when we were at max testing, even then you start to pivot to the point, like you were saying, the home testing, like if I test and my seven year old happens to have it, finding time to look up the public number for my county, much less the state while I'm trying to put on Netflix so I can tell everybody I'm not coming to work this and that. It's not on the [00:30:00] list, and it's really just not an efficient way of doing things. Right. At the same time, this is why it's so important we are constantly seeking alternative ways of looking at the bigger picture and going, there has to be something else available to us, whether it's on the measurement side or the verification side, or the testing side or the collection side. Like this can't be it. What else are we doing all day that can possibly provide some information for us.

Right? It's sort of like the prevalence of, um, all these startups making air quality monitors and you know, they're not perfect, but you can order a purple air monitor online, or you can order 10 and send them to your school district and build a dashboard. And within a couple days you can have a pretty good idea of what the actual air quality is around your kids' schools, which again, coming from Los Angeles for 20 years. You get a pretty good idea pretty quickly without anybody doing anything else that certain school districts have it a lot worse cuz they're exposed to more tires and more roads and more the harbor or whatever it might be. But it doesn't just [00:31:00] require taking kids in and testing them to see if they have asthma.

Right. There has to be ways to measure what's out there and what we're already doing, so I find it very appealing. 

Newsha Ghaeli: I'll also add that it's important to have like multiple types of testing diagnostics, so at-home antigen tests are incredible and it's so good that we have such a wide availability of them because that can really help also curb the spread of infection.

If you have a sneaking suspicion you're sick, you take a test. So it's not that that behavior should not change, it's just that we need to now also bring in wastewater monitoring to help fill the gaps that we have in the clinical reporting. 

Quinn: Well, it fills out that map, right? Again, to use a ridiculous metaphor, which I try not to overdo these, but it's the, the fog of war as they put it, its like you don't know what you don't know.

If you're not putting the information out there, and if you actually piece all these different versions of testing together, you really get a picture to make everybody healthy. And that's when everyone's like, well, we gotta get back to work and this and this. Well, would you like to know what affects the economy?

[00:32:00] It's people being sick or deciding not to wear masks cause there's no information. Or they can't afford personal tests. Does the government send them anymore? It's like, let's paint the fullest picture we can to give people the best messaging we can so that we can all actually be as healthy as we can every day and make things and buy things and provide services to each other like that's how an economy hopefully works. We're gonna get to the point here where we say, okay folks, if you want Biobot in your neighborhood, here's what you're gonna do. What is really required of a city or a county or a, again, you know, I've got the College of William Mary's like 10 feet that way, let's say they go, yeah, let's do Biobot because STDs, whatever it might be, what is required of them, both financially, contract wise, things like that.

And obviously, you know, you can give away what you want to give away here. But I want people to have the fullest pictures so that when they go to these meetings, which you know, takes a little courage to go and speak up at something like this, that somebody doesn't look at it and go, well, we can't do these 10 things.

Like, this is complicated. I want them to [00:33:00] know what they're walking into. So talk to me about that process. 

Newsha Ghaeli: What we would need is the willingness of the waste, the local wastewater treatment plant to actually send us samples. So unpackage our kits, pour some sewage into the three tubes we have. Slap on the shipping label, call FedEx, ship it off.

That commitment is required. I bring this up because we have worked with communities very rural, where they have a wastewater treatment plant that might have two staff members, and so when one of them is sick, they can't send a sample that week. So not everywhere is staffed or resourced the same, so that that sort of willingness has to be there.

But it exists, it's there. Identifying the wastewater folks and then it would really be engagement from some other body, like either city council, the executive office, mayor's office or the public health agency, to actually be the ones that are gonna say, I'm gonna [00:34:00] consume this data and this data is gonna make a difference in the work that we do.

Again, whether that work is education and awareness, whether it's resource planning, intervention design, things like that. For a city to get online to send us samples and get data for COVID, it's about $1,500 a month. For high-risk substance monitoring, so that's looking at substances like meth, cocaine, fentanyl, to help understand what's driving consumption and what's driving overdoses.

In our city, it's about $1,000 a month, so the cost is, is extremely, I mean, I would say reasonable considering what you're getting, the value. And then I'd say the biggest sort of value of all is that once this is in place, once that infrastructure is in place, we can start to layer on additional applications as either they become available on our side or they become priorities on the city [00:35:00] side.

That lift is then extremely low.

Quinn: Because everyone's doing the work already. Exactly, and that is one of the arguments against building a real-time piece of machinery is you don' semd city council an email saying, guess what? Now we can do magic virus. It requires us to come out and you gotta buy this thing and we gotta install it and it's got a warranty and this and this.

It's just no, just keep shipping us poop and maybe pay us a little more and we'll do these tests too. Is that dumbing it down too much? 

Newsha Ghaeli: No, that's, that's accurate. That's perfect. If anybody is interested in bringing this up with city council members who, for what it's worth, we found our excellent entry points into gaining support for this type of work is city council members and then obviously like a mayor's office or county executive's office, and then, of course, the public health agencies, the public health departments at the county level, if anybody's interested and wants support in a one pager or anything to share or bring with them to equip with [00:36:00] them, they can reach out to us and we'd be more than happy to provide this because, you know, I think the support from people in a community is so important because at the end of the day, our elected officials are there and our government services are there to support us as constituents and residents. We need to tell them what we want. And what technologies or programs we want them to implement to help keep us safe. Our voice is so important in this whole pandemic preparedness disease surveillance work. Our, our voice is very important and we need to make sure that, that advocating for the technologies that, that we want our cities to have.

Quinn: So, best to normal case scenario. I go to a city council meeting tonight. I present the one pager and give my little speech and set them up and they go Sure. Great. That sounds awesome. It's Tuesday, so maybe they get it done by Friday. How soon from me going to the city council meeting to them collecting [00:37:00] their first poop and sending it to you?

When do I get to look at my first city dashboard? 

Newsha Ghaeli: If they decide they wanna start, we can get them kits within one to two days, we can express ship kits to that community. We need to get them registered. It takes no more than one or two days. They collect the sample within a day. It's back at our labs the next day.

That data is back in the city's hands. We can create a plot for your community on our website. If you visit biobot.io/data, you can actually see nationwide average of our data that we collect divided by region. And then if you keep scrolling individual counties, we'll show the time series of the, the COVID data and the variant data.

And so within a week you can have your county on that dashboard and, and that data there with your first little dot and slowly populating over time. 

Quinn: Does it show me relative to other counties or compared [00:38:00] to a nationwide average or anything? Obviously it hugely varies by demographics and all that sort of stuff, but I'm trying to get an idea of context, like what does my dot really mean? In the grand scheme of things. 

Newsha Ghaeli: One of the things that we do when we analyze the wastewater is we actually normalize the data. And what that essentially means is if it happens to be raining in your community or you happen to have 10 times more people than another community we’re sampling, so therefore 10 times more poop and therefore 10 times more covid.

Yeah, we correct for all of these factors so that all of our data is comparable, and it's not only comparable across locations, but then your data from your county is comparable to itself over time. So we can build these beautiful and extremely informative time series that show how Covid is trending.

And so, yes, if you're on our website, you can see the trend data from your community. You can look at that [00:39:00] absolute value, and then you can look at our nationwide average and then absolute value, and see where you fall in comparison to that.

Quinn: Mets not going great this week compared to Texas, et cetera, et cetera.

That's a pretty quick turnaround. I think it's easy for folks to get attached to this idea of yeah, but, but real time, like, shouldn't we be able to do it real time? And, and this and that as much as a week is very quick to do anything much less, like once it's ongoing, it's, it's, you know, within two days.

And that is really compelling because, wastewater data is a pretty leading indicator of some of these things, right? Uh, aren't you seeing signals way before we would normally see them with general testing. 

Newsha Ghaeli: We have seen that data from wastewater can be a leading indicator for Covid up to anywhere from like two weeks, 10 days.

And what that means is that we'll start to see a rise in the wastewater concentration about 14 to 10 days before we start to see a [00:40:00] similar rise in the reported clinical data. The reasons for that, there's a couple reasons. You know. One is that biologically when we get sick, with covid or, or most infectious diseases, you're shedding the virus in your stool right away or within a matter of days.

You know, as we've touched on multiple times throughout this conversation, all you have to do is just keep pooping like you usually do. And within a couple days, we'll be able to detect the presence of the virus, whereas if you get sick with Covid, you might not develop symptoms for about five days, six days or at all.

And then you have to go get tested. If you do get a test from your doctor and it is reported, that lag can be upwards of about a week, and that's all because of just like the systemic kind of infrastructure around clinical testing in our cities. What ends up happening is that the wastewater data is one or more weeks, two weeks, even ahead of the clinical data.

Quinn: Do you really feel [00:41:00] like you're scratching your future of city's itch doing this work? You seem so passionate about it, about both its power now to help people, but also do this greater conversation of how do we maintain better but also prepare better? Because again, this stuff is, I mean, talk to Sam all day, like this stuff is going to keep on happening because of a thousand different reasons.

Cuz they always have, but also cuz of other reasons. Is this doing it for you?

Newsha Ghaeli: Absolutely. I mean, the more and more communities that participate in wastewater monitoring and the more prevalent wastewater intelligence becomes as a data source, the more powerful it is. So, you know, it's incredible to have one city doing it.

The potential once you have an entire state, that connected data, because disease or drug consumption for that matter. Disease doesn't know any boundaries. Doesn't stay within city limits or the limits of a wastewater community. So it's very [00:42:00] important to know what is happening in the city next to mine, or even the state next to mine, or even what's happening across the ocean over in Europe.

What's happening over in Asia because that's just a, an eight hour or a 10 hour flight away. Yeah. If you project into the future and think about the potential of having this interconnected sort of global wastewater intelligence system where we're able to see around the world, what are things that are emerging, where are they spreading, how are they then sort of declining and dying down?

Like that information will be so useful in helping us come together as a planet essentially and prepare for the next pandemic because they're going to keep happening. Climate change, extreme weather events are increasing the likelihood of pandemics or infectious disease outbreaks of pandemic potential that's compounding on things like [00:43:00] overpopulation.

And urbanization, increased population in our cities, uh, and also increased globalization. We're all traveling so much. All of those factors are just gonna increase the potential of disease spread and outbreaks of pandemic potential. And so a global system is really the future, and that's what we're building towards.

Quinn: I mean, I love it. Again, it's this idea of like, how do we take a step back into like fixing electronic health records and fax machines and HIPAA and state and public funding and all these things is, is a admirable and necessary and we've gotta keep making it better and more practical and usable and all those things.

But also like how do we do an end around to create a weather report essentially for infectious disease because that system already exists and it works pretty great. You know? We keep building new supers computers and going like, it's great. Can we make it better? Can we give people more time?

This and that. There's no reason why we can't not ignore this bigger problem that [00:44:00] there's incredible people working on, and it's complicated. I, I've a lot of friends in government that are doing their best right at every level, but there's no reason we can't step aside and go, well, this is here. If we were to start from scratch, what would it look like?

And it looks like your dashboards and that data point. That you could normalize poop per capita, basically to tell people like, when you land in London, this is what's going on. 

Newsha Ghaeli: We love the weather app analogy. That's exactly how we should be thinking about data from wastewater. That it's a normalized natural input into not only our public health systems, but also into our lives.

As consumers and travelers and citizens, we should be equipped with that information. And doesn't mean that we're all gonna stay home and and be holed up in our apartments. It just means that we're gonna be prepared in the same way that if it's raining, like I brought an umbrella with me today because it's supposed to rain all day in New York, right? Maybe I would bring a mask if, if I have, uh, certain information that I can [00:45:00] access in the morning on our wastewater data. 

Quinn: What voices are missing from, I guess, this work? Is it marketing? Is it design? Is it more data scientists? Is it engineering? Is it. Is it lobbying?

Cuz you get people jumping from all over the place who are trying to contribute to these bigger problems and they might just not otherwise think like, oh, I guess I could go work on poop. Like I never thought about that. But at the same time, like someone's designing your dashboards, which looks so elegant and wonderful.

And we've all tracked 70 different dashboards over the past three years, right? So we understand what's good and what's not, and what's good information and what's not helpful. What's missing? Which do you wish, like, oh, if I could get that advertising guy. 

Newsha Ghaeli: I wouldn't say that these two things are missing.

But definitely they're very important to the work and can only grow is data science and our ability to just be able to dig into the data, which you know we already do, and understand like unique patterns and essentially what are some of the [00:46:00] stories in that data that we can tease out that can not only make a difference in how we're designing our, our public health response, but also stories that we can tease out that we can then share with the general public, share with government agencies to build support behind wastewater monitoring. So I'd say continued investment in data science capabilities and just knowledge and familiarity around wastewater in general.

And we're seeing that, we're seeing so many more students within academia choosing to focus their work and research on wastewater monitoring and wastewater data. So in the fields of computational biology and computational epidemiology. That's incredible cuz that's gonna help continue to advance the field.

On the other hand, we also need more and more government officials who are willing to get behind the promotion of this work because it is complicated in that it requires multiple stakeholders from [00:47:00] different agencies with different backgrounds and expertise to come together and make it happen. We need the water folks sitting at the table with the public health folks sitting at the table with the elected officials and the communications folks to make sure that the data's being communicated to the general public properly.

And that's a tough mandate. Like, let's get all these people in a room together and create a program together. And yeah, that's been one of our big focuses as well, is being a convener and bringing these different groups and communities together. And so I would say, just increased sort of education amongst our government officials so that they can be champions for this work.

Quinn: I love that. And yes, getting those people in a room together. Step one, not easy. Step two, getting them to agree to do something. Step three, actually finding the funding to do it. It is a tall order, but obviously a necessary one. Okay, one last practical question and then a couple little lightning round ones, and then you're outta here.

If I'm, uh, a human who's like, great, I'm in, [00:48:00] I'm gonna take this to my city council, literally, what is the URL they’re going to and what is the first step?

Newsha Ghaeli: Yes. So I would say step number one is go to www.biobot.io. Slash data and scroll down and see if your county is already represented or not. But also that's a peak at where the county data will go so that you can share that with your city council. Then I would say, you can send us an email @ hello at biobot.io. Maybe put important, not important in the subject line and let us know that you wanna speak with your community, with your city council, and we will work with you to give you the information that, that you need to take forward so that you know we can support you from the sidelines.

Quinn: Awesome. Super helpful. Thank you. I try to spell it out for everybody as much as we can. Last couple questions and then we're gonna get you outta here. Newsha, when was the first time in your life when you realized you had the power of change or the power to [00:49:00] do something meaningful to move the needle?

Could have been running for school council in second grade or beating up a bully or, or helping somebody or whatever it might, it could have been two weeks ago. It doesn't seem that way. But, I'm curious for you. 

Newsha Ghaeli: I would say it was when I got my research fellowship position at MIT, you know, for somebody who had studied architecture and engineering, I finished grad school and I knew that I didn't wanna be an architect.

And it was, that was a scary place to be. Right? You just invested like seven years, including my bachelor's and master's degree. Seven years in a, in a discipline. And I didn't wanna be an architect, and I applied to this research fellowship at MIT really to help as like a transition into, you know, figuring out what I wanted to do, but also transition into a different, industry, and when I got it, it's not a huge leap, but to work on the future of cities where I really thought I wanted to focus, I feel like that was a first for me to realize, you know what?

You can do what you [00:50:00] wanna do if you put your mind to it. You don't need to sort of resign to the path that has been laid out already, if that's not what you wanna do. 

Quinn: I love that. Thank you for sharing that. Who is someone in your life that has positively impacted your work in the past six months? 

Newsha Ghaeli: Oh, this might be a little cheesy, but it's hard being a founder. It's hard being part of a very rapidly growing startup. Things are changing all the time. Things are moving so fast. I'm a first time founder. I'm learning on the job, and so, I mean, I would have to say my husband and we've only been married for about five months, so just- 

Quinn: Congratulations.

Newsha Ghaeli: Thank you. So, of course he's always been willing to, to be super supportive in whatever I need to, to put into work. But in particular, when you're a newlywed, um, being able to be that selfless I think is, is really awesome. 

Quinn: I love that. I would be, uh, nowhere without my wife. She's the most incredible human she puts up with quite a [00:51:00] bit. Last one. What is a book you've read in the past year or so that has either changed your mind about something or opened your mind to a topic or idea that you hadn't considered before? We get a whole list up on bookshop that we let people peruse. 

Newsha Ghaeli: Well, I'm a little bit late to this game. This book's been out for a while and I know as talked about a lot, but I recently, like about a year ago, read Sapiens.

Which I mean was just an incredible read. Really makes you think about, you know, where we came from, where we're going. I am, I know the author's written a few other books and so I'm excited to, to get into those in particular. I think there's one he's written that I haven't read yet. Lessons for the 21st Century.

Quinn: Yeah, something like that. 

Newsha Ghaeli: Yeah. That's supposed to be much more forward thinking and I'd be really curious to read, to read that one. And then another book that also, I was late to the game, but I managed to, to squeeze it in right before actually watching the movie that came out, but was Dune.

[00:52:00] Oh, that was amazing. 

Quinn: So good, right? 

Newsha Ghaeli: Yeah, yeah. Yeah. That was great. 

Quinn: The movie was tremendous. I, watched it 12 times. That's it. Newsha, thank you so much for your time and, and all your, uh, incredible tenacity and diligence to, to build something drastically better and incredibly helpful to more folks who are already doing their part, whether they know it or not, they've been doing it all along.

We've just gotta use it better. And for the low, low cost of 1500 bucks a month, we can start to do that. So, I really appreciate it. I think hopefully this really spells it out, folks, be able to go out in the world to protect your kids, to send them to school, this and that and this seems like such a no-brainer if we can just get more places on board.

So excited to help overload your loading. That is the goal. 

Newsha Ghaeli: Yes. And keep on pooping. That's the other thing. Keep I'll say to everybody.

Quinn: You know for a thousand different reasons, please keep on pooping. If it's been a couple days have some chia seeds, it'll be great. Newsha, thank you so much for your time. I really appreciate it.

And that's all I got. 

Newsha Ghaeli: [00:53:00] Thanks, Quinn. Thank you for having me.

Quinn: Yeah, absolutely. That's it for this week. Important, Not Important is hosted by me, Quinn Emmett. It's produced by Willow Beck, edited by Anthony Luciani. The music is made by Tim Blaine. You can read our critically acclaimed newsletter and essays, get notified about new podcast conversations @ importantnotimportant.com.

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Let us know how we did. Thanks so much for watching and thanks for giving a shit.