Ever since the pandemic we’ve been told we’ll need to learn to live with COVID-19, while also being warned it won’t be the last pandemic to hit us. Yet health risks aren’t equal in their impacts, so finding ways to intelligently manage risks around illness and infectious disease is critical work. Step forward Untap Health, a startup out of London, U.K. that’s presenting on the Disrupt SF Battlefield stage today with a pitch about pulling a stream of actionable risk data from wastewater.
The team’s conviction is there’s huge untapped value, both commercial and for people’s health and the public good, in sampling and testing collective sewage for traces of disease — aka “wastewater-based epidemiology” in the scientific parlance.
This type of community health surveillance isn’t new. It stepped up markedly during COVID-19. Although the processes involved (sewage collection, sending samples to a lab for analysis) still tend to be very manual, with a delay of several days or even a week before you get results. But what if wastewater could be tested continuously — streaming insights to a digital dashboard where building managers or health & safety leads get real-time intelligence on the infectious disease risk for people living or working on site? No eye-watering lateral flow tests necessary…
That’s Untap’s vision in a nutshell. Its pair of academic co-founders, Dr Claire Trant and Dr Jay Bullen, have been working since early 2021 to bring this idea to life after meeting and clicking over the idea at Entrepreneur First. Bullen has a PhD in water chemistry, while Trant spent several years working in water tech regulation before being bitten by the entrepreneurial bug (her “totally irrelevant” PhD is in aerospace engines).
Inspiration amid a pandemic
Trant says the realization there was a problem to be solved in sewage surveillance came to her during the pandemic when she saw up close how much of a “logistical nightmare” the government was struggling with, shipping manually collected sewage samples from all over the country to a single lab for testing as everyone screamed for more data.
“They were looking at technologies coming out of universities and organisations that could be used to make this operational nightmare bit easier,” she tells TechCrunch. “Essentially, what the government was doing, and what most service vendors’ techniques are doing, is manual collection of sewage. You then courier it to a lab, and then you analyse the data and send it back. That takes around a week so it was only really used on a city scale — just because it’s too slow to use any more granularly than that. So the government was looking to step it up. And there was no obvious solution for that on the market. And that’s why I really came to it.”
Bullen, meanwhile, had his own brush with the inner workings of government a couple of years before the pandemic — via a three-month placement with the civil service. There at DFID he led a research project horizon-scanning innovations for real-time water quality monitoring. He says the experience left him with a feeling of potential; that much more could be done with wastewater — and a sense that wastewater based epidemiology, specifically, would emerge as far more important and impactful in the coming years. Then COVID-19 happened and changed everything.
Wastewater surveillance had been a bit of an academic back water (ha!) til then, as Bullen tells it. But suddenly governments around the world were extremely interested and scrambling to deploy resources to see what insights could be pulled out of the sewers to help their COVID-19 responses. The community of researchers then pulled in by policymakers were “pleasantly surprised” by how much scope the technique had to detect the presence of what is primarily a respiratory infection.
Untap was set up to respond to this pandemic-driven surge of interest in wastewater surveillance. Initially the team was looking at community monitoring on a city scale as that’s where governments were focused with COVID-19. But as they were working on their prototype Trant says they realized they were producing data so fast in comparison to traditional wastewater surveillance methods that there were many more possible use cases and they saw an opportunity to sell real-time illness detection directly to organisations likes care homes, offices and even cruise ships.
“We saw the original market and then realised the potential and much, much bigger market that was there,” she recalls. “That’s why we’re building this multi-pathogen [detection capability]. So we’re looking to develop a technology for up to 12 pathogens for our first product. Which means that we can do COVID-19, flu, Norovirus, RSV — and whatever else, unfortunately, may come at us.”
The next pathogens on its detection expansion list are: E. coli, Campylobacter, Rotavirus and Enterovirus. While initial target customers are care homes and offices — where Trant says they’ve seen some early interest in their proposition.
The goal is to launch a commercial service which automates PCR testing of collective sewage, doing this on-site and serving up same-day infection data on the building’s community of users — creating the chance for these locations to prevent outbreaks. The startup says its solution will be cheaper (and less intrusive) than lateral flow testing a whole community. It also points out the approach avoids the cost (and mess) of having to manually access sewage.
Turning waste into data
Untap’s mission sounds like an alchemy of sorts (turning waste into something precious). Except it’s actually chemistry, epidemiology, engineering and data science. The startup has amassed a team of 11 at this point — which includes professionals in biochemistry, mechatronics, electrical and electronic engineering and design; a blend of engineering talent that’s enabled it to develop its prototype hardware to automate sewage surveillance.
Its pathogen detection hardware uses the same basic chemistry as when a lab runs a PCR test on a blood or saliva sample to look for disease. This was a key decision, per Bullen, who says sticking with the “gold standard” PCR test sets Untap apart from other early competitors trying to develop systems for on site continuous monitoring. (Full details of the team’s hardware prototype remain under wraps for now — and we weren’t shown any photographs or videos of the actual device working — as the co-founders are still filing about half their IP.)
They say what they’ve developed is robust enough, small enough and affordable enough to be installed on site, inside a customer’s building. Once in place it can perform multiple tests over the course of a day to produce a stream of data on infection risk — meaning it could, for example, cover different shift patterns.
The hardware does need to be serviced every one to two months, according to Bullen. Although this is the first iteration of the product and he says they hope to keep improving it, with the goal of shrinking it even more (so it could fit underneath a manhole); and reducing how often it needs to be serviced (once per year is the target).
The main (raw) data points Untap’s hardware is collecting is a measurement of the concentration of genetic material of the different tracked viruses or bacteria in the wastewater. And while finding traces of disease in collective sewage isn’t necessarily going to tell you whether you have a lot of infectious people in a building or a few folks shedding a lot of virus, for example — nor can it even tell you whether people are infectious in that moment — the idea is that by tracking changes in a local baseline the service can provide a useful risk score over time.
Hence, says Trant, their focus with the product will be on quantifying risk for customers. “The data itself, in one day, doesn’t really say much. It’s actually related to the previous day it’s really interesting — or the previous data point,” she says. “If you can say, actually, the risk is increasing in your community… it doesn’t actually matter if the number of people that have a virus increases; it matters that the amount in the community is increasing. You might be reaching your peak infection or there might be more people that are sick but, either way, the outcome is the same: Risk is higher. And that’s really what matters.”
Untap is still working on designing the product experience — and Trant notes it will be taking customer feedback via an incoming wave of pilots — but expect some kind of dashboard-type view. The idea is customers will get alerts on infection risk rising or falling, enabling them to implement different strategies to help protect (or reassure) their community, whether that’s (in an office context) encouraging masking and social distancing or suspending hot-desking and recommending home working. Or, if the risk is low, sharing the good news with staff so they feel more comfortable coming in.
In addition to the 12 pathogens planned for the first product, more detection capabilities could be added to the system but Untap will need to tread carefully here. Testing for COVID-19, flu and other unpleasant bugs and health risks is one thing but workplaces with real-time wastewater surveillance of the loos to keep tabs on staff drug and alcohol use, say, are all too easy to imagine. Indeed, Trant says they have had customers ask about that sort of functionality. But she’s emphatic it’s not a road the startup wants to go down.
“We’re not doing drug detection. We don’t want to go down that route. We don’t want people to not want us to be there. We want to really be a positive in people’s eyes,” she tells us, adding: “Testing for alcohol metabolites or caffeine or nicotine, I’m sure they will have a place somewhere — but I just don’t think that’s within our wants, needs, desires to achieve.”
There could also be ethical considerations and privacy concerns attached to the detection of certain types of disease. HIV, for instance. So caution and sensitivity will be needed. “We’re keeping a very slow mind when it comes to new pathogens,” she says, agreeing HIV is “a very wary one”. “We’re just taking it slowly, slowly — with things that really do affect the population at large.”
The road ahead
Looking ahead, Untap has had some exploratory chats with smart buildings companies — so it’s thinking how its technology could integrate with things like presence sensors to enable it to deepen the insights it can offer and/or support smarter infection prevention.
Add to that, and likely a couple of years down the line — once they’re up and running and ingesting and processing a lot more data — Trant confirms there’s a place on the roadmap for applying machine learning to power predictive insights on infection risk.
Using aggregated data from customers’ buildings for public health purposes is another future goal/hope. Such as by being able to collate data at a city level to power smarter procurement and healthcare resource management. “Imagine you’ve got Liverpool, London, Manchester, Birmingham. And you can see that one city had an outbreak before another. Imagine if you could send antivirals or vaccines intelligently across the city,” suggests Trant on that. “You could do a more intelligent vaccine rollout program… buy [antiviral medicines or PPE] more intelligently in batches and get it to people that need it most.”
“What this generation [of startups] is really focusing on — what I’ve seen from other startups — is not health management; it’s preventative health care,” she adds. “This is the ultimate preventative health care — when you’ve aggregated the data.”
The potential for turning pipelines of (literal) waste into streams of valuable information does look exciting — even as it’s still early for Untap’s journey to make useful sense of sewage.
So far, the startup has raised just under $2 million to drive toward a future where we don’t have to let valuable health intelligence go down the drain with our wastewater. Trant says the team will be looking to raise more funding next year — tentatively dubbed a seed round — to fund manufacturing of its hardware for a commercial rollout.
Comment