Smart toilets may play a part in future COVID-19 tracking efforts, according to a new article published in Nature. The authors describe a smart toilet platform, dubbed the Coronavirus: Integrated Diagnostic toilet, which features a bidet-like attachment equipped to test fecal material for COVID-19 that is able to isolate fecal RNA.

Users are able to use a QR code to consent to the stool sampling. The platform then digitally alerts a patient about their disease status. Researchers explained the results can be connected to existing "Bluetooth contact tracing systems implemented by Apple and Google for COVID-19 exposure notifications." The results can also provide public health agencies with "individualized, longitudinal data." 

"A smart toilet can access this underutilized data without requiring significant user intervention, and even circumvent potential behavioral fatigue associated with routine COVID-19 testing," authors wrote.

Researchers and government agencies have previously used wastewater to help track the spread of the COVID-19 virus.

"Measuring SARS-CoV-2 RNA concentrations in wastewater may enable the prediction of possible adjacent viral hot spots, and sequencing it can identify emerging variants or establish viral mapping of the most transmissible variants." 

The study authors point out that wastewater tracking has limitations due to wastewater system variability. The tracking is also focused at the population level. However, a smart toilet has the potential to go one step further and tell individuals about their COVID-19 status.

In order to be successful, authors said the smart toilets need to provide participants' test results "ideally" within 15 minutes, be fully automated, provide a hygienic environment for users, securely connect data to a centralized network and de-identify user data when uploaded to a tracing network. 

"However, the success of such a strategy will hinge on user acceptance. Certain settings such as military barracks or naval ships, which have experienced rapid and widespread outbreaks, are virtually guaranteed to have their inhabitants use the COV-ID toilet if it is installed, but consent is likely required for individualized testing.

"In the general public, people may avoid the toilets or not consent to testing if they feel there is a risk to personal privacy or are otherwise averse to testing."

WHY IT MATTERS 

Since the beginning of the pandemic, the CDC has reported close to 80 million COVID-19 cases, and just under one million COVID-19 deaths. 

However, national COVID-19 cases have been declining since they peaked in January 2022. The agency reports that 81.8% of individuals over the age of 5 have at least one dose of the COVID-19 vaccine. 

THE LARGER TREND 

Sewage water has been key in helping detect COVID-19 trends for over a year. In February 2022, the CDC added wastewater surveillance to its digital COVID-19 Data Tracker. The tool displays virus levels in wastewater from over the last 15 days. Users can also access information about the percentage of positive tests from a certain area over the last 15 days.