Covering COVID-19 is a daily Poynter briefing of story ideas about the coronavirus and other timely topics for journalists, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.

In April 2020, less than two years ago, then-President Donald Trump said the final death toll from the COVID-19 pandemic could be as high as 100,000. At other times, he said the highest death toll would top out at 50,000 to 60,000.

Dr. Deborah Birx, the White House coronavirus response coordinator under President Trump, said on March 30, 2020, that 2.2 million could die if there were no mitigation efforts and that at least 100,000 were likely to die even with good mitigation efforts.

This weekend, the U.S. death toll from COVID-19 passed the 900,000 mark. Only two months ago, President Joe Biden observed the country passing 800,000 COVID-19 fatalities.

But somehow, the 900,000 figure barely makes news. So many have died and so many are still dying from the virus that, in our quest to feel normal again, we have become numb to the numbers.

On May 24, 2020, this was the front page of The New York Times. It named some of the people who had died at what was then an unimaginable rate in the pandemic.

(The May 24, 2020, front page of The New York Times)

On Saturday, Feb. 5, 2021, the Times noted the moment that the American death toll topped 900,000. The headline read: “900,000 Dead, but Many Americans Move On.”

(The Feb. 5, 2022, front page of The New York Times)

A year ago, about 2,900 people were dying every day in the United States from COVID-19. The death rate today is at virtually the same level.

(Johns Hopkins)

But there is this stunning projection from the Institute for Health Metrics and Evaluation. Its latest forecast is that COVID-19 deaths will sharply fall between now and the end of April.

(Institute for Health Metrics and Evaluation)

Canada’s growing protests over mandates

Keep an eye on whether demonstrations against COVID-19 vaccination mandates spread this week in Canada. The protests have mainly been in Ottawa for the last two weeks, but they are spreading. Police called it “a nationwide insurrection.” U.S. officials say American anti-vaccine groups are helping to support the Canadian protests.

Anti-vax groups hauling in millions of dollars in donations

Some of the loudest anti-vaccine groups have found that donations seem to follow visibility. A couple of the best-known opposition groups saw donations increase 60% to 100% in the last year.

The future of COVID may be found in sewers

There is a lot of excitement about sewers these days. It is because the future of COVID-19 research may be in sewer pipes. By testing batches of sewage, researchers may find out that the virus is spreading way before people show up at a doctor’s office to get tested and the tests get confirmed, then reported.

The Centers for Disease Control and Prevention now has 400 testing sites in 19 states in a system called the National Wastewater Surveillance System, or NWSS. This is a map of the sites currently reporting wastewater data:

(CDC)

The CDC says wastewater surveillance has a lot of advantages over traditional COVID-19 testing:

• Wastewater surveillance captures presence of SARS-CoV-2 shed by people with and without symptoms. By measuring SARS-CoV-2 levels in untreated wastewater over time, public health officials can determine if infections are increasing or decreasing in a sewershed.
• Wastewater surveillance can be an early indicator that the number of people with COVID-19 in a community is increasing or decreasing.
• Unlike other types of COVID-19 surveillance, wastewater surveillance does not depend on people having access to healthcare, people seeking healthcare when sick, or availability of COVID-19 testing.
• Wastewater surveillance can be implemented in many communities since nearly 80 percent of U.S. households are served by municipal wastewater collection systems.

CNN explained other advantages:

This kind of testing is highly sensitive. It can pick up the presence of the virus when just one person out of 100,000 in a given area, or sewershed, is infected.

And because wastewater testing doesn’t depend on people to realize they’re sick and seek out a test, or even to have symptoms at all, it’s often the earliest warning a community has that wave of Covid-19 infections is on the way.

The CDC estimates that it takes five to seven days after a toilet flushes to get the wastewater data to its COVID Tracker, and the samples typically turn positive in an area four to six days before clinical cases show up.

“As long as people are using a toilet that’s connected to a sewer, we can get information on those cases in that community,” said Amy Kirby, a CDC microbiologist who leads the NWSS project.

Government investment has taken what had been a little-known branch of public health and brought it into the mainstream.

“It’s really exploded the field,” said Colleen Naughton, a civil engineer at the University of California at Merced who runs the @CovidPoops19 Twitter account. “We did wastewater monitoring for other pathogens before this, like poliovirus, but it’s really, the amount of people involved in everything has really increased exponentially.”

In New York City, researchers have been trying to find the origin of one virus sequence that showed up in sewage but has never been detected in human tests. Of course, the concern is that a new version of the virus may be lurking, waiting for a host.

In a research paper published in Nature, the authors offer a couple of theories including, “The existence of these cryptic lineages may point to COVID-19 infections of human patients that are not being sampled through standard clinical sequencing efforts.” In other words, it could be that whoever is sending their unknown virus into the sewer system has never been tested by a lab that sequences viruses and reports the findings.

Another possibility is that the virus is coming from another species, such as sewer rats, cats or dogs. But for now, it is just a theory.

We’ll be back tomorrow with a new edition of Covering COVID-19. Are you subscribed? Sign up here to get it delivered right to your inbox.