Pandemic fuels 'wastewater epidemiology'; we remain obsessed with poop

Since the COVID-19 pandemic, nations worldwide have intensified their focus on human waste through wastewater monitoring, elevating "fecal forensics" to a critical component of national health infrastructure. Warwick Anderson, author of "The Spectacle of Excrement," notes that this practice vividly illustrates how human excrement ultimately re-enters the logic of biosecurity.

Our feelings about excrement, or "feces," are deeply ambivalent. While we carry it within us without conscious thought, we wish to banish it once it leaves our bodies. As children, the word itself might elicit delight, but upon learning societal norms, it becomes taboo. This duality is so profound that some psychoanalysts suggest our personality development hinges on overcoming our relationship with feces. Sigmund Freud's insights appear relevant: even in an era of space exploration and AI, humanity has not fully resolved its complex relationship with excrement.

Anderson, a trained physician and professor of medical history and anthropology at the University of Sydney, delves into humanity's "strong denial, fervent distancing, desperate suppression, and expulsion" of feces. Yet, he observes that humans simultaneously "analyze, calculate, investigate, and record" it. This paradox, he suggests, might be what defines us as modern beings. The author dissects humanity's reaction to feces as a "spectacle," traversing the realms of humanities, social sciences, and science. His prose, filled with sharp wit and playful humor, makes for engaging reading as he chronicles humanity's raw "push and pull" with the inherently dirty nature of waste, eschewing euphemisms like "excrement" or "stool."

The book traces the 20th century as a period when humanity's ambivalent relationship with feces flourished. Following Freud's "anal stage" theory, 20th-century social anthropologists like Mary Douglas highlighted the anxiety generated by "matter out of place," including feces, and the symbolic control mechanisms employed. Julia Kristeva viewed excrement as a symbol of "threats to identity originating from the outside." Anderson cynically notes how primarily "white" theorists and medical scientists have "constantly appointed themselves as guardians of feces," suggesting Western civilization's verbose discourse on waste ultimately amounts to "dog excrement" in his view.

Anderson connects the Western근대's obsession with feces to "excremental colonialism." He criticizes imperial officials who viewed themselves as controlled beings while labeling colonized populations as "promiscuous defecators." Early 20th-century U.S. public health officials warned that "human excrement is more dangerous than arsenic or strychnine." Filipinos unable to manage such dangerous waste were deemed "countless young children needing a strong hand to guide them." The situation in Korea under Japanese colonial rule was similar, with hygiene police monitoring infectious diseases and managing defecation and waste. Records from 1918 indicate hygiene police warned of punishment for non-compliance with latrine improvement directives. Feces thus occupied a central position in the dichotomies of hygiene/contamination, purity/danger, and modernity/primitivism.

This colonial obsession fueled the construction of "latrines," a term coined by Anderson. He satirizes the early 20th-century "era of proliferating latrines" driven by imperial powers. The U.S. extensively built latrines in colonial Philippines, and the Rockefeller Foundation funded latrine construction not only in impoverished U.S. regions but also in developing countries. By the early 20th century, millions of latrines had been built across colonies, encircling the equator. The author points out the significance of the English word "colonize" sharing its root with "colon," the large intestine.

While critiques of Western "anal stage" fixation or colonial hygiene practices might not be entirely new, Anderson offers a further insight: despite modernity's strenuous efforts to distance itself from feces, humanity remains captivated by it. This is evident in the global "wastewater epidemiology craze" following COVID-19. Despite early hypotheses about fecal transmission of the virus being quickly dismissed, experts focused on virus surveillance through wastewater. This mobilized a diverse workforce, from "excreters" to "wastewater samplers, lab assistants, microbiologists, molecular biologists, and public health statisticians," integrating them into national pandemic response systems.

Anderson describes this as a "powerful sublimation of a potentially pathogenic sample and a process of legitimizing feces as a marker." He states, "Wastewater epidemiology vividly illustrates how human excrement ultimately re-enters the logic of biosecurity." South Korea, since 2023, has been monitoring not only COVID-19 but also norovirus and influenza across 64 wastewater treatment plants nationwide. Even after transitioning from full surveillance to sample-based monitoring, wastewater surveillance continues as an early warning system. However, Anderson argues that such monitoring serves only a "complementary" function, exerting "excessive symbolic appeal relative to its limited utility in public health management." This implies that wastewater monitoring merely underscores humanity's enduring obsession with feces. The author's assertion that humanity remains stuck in an "anal stage," fixated on feces, does not necessarily lead to a "smooth bowel movement" of thought, potentially prompting a "So what?" reaction. Yet, the existence of feces, which troubles us while residing in our large intestines today, remains a persistent presence.

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Wastewater epidemiology vividly illustrates how human excrement ultimately re-enters the logic of biosecurity.