Recovered patients continue to shed coronavirus in poop: Amitabh Bachchan's tweet is partly correct

Amitabh Bachchan - Bollywood celebrity and advocate for an open defecation-free India - tweeted on Tuesday evening that the novel coronavirus can stay in human poop for weeks after a COVID-19 patient has completed treatment. His information — based on a study published in  The Lancet, a peer-reviewed science journal — is correct albeit incomplete.

In a country where open defecation is still a problem, faecal contamination being a mode of transmission for this new virus could be bad news. There’s more: even after we make functional toilets for our entire population of 1.3 billion people, there would be the issue of treating over 1.7 million tonnes of human waste per day in India! However, the researchers — who published their findings in  The Lancet  on 19 March 2020 — have added that they don’t yet know if the viral load in the poo of recovered patients is high enough to cause a fresh infection. That said, they have recommended collecting poo samples as well as respiratory samples from recovered patients, as this coronavirus is new and every day we learn something more about it. [caption id=“attachment_7549081” align=“alignleft” width=“380”]  Representational image. Image by Clker-Free-Vector-Images from Pixabay[/caption]

The poop problem

So far we know that the SARS-CoV-2 virus affects the respiratory system and enters our body through the eyes, mouth and nose. The new study — done on 98 patients by a team of researchers at a hospital affiliated to the Sun Yat-sen University, Zhuhai, China — has found that the RNA of COVID-19 virus can be seen for up to 27.9 days in the patient’s faeces. This is much longer than the mean time that the viral RNA was found in the respiratory samples of the same patients - 15.4 days. So, to break this down: patients who have recovered from COVID-19 continue to shed this coronavirus in their poo for nearly a month after treatment! According to the study, one of the patients continued to shed the virus for up to 33 days in faeces even though their respiratory samples — swabs and spit — tested negative for it. RNA or ribonucleic acid is the genetic material of the COVID-19, just like we have DNA (deoxyribonucleic acid). The presence of viral RNA in poo has nothing to do with the presence of gastrointestinal symptoms or the severity of the disease.

The uncertainty

Despite their findings, the Zhuhai team says that this is just an initial study and just because the viral RNA is present in the patient’s faeces, it does not mean that it is viable enough to cause a new infection.   Since we don’t know anything about the viability of the SARS-CoV-2 virus, more studies will be needed to check for the transmission potential of COVID-19 through the faecal-oral route. So far no cases of COVID-19 point to the possibility of faecal-oral transmission. However, the study published in  The Lancet  suggested that the patients’ faecal samples should also be tested for the presence of the virus. Currently, COVID-19 patients are discharged when they show two subsequent negative tests (24 hours apart) for viral RNA in the respiratory samples. Also, the discharged patients don’t show any symptoms or are only mildly symptomatic when they are released. But we do know that asymptomatic patients can also spread the virus. In his video on Twitter, Amitabh Bachchan said we need to come together to fight coronavirus, just like we fought polio and make it a Jan Andolan like the Swachha Bharat Mission so we can eliminate the disease from our country. Who could disagree with that? For more tips, read our article on   Frequently Asked Questions about COVID-19_._ Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.