In March of last year, the pandemic came knocking, and everyone was suddenly obsessed with—of all things—toilet paper. Store shelves emptied out and remained vacant. People were selfishly hoarding, onlookers claimed, or just wanted to feel a sense of control amid uncertainty. Others rightly pointed out that people simply needed more toilet paper than usual if they were going to be home all the time, instead of going to school and to work, and that it wasn’t easy for the supply chains to reroute it. Many changed their toilets altogether, with bidet companies reporting mass orders.
Chelsea Wald is the author of Pipe Dreams: The Urgent Global Quest to Transform the Toilet.
A lot of the country seemed surprised by this seemingly odd turn of events—but I wasn’t. As a science and environmental journalist who writes about sanitation, I know that nearly every human drama comes with a toilet aspect, whether we talk about it or not. Urinating and defecating are everyday human functions, and health and economic crises such as the pandemic often throw into stark relief the significance of having access to a clean and safe place to relieve ourselves. Times like these can also betray the vulnerabilities in our toilets, and more importantly, reveal how they need to change in order to help us better cope with the problems of the future.
Last spring, while consumers stressed about how they’d wipe, scientists learned that infected people shed bits of the coronavirus’s genetic material in their stool. Their immediate concern: Could sewage be a major cause of outbreaks? The answer was ultimately no. But that doesn’t mean we’re in the clear. The fact is, while our toilet systems have done a great deal for public health, the core technologies were developed more than a hundred years ago—at a time when people couldn’t conceive of many of the challenges that we face today. On top of that, much of the hardware in the ground is reaching the end of its lifespan and crumbling due to a lack of investment in its maintenance and upkeep. This year, the American Society of Civil Engineers gave US wastewater infrastructure a D+ in its annual report card. There’s altogether too much poop around, and it’s creating a public health and environmental hazard—pandemic or not.
Evidence of our failing systems is all around us. Combined sewers—a flawed design still common in many cities with older systems—overflow during rainfalls, releasing potentially infectious pathogens into waterways, along with the trash, nutrients, chemicals, and pharmaceuticals that make it into our sewers. Failing septic tanks contaminate soil and groundwater. And wet wipes and other trash—on a dramatic rise since the pandemic—create enormous clogs that lead to sewage backups. Extreme events, driven in part by climate change, tax these systems even further. In the past year, major flooding from Tennessee to Australia left residents awash in sewage-contaminated waters. In August, a series of unlikely power failures during a major heat wave in California caused a wastewater treatment plant to spill 50,000 gallons of raw and partially treated sewage into the Oakland Estuary, just when people would have wanted to take a dip and open their windows to cool off. In February 2021, Texas got blasted with cold, leaving people without running taps and heat for days. One hospital trucked in water just for the purpose of flushing the toilets. Inmates in prisons and jails endured days of filth.
Not only do conventional wastewater systems fail, they are too often absent. More than half of the world’s population doesn’t have safely managed sanitation, in which their poop makes it to treatment. That includes an estimated 2 million Americans who don’t have complete plumbing, which leads directly to health conditions ranging from skin rashes to diarrhea to hookworm, and indirectly to many other kinds of illness and suffering. Pamela Rush, an activist from rural Alabama, brought attention to this problem when she dared to share her story of living amid raw sewage like many other poor, often nonwhite, Americans, who sometimes find themselves subject to fines and criminal prosecution because they can’t afford the high cost of septic tanks or their maintenance. Tragically, she became one of the pandemic’s many victims. “The official cause of death was Covid-19, but the underlying causes of her suffering were poverty, environmental injustice, climate change, race, and health disparities,” writes Rush’s friend Catherine Coleman Flowers, an environmental justice activist.
For those without access to private toilets, lockdowns also made publicly available restrooms even scarcer than they normally are. This was particularly hard on the unhoused population, as well as those with intestinal and other disorders. In the slums of some of the world’s fast-growing cities, shared facilities—sometimes the only ones available—often remained open but made social distancing difficult.
It’s not only wastewater infrastructure that’s aging or at risk; the sanitation workforce is too. In the United States, the sector is facing a wave of retirements sometimes dubbed the “silver tsunami.” As the pandemic began, a few wastewater utilities, afraid of losing their critical, hard-to-replace older workers to illness or worse, locked down their facilities with the workers inside for weeklong shifts, so that the virus couldn’t enter. In India, sewer cleaners, who often come from a highly stigmatized caste, petitioned the government for simple personal protective equipment so that they could keep doing their critical jobs.
The solution to our poop problem isn’t only to rebuild conventional infrastructure, but also to adopt a variety of more recent innovations, as well as encourage new ones, that will make our toilets much better—healthier, more sustainable, and more equitable. For this to become a reality, state and local governments will need sufficient funding as well as new public policies that create incentives.
Fortunately, the Biden administration seems to be taking steps in the right direction. The president’s recent infrastructure bill calls for modernizing “aging water systems [that] threaten public health in thousands of communities nationwide.” (Exactly how much money will go to wastewater specifically isn’t yet clear.) An infusion of federal funding could open up many avenues to improvement: Where centralized infrastructure already exists, cities can use both established and new tools to mine sewage for heat, water, nutrients, chemicals, and precious metals, as well as for biogas and other forms of fuel far more than they already do; digital sensors suited for the harsh sewer environment can help overtaxed systems use pipes more intelligently and reduce spills; novel installations can pull used toilet paper out of sewage streams before it gets to treatment and recycle it into cellulose, a raw material with broad applications, or even valuable industrial chemicals. With the right tools, even fatbergs—congealed masses of trash that cause damaging and expensive sewer clogs—can become biofuel thanks to the oils, fats, and grease in them, though it would be better for people to stop flushing wipes and disposing of oils down drains altogether.
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And there are more radical reinventions in the pipeline too. Small distributed systems that treat toilet waste and reuse water on site (in buildings or communities) are developing quickly. Container-based sanitation businesses are working to provide regular pick-up service. And “urine-diverting” toilets, which separate high-nutrient, low-pathogen urine from feces and water, act more like recycling bins than trash cans. These innovations can be more suitable to tough contexts, more resilient to extreme events, have smaller climate impacts, pollute less, and produce resources such as clean water, compost, fuel, and even insect protein. They could also create revenue streams and provide safe, well-paying jobs in sanitation—ones that bring in the kind of young, environmentally minded, and diverse workers the field needs. Many of these concepts are in the pilot and demonstration phase; to make them a reality on a larger scale, they need more investment, government policies that support their efforts, and the buy-in of everyday people who are willing to overcome squeamishness to become early adopters of innovative toilet technologies.
Other promising innovations have to do with those little bits of the coronavirus genetic material in poop. Toilets and sewers effectively take stool samples from us everyday. Scientists around the world have already been analyzing sewage, providing feedback to public health experts and policymakers about new outbreaks, trends, and the effects of rules and restrictions. They’ve even managed to catch and halt outbreaks early on in settings like college dorms. It’s not hard to imagine medical toilets of the future—like one that’s already on the market for senior living centers—warning us when we have been infected. These efforts could continue to pay off for years to come, even after the pandemic, in terms of monitoring not only for the coronavirus but other diseases and health threats.
Innovators are also trying out new ideas for public toilets that could make them as ubiquitous and welcoming as they should be. In Pune, India, a serviced public women’s restroom concept, in a refurbished bus, adds on a small shop and café, whose revenues help keep the restroom costs down. From Portland, Oregon, the iconic Portland Loo prevents common restroom problems such as graffiti and other vandalism, prostitution, and drug use through clever design, allowing the restroom to remain open 24 hours a day for its primary purpose. Some cities have implemented or are considering schemes in which they pay a small fee to cafés, restaurants, and other businesses to open their toilets to the public. As a bonus, the businesses get free advertising, and a sense of performing a public service.
Ultimately, this pandemic year has offered an even greater insight about toilets: They are not just a technology, but often a potent symbol of privilege. In fact, you can divine a lot about a person’s social and economic status from the toilet they use. But that should not stand. No person should have to live without access to safe and sanitary sewage systems. New investment in sewage in the United States and worldwide would not only help upgrade old systems and extend the dignity of safe sanitation to all, but it could also potentially help us avoid further damage from future outbreaks and environmental disasters. From every human crisis comes, inevitably, a toilet opportunity—if only we will harness it.
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