SARS-CoV-2 has recently been detected in feces, which indicates that wastewater may be used to monitor viral prevalence in the community. Here, we use RT-qPCR to monitor wastewater for SARS-CoV-2 RNA over a 74-day time course. We show that changes in SARS-CoV-2 RNA concentrations follow symptom onset gathered by retrospective interview of patients but precedes clinical test results. In addition, we determine a nearly complete (98.5%) SARS-CoV-2 genome sequence from wastewater and use phylogenetic analysis to infer viral ancestry. Collectively, this work demonstrates how wastewater can be used as a proxy to monitor viral prevalence in the community and how genome sequencing can be used for genotyping viral strains circulating in a community.

SARS-CoV-2 has recently been detected in feces, which indicates that wastewater may be used to monitor viral prevalence in the community. Here we use RT-qPCR to monitor wastewater for SARS-CoV-2 RNA over a 52-day time course. We show that changes in SARS-CoV-2 RNA concentrations correlate with local COVID-19 epidemiological data (R2=0.9), though detection in wastewater trails symptom onset dates by 5-8 days. We determine a near-complete (98.5%) SARS-CoV-2 genome sequence from the wastewater and use phylogenic analysis to infer viral ancestry. Collectively, this work demonstrates how wastewater can be used as a proxy to monitor viral prevalence in the community and how genome sequencing can be used for high-resolution genotyping of the predominant strains circulating in a community.

The results from this study have assisted in determining the factors that contribute to developing, establishing and implementing successful diabetes prevention programs in two rural areas. Recommendations to increase the likelihood of success of programs in rural communities include: securing funding early for the program; establishing support from community leaders and developing positive relationships with health care providers; creating a professional team with passion for the program; encouraging participants to celebrate their small and big successes; and developing procedures for providing post-intervention support to help participants maintain their success.

SARS-CoV-2 genomic surveillance identifies naturally occurring truncation of ORF7a that limits immune suppression Graphical abstract Highlights d ORF7a mutations are found in SARS-CoV-2 genomes isolated from around the globe d The ORF7aD115 isolate displays a replication defect d An ORF7a mutation limits viral suppression of the interferon response

Objective To determine if an evidence-based, behavioral lifestyle intervention program delivered at a worksite setting is effective in improving type 2 diabetes and CVD risk factors. Methods A randomized six-month delayed control design was utilized, with two-thirds of the participants assigned to begin intervention immediately and one-third beginning six months later. The year-long program (weekly for 3 months transitioning to monthly) focused on weight loss and increasing physical activity. Results The immediate intervention group had greater mean weight loss (−10.4 lbs., 5.1%, vs. −2.3 lbs., 1%, p=0.0001) than the delayed control group at 6 months and relatively greater improvements in activity, HbA1c and other risk factors. The delayed group experienced similar improvements after completing the intervention program. Conclusions A worksite behavioral lifestyle intervention is feasible and effective in significantly improving risk factors for diabetes and CVD.