Wastewater-based epidemiology (WBE) has been utilized
for outbreak
monitoring and response efforts in university settings during the
coronavirus disease 2019 (COVID-19) pandemic. However, few studies
examined the impact of university policies on the effectiveness of
WBE to identify cases and mitigate transmission. The objective of
this study was to retrospectively assess relationships between severe
acute respiratory syndrome coronavirus 2 (SARS-CoV-2) wastewater outcomes
and COVID-19 cases in residential buildings of a large university
campus across two academic semesters (August 2020–May 2021)
under different COVID-19 mitigation policies. Clinical case surveillance
data of student residents were obtained from the university COVID-19
response program. We collected and processed building-level wastewater
for detection and quantification of SARS-CoV-2 RNA by RT-qPCR. The
odds of obtaining a positive wastewater sample increased with COVID-19
clinical cases in the fall semester (OR = 1.50, P value = 0.02), with higher odds in the spring semester (OR = 2.63, P value < 0.0001). We observed linear associations between
SARS-CoV-2 wastewater concentrations and COVID-19 clinical cases (parameter
estimate = 1.2, P value = 0.006). Our study demonstrated
the effectiveness of WBE in the university setting, though it may
be limited under different COVID-19 mitigation policies. As a complementary
surveillance tool, WBE should be accompanied by robust administrative
and clinical testing efforts for the COVID-19 pandemic response.
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