Monitoring waves of the COVID-19 pandemic: Inferences from WWTPs of different sizes

Rusiñol, Marta; Zammit, Ian; Itarte, Marta; Forés, Eva; Martínez-Puchol, Sandra; Gironés, R.; Borrego, Carles M.; Corominas, Lluís; Bofill-Mas, Sı́lvia

doi:10.1016/j.scitotenv.2021.147463

Cited by 59 publications

(45 citation statements)

References 42 publications

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“…Since these excreta are frequently shed into domestic sewage, wastewater surveillance of SARS-CoV-2 RNA has emerged as a non-intrusive approach to monitor and manage coronavirus disease 2019 (COVID-19) (Bivins et al, 2020;Fuschi et al, 2021;Lundy et al, 2021). Community-level COVID-19 dynamics have been assessed (Fernandez-Cassi et al, 2021) by measuring SARS-CoV-2 RNA in both raw sewage (Agrawal et al, 2021;Li et al, 2021) and settled solids (Wolfe et al, 2021) at wastewater treatment plants (WWTPs) of varying sizes (Rusiñol et al, 2021). Monitoring wastewater from buildings has also proven useful as an approach for managing COVID-19 at finer spatial scales on college campuses (Betancourt et al, 2021;Harris-Lovett et al, 2021), in schools (Crowe et al, 2021;Hassard et al, 2021), in skilled nursing facilities (Spurbeck et al, 2021), and even on aircraft and cruise ships (Ahmed et al, 2020b).…”

Section: Introductionmentioning

confidence: 99%

Contribution of SARS-CoV-2 RNA shedding routes to RNA loads in wastewater

Crank

Chen

Bivins

et al. 2022

Science of The Total Environment

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A portion of those infected with SARS-CoV-2 shed the virus and its genetic material in respiratory fluids, saliva, urine, and stool, thus giving the potential to monitor for infections via wastewater. Wastewater surveillance efforts to date have largely assumed that stool shedding has been the primary source of SARS-CoV-2 RNA signal; however, there are increasing questions about the possible contribution of other shedding routes, with implications for wastewater surveillance design and feasibility. In this study we used clinical SARS-CoV-2 RNA shedding data and a Monte Carlo framework to assess the relative contribution of various shedding routes on SARS-CoV-2 RNA loads in wastewater. Stool shedding dominated total SARS-CoV-2 RNA load for community-level surveillance, with mean contributions more than two orders of magnitude greater than other shedding routes. However, RNA loads were more nuanced when considering building-level monitoring efforts designed to identify a single infected individual, where any shedding route could plausibly contribute a detectable signal. The greatest source of model variability was viral load in excreta, suggesting that future modeling efforts may be improved by incorporating specific modeling scenarios with precise SARS-CoV-2 shedding data, and beyond that wastewater surveillance must continue to account for large variability during data analysis and reporting. Importantly, the findings imply that wastewater surveillance at finer spatial scales is not entirely dependent on shedding via feces for sensitive detection of infections thus enlarging the potential use cases of wastewater as a non-intrusive surveillance methodology.

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Section: Introductionmentioning

confidence: 99%

Contribution of SARS-CoV-2 RNA shedding routes to RNA loads in wastewater

Crank

Chen

Bivins

et al. 2022

Science of The Total Environment

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“…Wastewater-based epidemiology (WBE) has been used in areas with centralized sewage network systems for evaluating the circulation of etiological agents of communicable diseases such as hepatitis C virus, poliovirus, and antibiotic-resistant bacteria, consumption patterns of illegal drugs, nicotine, alcohol, and pharmaceuticals in communities (Gracia-Lor et al 2017, Lorenzo and Picó 2019, Sims et al 2020. Recently, WBE has been reported as a quick, sensitive, and cost-effective approach for monitoring the prevalence, trend, and circulation of coronavirus disease pandemics at the population level (Medema et al 2020a, Hart and Halden 2020, Sherchan et al 2020, Gonzalez et al 2020, Hillary et al 2021, Rusiñol et al 2021, Lundy et al 2021, and as an early warning tool (Medema et al 2020a, Wu et al 2020a, Ahmed et al 2021a.…”

Section: Introductionmentioning

confidence: 99%

Detection and quantification of SARS-CoV-2 RNA in wastewater influent in relation to reported COVID-19 incidence in Finland

Tiwari

Lipponen

Hokajärvi

et al. 2021

Preprint

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Wastewater-based surveillance is a cost-effective concept for monitoring COVID-19 pandemics at a population level. Here, SARS-CoV-2 RNA was monitored from a total of 693 wastewater (WW) influent samples from 28 wastewater treatment plants (WWTP, N = 21-42 samples per WWTP) in Finland from August 2020 to May 2021, covering WW of ca. 3.3 million inhabitants (~ 60% of the Finnish population). The relative quantity of SARS-CoV-2 RNA fragments in the 24h-composite samples was determined by using the ultrafiltration method followed by nucleic acid extraction and RT-qPCR assay targeted with N2-assay. SARS-CoV-2 RNA signals at each WWTP were compared over time to the numbers of new and confirmed COVID-19 cases in the sewer network area. Over the 10-month surveillance period, the detection rate of SARS-CoV-2 RNA in WW was 79% (including 6% uncertain results), while only 24% of all samples exhibited gene copy (GC) numbers above the quantification limit. The range of the SARS-CoV-2 detection rate in WW varied from 33% (including 10% uncertain results) in Pietarsaari to 100% in Espoo. Only six out of 693 WW samples were positive with SARS-COV-2 RNA when the reported COVID-19 case number from the preceding 14 days was zero. Overall, the 14-day COVID-19 incidence was 7.0, 18 and 36 cases within the sewer network area when the probability to detect SARS-CoV-2 RNA in wastewater samples was 50%, 75% and 95%, respectively. The quantification of SARS-CoV-2 GC required significantly more COVID-19 cases: the quantification rate was 50%, 75% and 95% when the 14-day incidence was 110, 152 and 223 COVID-19 cases, respectively, per 100 000 persons. Multiple linear regression confirmed the relationship between the COVID-19 incidence and the SARS-CoV-2 GC quantified in WW at 15 out of 28 WWTPs (overall R2 = 0.36, p < 0.001). At four of the 13 WWTPs where a significant relationship was not found, the GC of SARS-CoV-2 RNA remained below the quantification limit during the whole study period. In the five other WWTPs, the sewer coverage was less than 80% of the total population in the area and thus the COVID-19 cases may have been inhabitants from the areas not covered. Based on the results obtained, WW-based surveillance of SARS-CoV-2 could be used as an indicator for local and national COVID-19 incidence trends. Importantly, the determination of SARS-CoV-2 RNA fragments from WW is a powerful and non-invasive public health surveillance measure, independent of possible changes in the clinical testing strategies or in the willingness of individuals to be tested for COVID-19.

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“…The use of mobile device data (Thomas et al, 2017), chemical biomarkers present in urine (e. g. caffeine, pharmaceuticals) (Rico et al, 2017) or human-specific microbial/molecular markers (e.g. crAssphage, human adenovirus (HAdV), JC polyomavirus (JCPyV)) (Rusiñol et al, 2021;Sala-Comorera et al, 2021), are alternative metrics that have been shown to reduce measurement uncertainty when used to estimate population size for normalisation of target analyte concentrations.…”

Section: Population Factorsmentioning

confidence: 99%

Understanding and managing uncertainty and variability for wastewater monitoring beyond the pandemic: Lessons learned from the United Kingdom National COVID-19 Surveillance Programmes

Wade

Jacomo

Armenise

et al. 2021

Preprint

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quality and interpretation of data for public health decision-making, are varied and complex. While some factors remain poorly understood, we present approaches taken by the UK programmes to manage and mitigate the more tractable sources of uncertainty. This work provides a platform to integrate uncertainty management into WBE activities as part of global One Health initiatives beyond the pandemic.

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Monitoring waves of the COVID-19 pandemic: Inferences from WWTPs of different sizes

Cited by 59 publications

References 42 publications

Contribution of SARS-CoV-2 RNA shedding routes to RNA loads in wastewater

Contribution of SARS-CoV-2 RNA shedding routes to RNA loads in wastewater

Detection and quantification of SARS-CoV-2 RNA in wastewater influent in relation to reported COVID-19 incidence in Finland

Understanding and managing uncertainty and variability for wastewater monitoring beyond the pandemic: Lessons learned from the United Kingdom National COVID-19 Surveillance Programmes

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