Wastewater surveillance of SARS-CoV-2 across 40 U.S. states from February to June 2020

• Published in: Water research (Oxford) 2021-09, Vol.202, p.117400-117400, Article 117400
• Main Authors: Wu, Fuqing, Xiao, Amy, Zhang, Jianbo, Moniz, Katya, Endo, Noriko, Armas, Federica, Bushman, Mary, Chai, Peter R., Duvallet, Claire, Erickson, Timothy B., Foppe, Katelyn, Ghaeli, Newsha, Gu, Xiaoqiong, Hanage, William P., Huang, Katherine H., Lee, Wei Lin, McElroy, Kyle A., Rhode, Steven F., Matus, Mariana, Wuertz, Stefan, Thompson, Janelle, Alm, Eric J.
• Format: Article
• Language: English
• Subjects: COVID-19; Detection rate; Disease Outbreaks; Humans; RNA, Viral; SARS-CoV-2; Spatiotemporal dynamics; United States; Wastewater; Wastewater surveillance
• ISSN: 0043-1354; 1879-2448; 1879-2448
• DOI: 10.1016/j.watres.2021.117400

•Wastewater viral titers precede clinical COVID-19 surveillance data across the U.S.•SARS-CoV-2 detection rate in wastewater is 80% when incidence is 13 per 100k people.•SARS-CoV-2 detection rate in wastewater positively associates with catchment size.•Wastewater surveillance shows a 62.7% consistency to clinical reported data. Wastewater-based disease surveillance is a promising approach for monitoring community outbreaks. Here we describe a nationwide campaign to monitor SARS-CoV-2 in the wastewater of 159 counties in 40 U.S. states, covering 13% of the U.S. population from February 18 to June 2, 2020. Out of 1,751 total samples analyzed, 846 samples were positive for SARS-CoV-2 RNA, with overall viral concentrations declining from April to May. Wastewater viral titers were consistent with, and appeared to precede, clinical COVID-19 surveillance indicators, including daily new cases. Wastewater surveillance had a high detection rate (>80%) of SARS-CoV-2 when the daily incidence exceeded 13 per 100,000 people. Detection rates were positively associated with wastewater treatment plant catchment size. To our knowledge, this work represents the largest-scale wastewater-based SARS-CoV-2 monitoring campaign to date, encompassing a wide diversity of wastewater treatment facilities and geographic locations. Our findings demonstrate that a national wastewater-based approach to disease surveillance may be feasible and effective. [Display omitted]