TY - JOUR

T1 - Site Specific Relationships between COVID-19 Cases and SARS-CoV-2 Viral Load in Wastewater Treatment Plant Influent

AU - Fitzgerald, Stephen F

AU - Rossi, Gianluigi

AU - Low, Alison S

AU - McAteer, Sean P

AU - O'Keefe, Brian

AU - Findlay, David

AU - Cameron, Graeme J

AU - Pollard, Peter

AU - Singleton, Peter T R

AU - Ponton, George

AU - Singer, Andrew C

AU - Farkas, Kata

AU - Jones, Davey L.

AU - Graham, David W

AU - Quintela-Baluja, Marcos

AU - Tait-Burkard, Christine

AU - Gally, David L

AU - Kao, Rowland

AU - Corbishley, Alexander

PY - 2021/11/16

Y1 - 2021/11/16

N2 - Wastewater based epidemiology (WBE) has become an important tool during the COVID-19 pandemic, however the relationship between SARS-CoV-2 RNA in wastewater treatment plant influent (WWTP) and cases in the community is not well-defined. We report here the development of a national WBE program across 28 WWTPs serving 50% of the population of Scotland, including large conurbations, as well as low-density rural and remote island communities. For each WWTP catchment area, we quantified spatial and temporal relationships between SARS-CoV-2 RNA in wastewater and COVID-19 cases. Daily WWTP SARS-CoV-2 influent viral RNA load, calculated using daily influent flow rates, had the strongest correlation (ρ > 0.9) with COVID-19 cases within a catchment. As the incidence of COVID-19 cases within a community increased, a linear relationship emerged between cases and influent viral RNA load. There were significant differences between WWTPs in their capacity to predict case numbers based on influent viral RNA load, with the limit of detection ranging from 25 cases for larger plants to a single case in smaller plants. SARS-CoV-2 viral RNA load can be used to predict the number of cases detected in the WWTP catchment area, with a clear statistically significant relationship observed above site-specific case thresholds.

AB - Wastewater based epidemiology (WBE) has become an important tool during the COVID-19 pandemic, however the relationship between SARS-CoV-2 RNA in wastewater treatment plant influent (WWTP) and cases in the community is not well-defined. We report here the development of a national WBE program across 28 WWTPs serving 50% of the population of Scotland, including large conurbations, as well as low-density rural and remote island communities. For each WWTP catchment area, we quantified spatial and temporal relationships between SARS-CoV-2 RNA in wastewater and COVID-19 cases. Daily WWTP SARS-CoV-2 influent viral RNA load, calculated using daily influent flow rates, had the strongest correlation (ρ > 0.9) with COVID-19 cases within a catchment. As the incidence of COVID-19 cases within a community increased, a linear relationship emerged between cases and influent viral RNA load. There were significant differences between WWTPs in their capacity to predict case numbers based on influent viral RNA load, with the limit of detection ranging from 25 cases for larger plants to a single case in smaller plants. SARS-CoV-2 viral RNA load can be used to predict the number of cases detected in the WWTP catchment area, with a clear statistically significant relationship observed above site-specific case thresholds.

KW - COVID-19

KW - Humans

KW - Pandemics

KW - RNA, Viral

KW - SARS-CoV-2

KW - Viral Load

KW - Waste Water

KW - Water Purification

U2 - 10.1021/acs.est.1c05029

DO - 10.1021/acs.est.1c05029

M3 - Article

C2 - 34738785

VL - 55

SP - 15276

EP - 15286

JO - Environmental Science and Technology

JF - Environmental Science and Technology

SN - 0013-936X

IS - 22

ER -