Importance - Genomic footprints of pathogens shed by infected individuals can be traced in environmental samples, which can serve as a noninvasive method for infectious disease surveillance.
Objective - To determine the efficacy of predicting COVID-19 cases using the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) found in air, surface swabs and wastewater samples.
Design - A prospective experimental design utilizing randomized surveillance of air, surface, and wastewater samples was performed from March to May 2021. SARS-CoV-2 in environmental samples was concentrated with electronegative filtration and quantified using Volcano 2nd Generation-qPCR. Descriptive analyses were conducted to examine the associations between time-lagged SARS-CoV-2 in environmental samples and clinically diagnosed COVID-19 cases.
Setting - This study was conducted in a residential dormitory at the University of Miami, Coral Gables campus.
Participants - Random air and surface swab samples were collected in high-traffic areas of a college dormitory, housing roughly 500 students, with the number of individuals contributing at any point in time. Wastewater was collected from the dormitory where individuals from the resident population as well as any visitors of the building contributed to the sewer system. Students from the dormitory were randomly screened for COVID-19 for 2-3 days / week.
Main Outcome - SARS-CoV-2 detection in environmental samples was an indicator of the presence of local COVID-19 cases and a 2-day lead indicator for a potential outbreak at the dormitory building scale. The hypothesis being tested was formulated prior to the data collection.
Results - A total of 445 air, surface swab and wastewater samples were collected, and these data were aggregated by day. SARS-CoV-2 genomic footprints were detected in air, surface swab and wastewater samples on 52 (63.4%), 40 (50.0%) and 57 (68.6%) days, respectively, during the study period. On 19 (24%) of 78 days SARS-CoV-2 was detected in all three sample types. Clinically diagnosed COVID-19 cases were reported on 11 days during the study period and SARS-CoV-2 was also detected two days before the case diagnosis on all 11 (100%), 9 (81.8%) and 8 (72.7%) days in air, surface swab and wastewater samples, respectively.
Conclusion - Proactive environmental surveillance of SARS-CoV-2 or other pathogens in a community/public setting has potential to guide targeted measures to contain and/or mitigate infectious disease outbreaks.