The Role of Wastewater Testing for SARS-CoV-2 Surveillance

Manuel, Douglas; Delatolla, Robert; Fisman, David N.; Fuzzen, Meghan; Graber, Tyson E.; Katz, Gabrielle M.; Kim, Jinhee; Landgraff, Chrystal; MacKenzie, Alex; Maltsev, A.V.; Majury, Anna; McKay, R. Michael L.; Minnery, John; Servos, Mark R.; Weese, J. Scott; McGeer, Allison; Born, Karen; Barrett, Kali; Schwartz, Brian; Jüni, Peter

doi:10.47326/ocsat.2021.02.40.1.0

Cited by 14 publications

(12 citation statements)

References 36 publications

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“…Wastewater testing has demonstrated usefulness in assessing SARS-CoV-2 levels in the community and acute care, however it can lack spatial resolution. (1) In built environments, reliable detection of SARS-CoV-2 has been shown with sampling of floors compared to other surfaces. (3,7) In long-term care homes, serial floor sampling may be particularly relevant as not all residents use toilets, and detection on floors was shown to predate COVID-19 outbreaks by days and even weeks.…”

Section: Discussionmentioning

confidence: 99%

“…Environmental surveillance for SARS-CoV-2 has been an effective public health tool for monitoring COVID-19 in the population, with the most studied approach being wastewater sampling. (1) Surface sampling within the built environment may be a more spatially refined approach for surveillance in specific contexts. For example, a recent multi-centre study across 10 long-term care homes demonstrated that the percentage of positive swabs for SARS-CoV-2 correlates with cases and outbreaks of COVID-19.…”

Section: Introductionmentioning

confidence: 99%

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Detection of SARS-CoV-2 in Schools Using Built Environment Testing in Ottawa, Canada: A Multi-Facility Prospective Surveillance Study

Thampi

Burhunduli

Strain

et al. 2023

Preprint

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Classroom and staffroom floor swabs across six elementary schools in Ottawa, Canada were tested for SARS-CoV-2. Schools in neighbourhoods with historically elevated COVID-19 burden had lower environmental swab positivity. Environmental test positivity did not correlate with student grade groups, school-level absenteeism, pediatric COVID-19-related hospitalizations, or community SARS-CoV-2 wastewater levels.SummaryEnvironmental SARS-CoV-2 sampling was performed in six schools in Ottawa, Canada. The percentage of floor swabs detecting SARS-CoV2 was not correlated with absenteeism, pediatric hospitalizations, or wastewater data. Schools in neighbourhoods with previously elevated COVID-19 rates had lower test positivity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Detection of SARS-CoV-2 in Schools Using Built Environment Testing in Ottawa, Canada: A Multi-Facility Prospective Surveillance Study

Thampi

Burhunduli

Strain

et al. 2023

Preprint

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“…Since the emergence and dominance of the Omicron variant, many jurisdictions globally have shifted from individual level testing to wastewater monitoring as a means for population-level COVID-19 surveillance. [4][5][6][7] Wastewater surveillance allows for the quantitation of SARS-CoV-2 within waste effluent, a metric that is correlated with the burden of disease in the population of the waste catchment. [21][22][23] While the results can provide surveillance on a population-level, one of the major criticisms is that they generally cannot provide results that are directly actionable.…”

Section: Discussionmentioning

confidence: 99%

“…The primary environmental surveillance approach to-date for COVID-19 has been wastewater surveillance. [4][5][6][7] Wastewater surveillance is a helpful public-health tool because it is a passive, non-invasive, and can detect early transmission of SARS-CoV-2 in the community. However, it lacks standardization, reproducibility, and the spatial resolution as it is typically reported on a regional-level.…”

Section: Introductionmentioning

confidence: 99%

Detection of COVID-19 Outbreaks in Long-Term Care Homes Using Built Environment Testing for SARS-CoV-2: A Multicentre Prospective Study

Fralick

Nott

Moggridge

et al. 2022

Preprint

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Background Environmental surveillance of SARS-CoV-2 via wastewater has become an invaluable tool for population-level surveillance of COVID-19. Built environment sampling may provide a more spatially refined approach for surveillance of COVID-19 in congregate living settings and other high risk settings (e.g., schools, daycares). Methods We conducted a prospective study in 10 long-term care homes (LTCHs) across three cities in Ontario, Canada between September 2021 and May 2022. Floor surfaces were sampled weekly at multiple locations (range 10 to 24 swabs per building) within each building and analyzed for the presence of SARS-CoV-2 using RT-qPCR. The exposure variable was detection of SARS-CoV-2 on floors. The primary outcome was the presence of a COVID-19 outbreak in the week that floor sampling was performed. Results Over the 9-month study period, we collected 3848 swabs at 10 long-term care homes. During the study period, 19 COVID-19 outbreaks occurred with 103 cumulative weeks under outbreak. During outbreak periods, the proportion of floor swabs positive for SARS-CoV-2 was 50% (95% CI: 47-53) with a median quantification cycle of 37.3 (IQR 35.2-38.7). During non-outbreak periods the proportion of floor swabs positive was 18% (95% CI:17-20) with a median quantification cycle of 38.0 (IQR 36.4-39.1). Using the proportion of positive floor swabs for SARS-CoV-2 to predict COVID-19 outbreak status in a given week, the area under the receiver operating curve (AUROC) was 0.85 (95% CI: 0.78-0.92). Using thresholds of ≥10%, ≥30%, and ≥50% of floor swabs positive for SARS-CoV-2 yielded positive predictive values for outbreak of 0.57 (0.49-0.66), 0.73 (0.63-0.81), and 0.73 (0.6-0.83) respectively and negative predictive values of 0.94 (0.87-0.97), 0.85 (0.78-0.9), and 0.75 (0.68-0.81) respectively. Among 8 LTCHs with an outbreak and swabs performed in the antecedent week, 5 had positive floor swabs exceeding 10% at least five days prior to outbreak identification. For 3 of these 5 LTCHs, positivity of floor swabs exceeded 10% more than 10 days before the outbreak being identified. Conclusions Detection of SARS-CoV-2 on floors is strongly associated with COVID-19 outbreaks in LTCHs. These data suggest a potential role for floor sampling in improving early outbreak identification.

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“…Furthermore, since virus generation times (time of a complete infection cycle) and presence of distinct symptoms vary between variants and there remains a time lag upon official case reporting, it is expected that time lags between wastewater and reported cases may be different between virus variants as well (Abbott et al, 2022;Hart et al, 2022;Olesen et al, 2021). Following advances in sample treatment and analysis methods, test sensitivity appears high for these methods, so that SARS-CoV-2 residues can be detected in wastewater with a lower threshold of 13/100k people (Manuel et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Linear Regression Modelling of SARS-CoV-2 cases based on local wastewater surveillance

Lehmann

Geißler

Hahn

et al. 2022

Preprint

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In the ongoing SARS-CoV-2 pandemic, there is a need for new strategies for surveillance and identification of arising infection waves. Reported cases of new infections based on individual testing are soon deemed inaccurate due to ever changing regulations and limited testing capacity. Wastewater based epidemiology is one promising solution that can be broadly applied with low efforts in comparison to current large-scale testing of individuals. Here, we are combining local wastewater data from the city of Dresden (Germany) along with reported cases and vaccination data from a central database (Robert-Koch-Institute) with virus variant information to investigate the correlation of virus concentrations in the wastewater and reported SARS-CoV-2 cases. In particular, we compared Linear Regression and Machine Learning (ML) models, which are both revealing an existing correlation of virus particles in wastewater and reported cases. Our findings demonstrate that the different virus variants of concern (Alpha, Delta, BA.1, and BA.2) contribute differently over time and parameters vary between variants, as well. By comparing the Linear Regression and ML-based models, we observed that ML can achieve a good fit for training data, but Linear Regression is a more robust tool, especially for new virus variants. We hereby conclude that deriving the rate of new infections from local wastewater by applying Linear Regression may be a robust approximation of tracing the state of the pandemic for practitioners and policy makers alike.

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The Role of Wastewater Testing for SARS-CoV-2 Surveillance

Cited by 14 publications

References 36 publications

Detection of SARS-CoV-2 in Schools Using Built Environment Testing in Ottawa, Canada: A Multi-Facility Prospective Surveillance Study

Detection of SARS-CoV-2 in Schools Using Built Environment Testing in Ottawa, Canada: A Multi-Facility Prospective Surveillance Study

Detection of COVID-19 Outbreaks in Long-Term Care Homes Using Built Environment Testing for SARS-CoV-2: A Multicentre Prospective Study

Efficacy of Linear Regression Modelling of SARS-CoV-2 cases based on local wastewater surveillance

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