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Quantification and Whole Genome Characterization of SARS-CoV-2 RNA in Wastewater and Air Samples

Quantification and Whole Genome Characterization of SARS-CoV-2 RNA in Wastewater and Air Samples

Published on: June 30, 2023

Timing and Trends for Municipal Wastewater, Lab-Confirmed Case, and Syndromic Case Surveillance of COVID-19 in

Nadine Kotlarz¹, David A Holcomb¹, A B M Tanvir Pasha¹

¹Nadine Kotlarz and Jane A. Hoppin are with the Department of Biological Sciences, North Carolina State University, Raleigh. David A. Holcomb and Lawrence S. Engel are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. A. B. M. Tanvir Pasha, Judith Kays, Yi-Chun Lai, Sean Daly, Francis L. de los Reyes III, and Angela Harris are with the Department of Civil, Construction, and Environmental Engineering, North Carolina State University. Stacie Reckling and Helena Mitasova are with the Center for Geospatial Analytics, North Carolina State University. Sivaranjani Palani is with the Department of Plant and Microbial Biology, North Carolina State University. Erika Bailey is with Raleigh Water, Raleigh, NC. Virginia T. Guidry, Ariel Christensen, and Steven Berkowitz are with the Division of Public Health, North Carolina Department of Health and Human Services, Raleigh.

American Journal of Public Health

|November 10, 2022

Abstract:

Objectives. To compare 4 COVID-19 surveillance metrics in a major metropolitan area. Methods. We analyzed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in wastewater influent and primary solids in Raleigh, North Carolina, from April 10 through December 13, 2020. We compared wastewater results with lab-confirmed COVID-19 cases and syndromic COVID-like illness (CLI) cases to answer 3 questions: (1) Did they correlate? (2) What was the temporal alignment of the different surveillance systems? (3) Did periods of significant change (i.e., trends) align? Results. In the Raleigh sewershed, wastewater influent, wastewater primary solids, lab-confirmed cases, and CLI were strongly or moderately correlated. Trends in lab-confirmed cases and wastewater influent were observed earlier, followed by CLI and, lastly, wastewater primary solids. All 4 metrics showed sustained increases in COVID-19 in June, July, and November 2020 and sustained decreases in August and September 2020. Conclusions. In a major metropolitan area in 2020, the timing of and trends in municipal wastewater, lab-confirmed case, and syndromic case surveillance of COVID-19 were in general agreement. Public Health Implications. Our results provide evidence for investment in SARS-CoV-2 wastewater and CLI surveillance to complement information provided through lab-confirmed cases. (Am J Public Health. 2023;113(1):79-88. https://doi.org/10.2105/AJPH.2022.307108).

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