COVID-19 hospital admissions and wastewater data in Canada: A statistical analysis

Since the COVID-19 pandemic, many jurisdictions have adopted wastewater-based surveillance for various pathogens. Indeed, monitoring pathogen concentration in wastewater, usually measured in RNA or DNA copies per milliliter, can efficiently assess the prevalence of infections in entire communities. However, wastewater-based surveillance does not provide a directly interpretable and actionable metric for public health. Here, we propose a statistical framework that assesses the relationship between COVID-19 hospital admissions and SARS-CoV-2 concentrations in wastewater for several large urban centres in Canada between 2021 and 2024. We also use this analysis to categorize early into an infection wave the clinical severity of future SARS-CoV-2 epidemics.