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在美国使用废水指标跟踪COVID-19

Meri R J Varkila¹, Maria E Montez-Rath², Joshua A Salomon³

¹Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Palo Alto, California.

JAMA network open

|July 26, 2023

概括

县废水SARS-CoV-2水平准确预测了2022年初的COVID-19病例和住院治疗情况. 然而,随着时间的推移,这种联系逐渐减弱,这表明传统的COVID-19监测方法面临挑战.

科学领域:

公共卫生公共卫生
流行病学流行病学
环境监督环境监督

背景情况:

在家中广泛使用COVID-19测试使得难以准确确定社区一级的疾病发病率.
传统的监测方法可能无法完全捕捉SARS-CoV-2感染的真实流行率.

研究的目的:

调查县级废水SARS-CoV-2指标与COVID-19病例和住院率之间的关联.
评估这些关联在家庭测试被广泛采用之前和之后.

主要方法:

一项观察性队列研究分析了2022年1月至9月期间来自美国268个县的时间序列数据.
县级废水SARS-CoV-2度 (废水百分比) 和其15天的百分比变化被用作暴露指标.
使用特定的人口门来定义高的COVID-19病例和住院率.

主要成果:

在2022年第一季度,废水百分比与高病例 (AUC,0.95) 和住院 (AUC,0.86) 率有很强的相关性.
百分比变化指标在预测病例和住院率方面表现不佳.
废水百分位数对病例的预测性能在2022年第二季度 (AUC,0.84) 和第三季度 (AUC,0.72) 下降.

结论:

县废水SARS-CoV-2水平与2022年初高的COVID-19临床指标有关.
在研究期间晚些时候,废水和临床数据之间的分离越来越多.
当传统数据变得不那么可靠时,废水监测为评估SARS-CoV-2流行率提供了一个有价值的策略.

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