COVID-19 containment on a college campus via wastewater-based epidemiology, targeted clinical testing and an intervention

• Published in: The Science of the total environment Vol. 779; p. 146408
• Main Authors: Betancourt, Walter Q., Schmitz, Bradley W., Innes, Gabriel K., Prasek, Sarah M., Pogreba Brown, Kristen M., Stark, Erika R., Foster, Aidan R., Sprissler, Ryan S., Harris, David T., Sherchan, Samendra P., Gerba, Charles P., Pepper, Ian L.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 20-07-2021; Published by Elsevier B.V
• Subjects: COVID-19; Dormitory; Humans; Outbreak prevention; RNA, Viral; SARS-CoV-2; Sewer manhole; University campus; Wastewater; Wastewater surveillance; Wastewater-Based Epidemiological Monitoring; Dormitory; Sewer manhole; University campus; Wastewater surveillance; Outbreak prevention
• ISSN: 0048-9697; 1879-1026; 1879-1026
• DOI: 10.1016/j.scitotenv.2021.146408

Wastewater-based epidemiology has potential as an early-warning tool for determining the presence of COVID-19 in a community. The University of Arizona (UArizona) utilized WBE paired with clinical testing as a surveillance tool to monitor the UArizona community for SARS-CoV-2 in near real-time, as students re-entered campus in the fall. Positive detection of virus RNA in wastewater lead to selected clinical testing, identification, and isolation of three infected individuals (one symptomatic and two asymptomatic) that averted potential disease transmission. This case study demonstrated the value of WBE as a tool to efficiently utilize resources for COVID-19 prevention and response. Thus, WBE coupled with targeted clinical testing was further conducted on 13 dorms during the course of the Fall semester (Table 3). In total, 91 wastewater samples resulted in positive detection of SARS-CoV-2 RNA that successfully provided an early-warning for at least a single new reported case of infection (positive clinical test) among the residents living in the dorm. Overall, WBE proved to be an accurate diagnostic for new cases of COVID-19 with an 82.0% positive predictive value and an 88.9% negative predictive value. Increases in positive wastewater samples and clinical tests were noted following holiday-related activities. However, shelter-in-place policies proved to be effective in reducing the number of daily reported positive wastewater and clinical tests. This case study provides evidence for WBE paired with clinical testing and public health interventions to effectively contain potential outbreaks of COVID-19 in defined communities.
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•Positive detection of SARS-CoV-2 RNA in wastewater led to selected clinical testing.•WBE identified one symptomatic and two asymptomatic individuals in a dorm.•79 positive wastewater samples provided early warnings of infection(s) in 13 dorms.•Cases increased following holidays and shelter-in-place policies proved effective.•WBE paired with clinical testing and interventions effectively contained outbreaks.