Wastewater Analysis of SARS-CoV-2 as a Predictive Metric of Positivity Rate for a Major Metropolis

Stadler, L. B.; Ensor, K.; Clark, J. R.; Kalvapalle, P.; LaTurner, Z. W.; Mojica, L.; Terwilliger, A. L.; Zhuo, Y.; Ali, P.; Avadhanula, V.; Bertolusso, R.; Crosby, T.; Hernandez Santos, H.; Hollstein, M.; Weesner, K.; Zong, D. M.; Persse, D.; Piedra, P. A.; Maresso, A. W.; Hopkins, L.

Wastewater monitoring for SARS-CoV-2 has been suggested as an epidemiological indicator of community infection dynamics and disease prevalence. We report wastewater viral RNA levels of SARS-CoV-2 in a major metropolis serving over 3.6 million people geographically spread over 39 distinct sampling sites. Viral RNA levels were followed weekly for 22 weeks, both before, during, and after a major surge in cases, and simultaneously by two independent laboratories. We found SARS-CoV-2 RNA wastewater levels were a strong predictive indicator of trends in the nasal positivity rate two-weeks in advance. Furthermore, wastewater viral RNA loads demonstrated robust tracking of positivity rate for populations served by individual treatment plants, findings which were used in real-time to make public health interventions, including deployment of testing and education strike teams.