Early detection of local SARS-CoV-2 outbreaks by wastewater surveillance: A feasibility study

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  • Maarten Nauta
  • Oliver McManus
  • Kristina Træholt Franck
  • Ellinor Lindberg Marving
  • Lasse Dam Rasmussen
  • Stine Raith Richter
  • Ethelberg, Steen

Wastewater surveillance and quantitative analysis of SARS-CoV-2 RNA are increasingly used to monitor the spread of COVID-19 in the community. We studied the feasibility of applying the surveillance data for early detection of local outbreaks. A Monte Carlo simulation model was constructed, applying data on reported variation in RNA gene copy concentration in faeces and faecal masses shed. It showed that, even with a constant number of SARS-CoV-2 RNA shedders, the variation in concentrations found in wastewater samples will be large, and that it will be challenging to translate viral concentrations into incidence estimates, especially when the number of shedders is low. Potential signals for early detection of hypothetical outbreaks were analysed for their performance in terms of sensitivity and specificity of the signals. The results suggest that a sudden increase in incidence is not easily identified on the basis of wastewater surveillance data, especially in small sampling areas and in low-incidence situations. However, with a high number of shedders and when combining data from multiple consecutive tests, the performance of wastewater sampling is expected to improve considerably. The developed modelling approach can increase our understanding of the results from wastewater surveillance of SARS-CoV-2.

Original languageEnglish
Article numbere28
JournalEpidemiology and Infection
Volume151
Number of pages9
ISSN0950-2688
DOIs
Publication statusPublished - 2023

Bibliographical note

Publisher Copyright:
© 2023 The Author(s). Published by Cambridge University Press.

    Research areas

  • COVID-19, early warning, modelling, wastewater-based surveillance

ID: 340319979