TY - JOUR
T1 - Precision public health in schools enabled by wastewater surveillance
T2 - A case study of COVID-19 in an Upstate New York middle-high school campus during the 2021–2022 academic year
AU - Kappus-Kron, Haley
AU - Chatila, Dana Ahmad
AU - MacLachlan, Ainsley Mabel
AU - Pulido, Nicole
AU - Yang, Nan
AU - Larsen, David A.
N1 - Publisher Copyright:
Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
PY - 2024/1
Y1 - 2024/1
N2 - Wastewater surveillance provides a cost-effective and non-invasive way to gain an understanding of infectious disease transmission including for COVID-19. We analyzed wastewater samples from one school site in Jefferson County, New York during the 2021–2022 school year. We tested for SARS-CoV-2 RNA once weekly and compared those results with the clinical COVID-19 cases in the school. The amount of SARS-CoV-2 RNA correlated with the number of incident COVID-19 cases, with the best correlation being one day lead time between the wastewater sample and the number of COVID-19 cases. The sensitivity and positive predictive value of wastewater surveillance to correctly identify any COVID-19 cases up to 7 days after a wastewater sample collection ranged from 82–100% and 59–78% respectively, depending upon the amount of SARS-CoV-2 RNA in the sample. The specificity and negative predictive value of wastewater surveillance to correctly identify when the school was without a case of COVID-19 ranged from 67–78% and 70–80%, respectively, depending upon the amount of SARS-CoV-2 RNA in the sample. The lead time observed in this study suggests that transmission might occur within a school before SARS-CoV-2 is identified in wastewater. However, wastewater surveillance should still be considered as a potential means of understanding school-level COVID-19 trends and is a way to enable precision public health approaches tailored to the epidemiologic situation in an individual school.
AB - Wastewater surveillance provides a cost-effective and non-invasive way to gain an understanding of infectious disease transmission including for COVID-19. We analyzed wastewater samples from one school site in Jefferson County, New York during the 2021–2022 school year. We tested for SARS-CoV-2 RNA once weekly and compared those results with the clinical COVID-19 cases in the school. The amount of SARS-CoV-2 RNA correlated with the number of incident COVID-19 cases, with the best correlation being one day lead time between the wastewater sample and the number of COVID-19 cases. The sensitivity and positive predictive value of wastewater surveillance to correctly identify any COVID-19 cases up to 7 days after a wastewater sample collection ranged from 82–100% and 59–78% respectively, depending upon the amount of SARS-CoV-2 RNA in the sample. The specificity and negative predictive value of wastewater surveillance to correctly identify when the school was without a case of COVID-19 ranged from 67–78% and 70–80%, respectively, depending upon the amount of SARS-CoV-2 RNA in the sample. The lead time observed in this study suggests that transmission might occur within a school before SARS-CoV-2 is identified in wastewater. However, wastewater surveillance should still be considered as a potential means of understanding school-level COVID-19 trends and is a way to enable precision public health approaches tailored to the epidemiologic situation in an individual school.
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U2 - 10.1371/journal.pgph.0001803
DO - 10.1371/journal.pgph.0001803
M3 - Article
AN - SCOPUS:85195695040
SN - 2767-3375
VL - 4
JO - PLOS Global Public Health
JF - PLOS Global Public Health
IS - 1
M1 - e0001803
ER -