Wastewater Sample Site Selection to Estimate Geographically Resolved Community Prevalence of COVID‐19: A Sampling Protocol Perspective
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Abstract
Wastewater monitoring for virus infections within communities can complement conventional clinical surveillance. Currently, most SARS‐CoV‐2 (severe acute respiratory syndrome coronavirus 2) clinical testing is voluntary and inconsistently available, except for a few occupational and educational settings, and therefore likely underrepresents actual population prevalence. Randomized testing on a regular basis to estimate accurate population‐level infection rates is prohibitively costly and is hampered by a range of limitations and barriers associated with participation in clinical research. In comparison, community‐level fecal monitoring can be performed through wastewater surveillance to effectively surveil communities. However, epidemiologically defined protocols for wastewater sample site selection are lacking. Herein, we describe methods for developing a geographically resolved population‐level wastewater sampling approach in Jefferson County, Kentucky, and present preliminary results. Utilizing this site selection protocol, samples ( n = 237) were collected from 17 wastewater catchment areas, September 8 to October 30, 2020 from one to four times per week in each area and compared to concurrent clinical data aggregated to wastewater catchment areas and county level. SARS‐CoV‐2 RNA was consistently present in wastewater during the studied period, and varied by area. Data obtained using the site selection protocol showed variation in geographically resolved wastewater SARS‐CoV‐2 RNA concentration compared to clinical rates. These findings highlight the importance of neighborhood‐equivalent spatial scales and provide a promising approach for viral epidemic surveillance, thus better guiding spatially targeted public health mitigation strategies.
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SciScore for 10.1101/2020.08.23.20180224: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:There are several limitations to this protocol. The site selection is framed to consider physical variation in sample state (travel time, sample temperature, flow data, background chemistry, variation in shedding by infected …
SciScore for 10.1101/2020.08.23.20180224: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:There are several limitations to this protocol. The site selection is framed to consider physical variation in sample state (travel time, sample temperature, flow data, background chemistry, variation in shedding by infected persons); however, the rapidly evolving understanding of decay of SARS-CoV-2 in wastewater may further refine sample location selection. In some cases, sewer line access was restricted. The number of sites was not predetermined, but based on spatial resolution of sewer catchment areas and on physical limitations of the system to select ideal population distributions. Flow data was not included in the same site selection criteria. In some areas, MSD has a combined sewer and storm water system, possibly diluting residential sources of SARS-CoV-2 or introducing non-toilet sources of SARS-CoV-2. However, dilution may largely be accounted for by normalizing to population and flow rate, as well as biological measurements of fecal dilution markers. Further, while we can partially account for resulting dilution, it is not possible to fully exclude industrial and commercial outflow. It should be noted that clinical data from testing the community’s residents potentially includes households not represented in the sanitary sewer system (e.g., septic tank users, individuals living in one area but spending the majority of their day in another area of the city). Areas for future exploration include: 1) sensitivity and temporal dynamics to determine if raw wastewater is...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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