Correlation of SARS-CoV-2 RNA in wastewater with COVID-19 disease burden in sewersheds

Abstract The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the coronavirus disease (COVID-19), is shed in feces and the virus RNA is detectable in wastewater. A nine-week wastewater epidemiology study of ten wastewater facilities, serving 39% of the state of Utah or 1.26M individuals was conducted in April and May of 2020. COVID-19 cases were tabulated from within each sewershed boundary by public health partners. The virus was detectable in 61% of 126 unique wastewater samples. Urban sewersheds serving >100,000 individuals and tourist communities had higher detection frequencies of the virus RNA. An outbreak of COVID-19 across two communities correlated with an increase in SARS-CoV-2 RNA in wastewater, while a decline in COVID-19 case counts preceded a decline in SARS-CoV-2 RNA. These results demonstrate the utility of wastewater epidemiology to assist in public health responses to COVID-19.