Application of neighborhood-scale wastewater-based epidemiology in low COVID-19 incidence situations

Chamteut Oh, Aijia Zhou, Kate O'Brien, Yusuf Jamal, Hayden Wennerdahl, Arthur R Schmidt, Joanna L Shisler, Antarpreet Jutla, Arthur R Schmidt IV, Laura Keefer, William M Brown, Thanh H Nguyen

Research output: Contribution to journalArticlepeer-review


Wastewater-based epidemiology (WBE), an emerging approach for community-wide COVID-19 surveillance, was primarily characterized at large sewersheds such as wastewater treatment plants serving a large population. Although informed public health measures can be better implemented for a small population, WBE for neighborhood-scale sewersheds is less studied and not fully understood. This study applied WBE to seven neighborhood-scale sewersheds (average population of 1471) from January to November 2021. Community testing data showed an average of 0.004 % incidence rate in these sewersheds (97 % of monitoring periods reported two or fewer daily infections). In 92 % of sewage samples, SARS-CoV-2 N gene fragments were below the limit of quantification. We statistically determined 10-2.6 as the threshold of the SARS-CoV-2 N gene concentration normalized to pepper mild mottle virus (N/PMMOV) to alert high COVID-19 incidence rate in the studied sewershed. This threshold of N/PMMOV identified neighborhood-scale outbreaks (COVID-19 incidence rate higher than 0.2 %) with 82 % sensitivity and 51 % specificity. Importantly, neighborhood-scale WBE can discern local outbreaks that would not otherwise be identified by city-scale WBE. Our findings suggest that neighborhood-scale WBE is an effective community-wide disease surveillance tool when COVID-19 incidence is maintained at a low level.

Original languageEnglish (US)
Article number158448
JournalScience of the Total Environment
Early online dateSep 2 2022
StatePublished - Dec 15 2022


  • Wastewater-based epidemiology
  • Low COVID-19 incidence
  • SARS-CoV-2 variant-specific RT-qPCR assays
  • Neighborhood-scale sewersheds

ASJC Scopus subject areas

  • Pollution
  • Waste Management and Disposal
  • Environmental Engineering
  • Environmental Chemistry


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