High throughput wastewater SARS-CoV-2 detection enables forecasting of community infection dynamics in San Diego county
ABSTRACT Large-scale wastewater surveillance has the ability to greatly augment the tracking of infection dynamics especially in communities where the prevalence rates far exceed the testing capacity. However, current methods for viral detection in wastewater are severely lacking in terms of scaling up for high throughput. In the present study, we employed an automated magnetic-bead-based concentration approach for viral detection in sewage that can effectively be scaled up for processing 24 samples in a single 40-min run. The method compared favorably to conventionally used methods for viral wastewater concentrations with higher recovery efficiencies from input sample volumes as low as 10 ml and can enable the processing of over 100 wastewater samples in a day. The sensitivity of the high-throughput protocol was shown to detect 1 asymptomatic individual in a building of 415 residents. Using the high-throughput pipeline, samples from the influent stream of the primary wastewater treatment plant of San Diego County (serving 2.3 million residents) were processed for a period of 13 weeks. Wastewater estimates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral genome copies in raw untreated wastewater correlated strongly with clinically reported cases by the county, and when used alongside past reported case numbers and temporal information in an autoregressive integrated moving average (ARIMA) model enabled prediction of new reported cases up to 3 weeks in advance. Taken together, the results show that the high-throughput surveillance could greatly ameliorate comprehensive community prevalence assessments by providing robust, rapid estimates.