ArticleThe Science of the total environment2021
Catching a resurgence: Increase in SARS-CoV-2 viral RNA identified in wastewater 48 h before COVID-19 clinical tests and 96 h before hospitalizations.
Article in The Science of the total environment, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 106 papers, 4 of them syntheses that pooled it.
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The trial behind it
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Who cites it
106 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Detecting SARS-CoV-2 in sludge samples: A systematic review.The Science of the total environment · 2023Pooled it
- Correlation between SARS-CoV-2 RNA concentration in wastewater and COVID-19 cases in community: A systematic review and meta-analysis.Journal of hazardous materials · 2023Pooled it
- Factors influencing SARS-CoV-2 RNA concentrations in wastewater up to the sampling stage: A systematic review.The Science of the total environment · 2022Pooled it
- Wastewater surveillance to infer COVID-19 transmission: A systematic review.The Science of the total environment · 2022Pooled it
- Early-warning surveillance of West Nile and Usutu viruses in wetland and larval habitat waters and in mosquito excreta using digital PCR.PLoS neglected tropical diseases · 2026Article
- Wastewater Surveillance to Track Resurgent Measles Outbreak, Ontario, Canada, 2025.Emerging infectious diseases · 2026Article
- Recommendations for the analysis of leading indicators in epidemic surveillance.PLOS digital health · 2026Review
- Long-Term Wastewater Genomic Surveillance Reveals SARS-CoV-2 Variant Dynamics in Italy from 2021 to 2025.Food and environmental virology · 2026Article
- Public Awareness and Acceptance of Wastewater Surveillance in the United States, June 2024.Public health reports (Washington, D.C. : 1974) · 2026Article
- Designing effective SARS-CoV-2 wastewater surveillance system: lessons learnt from sustained monitoring in Delhi, India.BMC infectious diseases · 2026Article
- A One-Year Wastewater-Based Surveillance Study of the Main Human Respiratory Viruses in a Middle-Size Spanish City During the COVID-19 Pandemic Period.Microorganisms · 2026Article
- Localized wastewater surveillance showed correlation but no early warning during Bengaluru's Omicron wave.PLOS global public health · 2026Article
- Near-Source Wastewater Surveillance of SARS-CoV-2, Influenza A, and Respiratory Syncytial Virus With Spatiotemporal Evaluation of Pepper Mild Mottle Virus as a Fecal Indicator.Water environment research : a research publication of the Water Environment Federation · 2026Article
- Review
- Wastewater-Based Surveillance of SARS-CoV-2 and Modeling of COVID-19 Infection Trends.Tropical medicine and infectious disease · 2025Article
- Norovirus trends in British Columbia from 2021 to 2022: the relationship between wastewater surveillance and clinical outbreak data during the COVID-19 pandemic.Scientific reports · 2025Article
- Skilled nursing facility wastewater surveillance: a SARS-CoV-2 and antimicrobial resistance detection pilot study.Journal of water and health · 2025Article
- Wastewater-Based Surveillance of Respiratory Syncytial Virus Reveals a Temporal Disconnect in Disease Trajectory across an Active International Land Border.Environment & health (Washington, D.C.) · 2025Article
- Measuring SARS-CoV-2 RNA in Bangkok wastewater treatment plants and estimating infected population after fully opening the country in 2023, Thailand.Scientific reports · 2025Article
- Identification of clinically relevant multi-drug resistant ESKAPEE isolates from hospital wastewater surveillance in Thailand.Frontiers in microbiology · 2025Article
46 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Curtailing the Spring 2020 COVID-19 surge required sweeping and stringent interventions by governments across the world. Wastewater-based COVID-19 epidemiology programs have been initiated in many countries to provide public health agencies with a complementary disease tracking metric and non-discriminating surveillance tool. However, their efficacy in prospectively capturing resurgences following a period of low prevalence is unclear. In this study, the SARS-CoV-2 viral signal was measured in primary clarified sludge harvested every two days at the City of Ottawa's water resource recovery facility during the summer of 2020, when clinical testing recorded daily percent positivity below 1%. In late July, increases of >400% in normalized SARS-CoV-2 RNA signal in wastewater were identified 48 h prior to reported >300% increases in positive cases that were retrospectively attributed to community-acquired infections. During this resurgence period, SARS-CoV-2 RNA signal in wastewater preceded the reported >160% increase in community hospitalizations by approximately 96 h. This study supports wastewater-based COVID-19 surveillance of populations in augmenting the efficacy of diagnostic testing, which can suffer from sampling biases or timely reporting as in the case of hospitalization census.
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