ArticleThe Lancet. Planetary health2021
COVID-19 wastewater epidemiology: a model to estimate infected populations.
Article in The Lancet. Planetary health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 108 papers, 2 of them syntheses that pooled it.
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Who cites it
108 citing papers in PubMed, 2 syntheses or guidelines pooled it, 196 citations in OpenAlex.
- Recent progress on wastewater-based epidemiology for COVID-19 surveillance: A systematic review of analytical procedures and epidemiological modeling.The Science of the total environment · 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
- A Wastewater-based Modeling Framework for Inferring Norovirus Transmission Dynamics.Environmental science & technology · 2026Article
- Multivariable Behavioral Change Modeling of Epidemics in the Presence of Undetected Infections.Statistics in medicine · 2026Article
- Site-specific wastewater-based surveillance in early detection of COVID-19 new cases and prediction of mass testing outcomes in long-term care facilities.Scientific reports · 2026Article
- Frequency, dynamics, and duration of faecal shedding in SARS-CoV-2-infected individuals, a scoping review.Epidemiology and infection · 2026Article
- Qualitative assessment of a novel results-based partnership between national wastewater surveillance centers of excellence and utility companies, Houston (Texas), Colorado, Wisconsin, and California, 2023.BMC public health · 2026Article
- Article
- SARS-CoV-2 wastewater surveillance in a central Chinese metropolis: variant responses and correlation with clinical cases.Frontiers in public health · 2026Article
- Wastewater-based epidemiology reveals spatiotemporal dynamics and diurnal temperature range effects on post-pandemic SARS-CoV-2 infection burden in Chongqing, China.Frontiers in public health · 2026Article
- Association between SARS-CoV-2 levels in urban wastewater and reported COVID-19 cases in Changsha, Central China.BMC infectious diseases · 2025Article
- Importance of wastewater-based and environmental surveillance for monitoring resistance to next-generation antibiotics.Future microbiology · 2025Article
- Global infectious disease early warning models: An updated review and lessons from the COVID-19 pandemic.Infectious Disease Modelling · 2025Review
- Post-recovery viral shedding shapes wastewater-based epidemiological inferences.Communications medicine · 2025Article
- Wastewater Surveillance to Estimate and Characterize Hepatitis E Virus Circulation.Food and environmental virology · 2025Article
- Could hybrid work schedules offer infection risk reductions? Insights from a COBuilding and environment · 2025Article
- Optimizing RT-qPCR multiplex assays for simultaneous detection of enteric and respiratory viruses in wastewater.Journal of water and health · 2025Article
- Evaluation of wastewater percent positive for assessing epidemic trends - A case study of COVID-19 in Shangrao, China.Infectious Disease Modelling · 2025Article
- Evaluating Interlaboratory Variability in Wastewater-Based COVID-19 Surveillance.Microorganisms · 2025Article
- The Impact of Viral Concentration Method on Quantification and Long Amplicon Nanopore Sequencing of SARS-CoV-2 and Noroviruses in Wastewater.Microorganisms · 2025Article
48 more citing papers are in PubMed but not listed here.
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWastewater-based epidemiology provides an opportunity for near real-time, cost-effective monitoring of community-level transmission of SARS-CoV-2. Detection of SARS-CoV-2 RNA in wastewater can identify the presence of COVID-19 in the community, but methods for estimating the numbers of infected individuals on the basis of wastewater RNA concentrations are inadequate.
methodsThis is a wastewater-based epidemiology study using wastewater samples that were collected weekly or twice a week from three sewersheds in South Carolina, USA, between either May 27 or June 16, 2020, and Aug 25, 2020, and tested for SARS-CoV-2 RNA. We developed a susceptible-exposed-infectious-recovered (SEIR) model based on the mass rate of SARS-CoV-2 RNA in the wastewater to predict the number of infected individuals, and have also provided a simplified equation to predict this. Model predictions were compared with the number of confirmed cases identified by the Department of Health and Environmental Control, South Carolina, USA, for the same time period and geographical area.
findingsWe plotted the model predictions for the relationship between mass rate of virus release and numbers of infected individuals, and we validated this prediction on the basis of estimated prevalence from individual testing. A simplified equation to estimate the number of infected individuals fell within the 95% confidence limits of the model. The rate of unreported COVID-19 cases, as estimated by the model, was approximately 11 times that of confirmed cases (ie, ratio of estimated infections for every confirmed case of 10·9, 95% CI 4·2-17·5). This rate aligned well with an independent estimate of 15 infections for every confirmed case in the US state of South Carolina.
interpretationThe SEIR model provides a robust method to estimate the total number of infected individuals in a sewershed on the basis of the mass rate of RNA copies released per day. This approach overcomes some of the limitations associated with individual testing campaigns and thereby provides an additional tool that can be used to inform policy decisions.
fundingClemson University, USA.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.