ArticleWater research2022
Metrics to relate COVID-19 wastewater data to clinical testing dynamics.
Article in Water research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 3 of them syntheses that pooled it.
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Who cites it
63 citing papers in PubMed, 3 syntheses or guidelines pooled it, 117 citations in OpenAlex.
- A Systematic Review of Methodological Approaches to SARS-CoV-2 Wastewater Surveillance.Viruses · 2026Pooled it
- 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
- Wastewater surveillance to infer COVID-19 transmission: A systematic review.The Science of the total environment · 2022Pooled it
- Revealing the hidden burden: wastewater-based epidemiology for underreported and emerging infectious diseases in communities.Environmental monitoring and assessment · 2026Review
- Barriers to translating continuous monitoring technologies for preventative medicine.Nature biomedical engineering · 2025Review
- Presence of Microorganisms in the Environment: One Health Approach.Microorganisms · 2025Review
- Wastewater-Based Surveillance of SARS-CoV-2 and Modeling of COVID-19 Infection Trends.Tropical medicine and infectious disease · 2025Article
- Application of joinpoint regression to SARS-CoV-2 wastewater-based epidemiology in Las Vegas, Nevada, USA.Epidemiology and infection · 2025Article
- Statistical Relationship Between Wastewater Data and Case Notifications for COVID-19 Surveillance in the United States From 2020 to 2023: Bayesian Hierarchical Modeling Approach.JMIR public health and surveillance · 2025Article
- Post-recovery viral shedding shapes wastewater-based epidemiological inferences.Communications medicine · 2025Article
- Variability of Clinical Metrics in Small Population Communities Drive Perceived Wastewater and Environmental Surveillance Data Quality: Ontario, Canada-Wide Study.ACS ES&T water · 2025Article
- Wastewater Surveillance for SARS-CoV-2 in Northern Italy: An Evaluation of Three Different Gene Targets.Microorganisms · 2025Article
- Epidemiological model can forecast COVID-19 outbreaks from wastewater-based surveillance in rural communities.Water research · 2025Article
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- Near-source wastewater surveillance of SARS-CoV-2, norovirus, influenza virus and RSV across five different sites in the UK.PLOS global public health · 2025Article
- Multisite community-scale monitoring of respiratory and enteric viruses in the effluent of a nursing home and in the inlet of the local wastewater treatment plant.Applied and environmental microbiology · 2024Article
- Implementation of Neighborhood-Level Wastewater-Based Epidemiology to Measure and Mitigate Inequities in SARS-CoV-2 Infection in Boston, Massachusetts.American journal of public health · 2024Article
- Wastewater Surveillance of SARS-CoV-2 in Slovenia: Key Public Health Tool in Endemic Time of COVID-19.Microorganisms · 2024Article
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3 more citing papers are in PubMed but not listed here.
Corrections and comments
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23 authors at 9 institutions in 2 countries.
Funding
Abstract
Wastewater surveillance has emerged as a useful tool in the public health response to the COVID-19 pandemic. While wastewater surveillance has been applied at various scales to monitor population-level COVID-19 dynamics, there is a need for quantitative metrics to interpret wastewater data in the context of public health trends. 24-hour composite wastewater samples were collected from March 2020 through May 2021 from a Massachusetts wastewater treatment plant and SARS-CoV-2 RNA concentrations were measured using RT-qPCR. The relationship between wastewater copy numbers of SARS-CoV-2 gene fragments and COVID-19 clinical cases and deaths varies over time. We demonstrate the utility of three new metrics to monitor changes in COVID-19 epidemiology: (1) the ratio between wastewater copy numbers of SARS-CoV-2 gene fragments and clinical cases (WC ratio), (2) the time lag between wastewater and clinical reporting, and (3) a transfer function between the wastewater and clinical case curves. The WC ratio increases after key events, providing insight into the balance between disease spread and public health response. Time lag and transfer function analysis showed that wastewater data preceded clinically reported cases in the first wave of the pandemic but did not serve as a leading indicator in the second wave, likely due to increased testing capacity, which allows for more timely case detection and reporting. These three metrics could help further integrate wastewater surveillance into the public health response to the COVID-19 pandemic and future pandemics.
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Registered trials
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.