Academic institution extensive, building-by-building wastewater-based surveillance platform for SARS-CoV-2 monitoring, clinical data correlation, and potential national proxy.

In this work, we report on the performance of an extensive, building-by-building wastewater surveillance platform deployed across 38 locations of the largest private university system in Mexico, spanning 19 of the 32 states, to detect SARS-CoV-2 genetic materials during the COVID-19 pandemic. Sampling took place weekly from January 2021 and June 2022. Data from 343 sampling sites was clustered by campus and by state and evaluated through its correlation with the seven-day average of daily new COVID-19 cases in each cluster. Statistically significant linear correlations (p-values below 0.05) were found in 25 of the 38 campuses and 13 of the 19 states. Moreover, to evaluate the effectiveness of epidemiologic containment measures taken by the institution across 2021 and the potential of university campuses as representative sampling points for surveillance in future public health emergencies in the Monterrey Metropolitan Area, correlation between new COVID-19 cases and viral loads in weekly wastewater samples was found to be stronger in Dulces Nombres, the largest wastewater treatment plant in the city (Pearson coefficient: 0.6456, p-value: 6.36710-8), than in the largest university campus in the study (Pearson coefficient: 0.4860, p-value: 8.288x10-5). However, when comparing the data after urban mobility returned to pre-pandemic levels, correlation levels in both locations became comparable (0.894 for the university campus and 0.865 for Dulces Nombres). This work provides a basic framework for the implementation and analysis of similar decentralized surveillance platforms to address future sanitary emergencies, allowing for an efficient return to priority in-person activities while preventing university campuses from becoming transmission hotspots.