Tracking community trends in SARS-CoV-2 burdens using surveillance

Sandra McLellan, Professor

School of Freshwater Sciences, University of Wisconsin-Milwaukee Wisconsin SARS-CoV-2 Wastewater Surveillance

SARS-CoV-2 surveillance team Adelaide Rouget, Post Doc Deb Dila, Research Associate Melinda Bootsma, Technician Lexi Passante, Grad Student Melissa Schussmann, Grad Student Angela Schmoldt, GLGC Research Associate

Shuchen Feng, Post Doc Jill McClary, Post Doc McLellan Lab Research New indicators of fecal pollution Microbiome of animals and sewage population structure water analysis

What are the organisms in sewage? Should the beach be What is the health risk and viral load? closed? How can we test the whole community at once?

Sewage is a representative sample of humans

SARS-CoV-2 (viruses that causes Covid-19) is shed in feces, also enters sewer system through kleenex, salvia How many people have Covid-19? This was the early testing scenario

Asymptomatic carriage ?

Test people who have symptoms SARS-CoV-2 virus detected in wastewater in Netherlands

Medema et al. 2020 Boehm (Stanford) and Wigginton (U of Silverman at NYC supports program for Michigan) examine and influent form 14 WWTPs servicing NYC 50 WWTPS Gonzalez (Hampton Roads SD) Utah launches Dashboard employ filtering and ddPCR spike early in April/May

LA Sanitation follow community and posts results online Noble and de les Reyes Gerba and colleagues identify test rural and urban NC cases in dorms at U of Arizona Communicating Sewage Surveillance (CoSeS) Interactive group of researchers working with public health and communication scholars to build capacity and communication networks for sewage surveillance - Funded by the Alfred P. Sloan Foundation

Sandra McLellan, UW-Milwaukee Andrea Silverman, New York University Alexandria Boehm, Stanford Kyle Bibby, Notre Dame Dominique Brossard, UW-Madison Communicating Sewage Surveillance to Public Health

Objective 1: Work with cites to implement wastewater surveillance- focus on NYC

Objective 2: Draw upon national expertise to create a communication strategy that is responsive to public health

Photo credit Grayline.com 14 WWTPs handle more than a Objective 1 billion gallons of wastewater Building capacity Source: Dr. Andrea Silverman, NYU Objective 2- Communication networks Experts Panel • Researchers have meet since early March to compare findings • There was no standard method; diverse approaches have led to faster discovery • Sampling needs to be tailored to the question

Proper controls are the key Alfred P. Sloan Foundation project

National Experts panel

https://sites.uwm.edu/coses/ Wisconsin SARS-CoV-2 Wastewater Surveillance

McLellan Lab Activities

• Initiated monitoring for Racine, Milwaukee, and Green Bay as part of a Statewide surveillance effort with the Wisconsin State Laboratory of Hygiene at UW- Madison, funded by Department of Health Services, now sampling 12 WWTPs

• Developing methods for tracking variants in sewage

12 service areas ~~1.8 M people Paper submitted to Environmental Science and Technology

What is the precision in the measurements?

How often should we sample?

Does wastewater reflect what is happening in the community? Paper submitted to Environmental Science and Technology

What is the precision in the measurements?

How often should we sample?

Does wastewater reflect what is happening in the community? Sampling and method overview

24 hour flow weighted sample at the WWTP

Sample processing RNA extraction ddPCR quantification (RNA concentration) Sampling and method overview

Standard 24 hour flow weighted sample at the WWTP Tricky

Just like the clinical lab

Sample processing RNA extraction ddPCR quantification (RNA concentration) What is the preci