Rondeau Nicole C, Rose Oliver J, Alt Ellen R, Ariyan Lina A, Elikan Annabelle B, Everard Jenna L, Schreier Abigail R, Tessler Maya E, Tulinsky Grace H, Vo Janet R, Ray Caroline A, Yang Cynthia Y, Miranda Jj L, Mailloux Brian J
Department of Biology, Barnard College, Columbia University, New York, New York, USA.
Office of Facilities Services, Barnard College, Columbia University, New York, New York, USA.
Microbiol Spectr. 2023 Mar 28;11(2):e0292922. doi: 10.1128/spectrum.02929-22.
We established wastewater surveillance of SARS-CoV-2 in a small, residential, urban college as part of an integrated public health response during the COVID-19 pandemic. Students returned to campus in spring 2021. During the semester, students were required to perform nasal PCR tests twice weekly. At the same time, wastewater monitoring was established in 3 campus dormitory buildings. Two were dedicated dormitories with populations of 188 and 138 students; 1 was an isolation building where students were moved within 2 h of receiving positive test results. Analysis of wastewater from isolation indicated that the amount of viral shedding was highly variable and that viral concentration could not be used to estimate the number of cases at the building level. However, rapid movement of students to isolation enabled determination of predictive power, specificity, and sensitivity from instances in which generally one positive case at a time occurred in a building. Our assay yields effective results with an ~60% positive predictive power, ~90% negative predictive power, and ~90% specificity. Sensitivity, however, is low at ~40%. Detection is improved in the few instances of 2 simultaneous positive cases, with sensitivity of 1 case versus 2 cases increasing from ~20% to 100%. We also measured the appearance of a variant of concern on campus and noted a similarity in timeline with increased prevalence in surrounding New York City. Monitoring SARS-CoV-2 in the sewage outflow of individual buildings can be used with a realistic goal of containing outbreak clusters but not necessarily single cases. Diagnostic testing of sewage can detect levels of circulating viruses to help inform public health. Wastewater-based epidemiology has been particularly active during the COVID-19 pandemic to measure the prevalence of SARS-CoV-2. Understanding the technical limitations of diagnostic testing for individual buildings would help inform future surveillance programs. We report our diagnostic and clinical data monitoring of buildings on a college campus in New York City during the spring 2021 semester. Frequent nasal testing, mitigation measures, and public health protocols provided a context in which to study the effectiveness of wastewater-based epidemiology. Our efforts could not consistently detect individual positive COVID-19 cases, but sensitivity is significantly improved in detecting two simultaneous cases. We therefore contend that wastewater surveillance may be more practically suited for the mitigation of outbreak clusters.
作为新冠疫情期间综合公共卫生应对措施的一部分，我们在一所小型城市住宿制学院开展了新冠病毒的废水监测。学生于2021年春季返校。学期期间，要求学生每周进行两次鼻腔PCR检测。与此同时，在校园的3栋宿舍楼建立了废水监测。其中两栋是专用宿舍，分别住有188名和138名学生；另一栋是隔离楼，学生在检测结果呈阳性后2小时内会被转移至此。对隔离楼废水的分析表明，病毒 shedding量变化很大，病毒浓度无法用于估计楼内的病例数。然而，学生迅速转移至隔离楼，使得能够根据楼内通常一次出现一例阳性病例的情况来确定预测能力、特异性和敏感性。我们的检测方法产生了有效的结果，阳性预测值约为60%，阴性预测值约为90%，特异性约为90%。然而，敏感性较低，约为40%。在少数出现两例同时呈阳性的情况下，检测效果有所改善，从约20%提高到100%，即1例阳性相对于2例阳性的敏感性。我们还监测了校园内一种关注变体的出现情况，并注意到其时间线与纽约市周边地区患病率上升的情况相似。监测单个建筑污水排放中的新冠病毒可用于实现控制疫情聚集性暴发这一现实目标，但不一定能用于发现单个病例。污水诊断检测可以检测循环病毒水平，以帮助为公共卫生提供信息。在新冠疫情期间，基于废水的流行病学特别活跃，用于测量新冠病毒的流行情况。了解单个建筑诊断检测的技术局限性将有助于为未来的监测计划提供信息。我们报告了2021年春季学期纽约市一所大学校园内建筑的诊断和临床数据监测情况。频繁的鼻腔检测、缓解措施和公共卫生协议为研究基于废水的流行病学的有效性提供了背景。我们的努力无法始终检测到单个新冠阳性病例，但在检测两例同时出现的病例时，敏感性显著提高。因此，我们认为废水监测可能在控制疫情聚集性暴发方面更具实际适用性。
