Wastewater Measures of SARS-CoV-2 Accurately Predict Frequency of Symptomatic Infections in the Community.

BACKGROUND Widespread immunity through vaccination or natural infection has altered the predictive ability of wastewater for hospitalization and mortality. METHODS Between January 2022 and August 2024, we conducted a longitudinal observational study aimed to examine the correlation between symptomatic COVID-19 in healthcare employees and the SARS-CoV-2 wastewater community levels. Wastewater was analyzed by quantitative RT-PCR for detection of SARS-CoV-2. The employee occupational health office for Fairview Health provided deidentified data. RESULTS We collected 215 wastewater samples from the TCWWTP over a 32-month interval. Over that period, there were 6,879 positive SARS-CoV-2 test results reported to Fairview Employee Health from individuals who lived in the wastewater catchment area. We found that SARS-CoV-2 levels in wastewater accurately predicted the subsequent COVID-19 case count the following week in the community (p = 0.001). CONCLUSION These data demonstrate the utility of SARS-CoV-2 wastewater surveillance as it accurately predicts the frequency of symptomatic infection in the community.