key: cord-0739282-cbzac3rn authors: Betancourt, W. W.; Schmitz, B. W.; Innes, G. K.; Pogreba Brown, K. M.; Prasek, S. M.; Stark, E. R.; Foster, A. R.; Sprissler, R. S.; Harris, D. T.; Sherchan, S. P.; Gerba, C. P.; Pepper, I. L. title: Wastewater-based Epidemiology for Averting COVID-19 Outbreaks on The University of Arizona Campus date: 2020-11-16 journal: nan DOI: 10.1101/2020.11.13.20231340 sha: 3260455af3f649ce219883140356ea65252677cb doc_id: 739282 cord_uid: cbzac3rn The University of Arizona utilized wastewater-based epidemiology paired with clinical testing as a surveillance strategy to monitor COVID-19 prevalence in a dormitory community. Positive SARS-CoV-2 RNA detection in wastewater led to prompt testing of all residents and the identification and isolation of three infected individuals which averted potential disease transmission. transmission. CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) preprint The copyright holder for this this version posted November 16, 2020. ; https://doi.org/10.1101/2020.11.13.20231340 doi: medRxiv preprint On March 13, 2020, UArizona advised students and employees to work remotely. During On August 17, students were permitted to move into Dorm A ( Figure 1 ). Before entering 55 on-campus housing, students were required to test negative via UArizona's COVID-19 nasal 56 swab antigen test and follow public health guidelines, such as wearing a mask and committing to 57 social distancing. Students testing positive were prohibited from entering the dorm and were 58 required to remain in isolation until remaining symptom-free for a minimum of 10 days, per 59 Centers for Disease Control and Prevention (CDC) guidelines (5). . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) preprint (Table 1 ). This positive sample triggered an emergency UA Task Force meeting, which 68 supported additional wastewater sampling and clinical testing among Dorm A residents ( Figure 69 1). The next day (August 26), five wastewater samples were collected once every five . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) preprint The copyright holder for this this version posted November 16, 2020. ; https://doi.org/10.1101/2020.11.13.20231340 doi: medRxiv preprint Over the next two days, antigen tests (34 individuals) and PCR tests (24 individuals) 83 were conducted for individuals not tested on August 26. All tests were negative (Table 2) . 84 Corresponding wastewater samples from August 27 and 28 were also negative (Table 1) , 85 indicating that the source(s) for SARS-CoV-2 had likely been removed from the dorm. However, 86 wastewater analysis on August 29 was positive for both N1 (1.04 x 104 copies/L) and N2 (9.93 x 87 105 copies/L) genes ( CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) preprint The copyright holder for this this version posted November 16, 2020. ; https://doi.org/10.1101/2020.11.13.20231340 doi: medRxiv preprint resulted in lower shedding loads, and ultimately, negative wastewater samples in the following 106 days. Due to negative wastewater samples on August 30 and 31 ( Figure 1 ; Table 1 is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) preprint March 2020: Retrospective cohort study. BMJ. 2020; 149 . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) preprint The copyright holder for this this version posted November 16, 2020. ; https://doi.org/10.1101/2020.11.13.20231340 doi: medRxiv preprint . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this this version posted November 16, 2020. ; https://doi.org/10.1101/2020.11.13.20231340 doi: medRxiv preprint 168 . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this this version posted November 16, 2020. ; https://doi.org/10.1101/2020.11.13.20231340 doi: medRxiv preprint (Table S1) . Similarly, samples were assayed for HCoV 229 E using a real-time Table S1 . is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) preprint The copyright holder for this this version posted November 16, 2020. ; https://doi.org/10.1101/2020.11.13.20231340 doi: medRxiv preprint respectively following the Roche system based on second-derivative Cq determination and 238 nonlinear fit algorithms. Limits of blank, detection, and quantification for the RT-qPCR assays 239 were determined following standard procedures previously described (6) and currently in use in value for the LoQ (CqLoQ) was calculated as q = q − 2( q ) where q is 257 the standard deviation of the CqLoD for this assay. This CqLoQ was used to calculate a 258 concentration (copies/rxn) using the standard curve run with the dilution series. A summary of 259 the performance of the standard curves for each assay is given in Table S2 . . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) preprint The copyright holder for this this version posted November 16, 2020. ; https://doi.org/10.1101/2020.11.13.20231340 doi: medRxiv preprint Table S1 . Primer and probe nucleotide sequences for SARS-CoV-2 and HCoV 229E **The FAM quencher is a minor groove binder nonfluorescent quencher (MGBNFQ)** 291 . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) preprint The copyright holder for this this version posted November 16, 2020. ; https://doi.org/10.1101/2020.11.13.20231340 doi: medRxiv preprint Monitoring wastewater for assessing community health: Sewage Chemical-128 Information Mining (SCIM) Pathogen surveillance through monitoring of Coronavirus-2 RNA in Sewage and Correlation with Reported COVID-19 Prevalence in 298 the Early Stage of the Epidemic in the Netherlands CoV-2 RNA in wastewater anticipated COVID-19 occurrence in a low prevalence area Sewage analysis as a tool for the 303 COVID-19 pandemic response and management: The urgent need for optimised protocols 304 for SARS-CoV-2 detection and quantification Detection of 306 pathogenic viruses in sewage provided early warnings of hepatitis A virus and norovirus 307 outbreaks Development of one-step, 309 real-time, quantitative reverse transcriptase PCR assays for absolute quantitation of human 310 coronaviruses OC43 and 229E Comparative effectiveness of membrane bioreactors, conventional secondary treatment, 313 and chlorine and UV disinfection to remove microorganisms from municipal wastewaters Centers for Disease Control and Prevention Division of Viral Diseases. CDC 2019-Novel -nCoV) Real-Time RT-PCR Diagnostic Panel Duration of Isolation and Precautions CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this this version posted November 16, 2020. ; https://doi.org/10.1101/2020.11.13.20231340 doi: medRxiv preprint disease/infection amongst persons in the dorm. Individuals were excluded from TATS testing if 284 they had already reported to CHS for testing on the same day or had proof of recently returning 285 from isolation and no longer experiencing symptoms. In essence, CHS tested individuals that 286 were symptomatic, and TATS tested individuals that were asymptomatic or had not yet reported 287 symptoms. CHS and TATS both utilized anterior nasal swab samples for antigen and/or PCR 288 tests. . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) preprintThe copyright holder for this this version posted November 16, 2020. ; https://doi.org/10.1101/2020.11.13.20231340 doi: medRxiv preprint Appendix References 296 318 . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) preprint CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) preprintThe copyright holder for this this version posted November 16, 2020. ; https://doi.org/10.1101/2020.11.13.20231340 doi: medRxiv preprint