Spatially-resolved wastewater-based surveillance enables COVID-19 case localization across a university campus, and confirms lower SARS-CoV-2 RNA burden relative to the surrounding community

Wastewater-based surveillance (WBS) has been established as a powerful tool that can guide health policy at multiple levels of government. However, this technology has not been well assessed at more granular scales, including large work sites such as University campuses. Between August 2021-April 2022, we explored the occurrence of SARS-CoV-2 RNA in wastewater from multiple complimentary sewer catchments and residential buildings spanning the University of Calgary’s campus and how this compared to levels from the municipal wastewater treatment plant servicing the campus. Concentrations of wastewater SARS-CoV-2 N1 and N2 RNA varied significantly across six sampling sites – regardless of several normalization strategies – with certain catchments consistently demonstrating values 1–2 orders higher than the others. Additionally, our comprehensive monitoring strategy enabled an estimation of the total burden of SARS-CoV-2 for the campus per capita, which was significantly lower than the surrounding community (p≤0.01). Real-time contact tracing data was used to confirm an association between wastewater SARS-CoV-2 burden and clinically confirmed cases proving the potential of WBS as a tool for disease monitoring across worksites. Allele-specific qPCR assays confirmed that variants across campus were representative of the community at large, and at no time did emerging variants first debut on campus. This study demonstrates how WBS can be efficiently applied to locate hotspots of disease activity at a very granular scale, and predict disease burden across large, complex worksites. Synopsis ‘This study establishes that wastewater-based surveillance with a node-based sampling strategy can be used to passively monitor for disease, locate disease “hotspots” and approximate the burden of infected individuals’ ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study was supported by Alberta Health and the Canadian Institutes of Health Research. Dr. Jangwoo Lee received salary support from a University of Calgary Eyes High Fellowship. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study received approval from the Conjoint Research Health Ethics Board of the University of Calgary (REB20-1544). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Key data produced in the present work are contained in the manuscript. The other data (not-shown) produced in the present study are available upon reasonable request to the authors.