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 that aimed to examine the correlation between symptomatic COVID-19 in health care employees and SARS-CoV-2 wastewater community levels. Wastewater was analyzed by quantitative reverse transcription polymerase chain reaction for detection of SARS-CoV-2. The Fairview Employee Occupational Health office provided deidentified data. RESULTS:We collected 215 wastewater samples from the Twin Cities Wastewater Treatment Plant over a 32-month interval. Over that period, there were 6879 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 = .001). CONCLUSIONS:These data demonstrate the utility of SARS-CoV-2 wastewater surveillance as it accurately predicts the frequency of symptomatic infection in the community.