Wastewater-based Epidemiology for Averting COVID-19 Outbreaks on The University of Arizona Campus

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. Text Wastewater-based epidemiology (WBE) utilizes concentrations of SARS-CoV-2 in sewage to monitor population-level COVID-19 infections ([1][1]–[3][2]) . Currently, WBE is a promising indicator to support public health decisions ([3][2],[4][3]) . In this case study, WBE was used to detect a COVID-19 outbreak in a student dormitory (henceforth Dorm A) at the University of Arizona (UArizona). The Study UArizona incorporated wastewater surveillance as a potential early-warning tool for COVID-19 outbreaks on campus. Grab samples (1L) were collected from a sewer manhole specific to Dorm A, between August 18-31 to monitor SARS-CoV-2 RNA in wastewater. Upon positive detection of viral RNA in wastewater samples, clinical testing was conducted on every individual living in the dorm. UArizona performed two clinical testing modalities, antigen (1 hour turnaround) test via anterior nasal swab and RT-PCR (48-72 hour turnaround) via nasopharyngeal swab samples. Individuals were subject to clinical testing via two routes: Campus Health Services (CHS) if experiencing symptoms or Test All Test Smart (TATS) regardless of symptoms. Refer to Appendix for method details. Article Summary Line Wastewater-based epidemiology with subsequent clinical testing identified individuals infected with COVID-19 living in a dormitory and further spread of disease was prevented with public health action. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The work was supported by the University of Arizona Campus Re-Entry Plan. ### 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: Christine Melton-Lopez, MS, CIP Director, Human Subjects Protection Program The University of Arizona All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. 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 and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data is available upon request to the corresponding author. [1]: #ref-1 [2]: #ref-3 [3]: #ref-4