Site specific relationships between COVID-19 cases and SARS-CoV-2 viral load in wastewater treatment plant influent

Stephen Fitzgerald, Gianluigi Rossi, Alison Low, Sean McAteer, Brian O’Keefe, David Findlay, Graeme J. Cameron, Peter Pollard, Peter T. R. Singleton, George Ponton, Andrew C. Singer, Kata Farkas, Davey Jones, David W Graham, Marcos Quintela-Baluja, Christine Tait-Burkard, David Gally, Rowland Kao, Alexander Corbishley

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Wastewater based epidemiology (WBE) has become an important tool during the COVID-19 pandemic, however the relationship between SARS-CoV-2 RNA in wastewater treatment plant influent (WWTP) and cases in the community is not well defined. We report here the development of a national WBE program across 28 WWTPs serving 50% of the population of Scotland, including large conurbations, as well as low-density rural and remote island communities. For each WWTP catchment area, we quantified spatial and temporal relationships between SARS-CoV-2 RNA in wastewater and COVID-19 cases. Daily WWTP SARS-CoV-2 influent viral RNA load, calculated using daily influent flow rates, had the strongest correlation (ρ>0.9) with COVID-19 cases within a catchment. As the incidence of COVID-19 cases within a community increased, a linear relationship emerged between cases and influent viral RNA load. There were significant differences between WWTPs in their capacity to predict case numbers based on influent viral RNA load, with the limit of detection ranging from twenty-five cases for larger plants to a single case in smaller plants. SARS-CoV-2 viral RNA load can be used to predict the number of cases detected in the WWTP catchment area, with a clear statistically significant relationship observed above site-specific case thresholds.
Original languageEnglish
JournalEnvironmental Science and Technology
Early online date5 Nov 2021
Publication statusE-pub ahead of print - 5 Nov 2021


Dive into the research topics of 'Site specific relationships between COVID-19 cases and SARS-CoV-2 viral load in wastewater treatment plant influent'. Together they form a unique fingerprint.

Cite this