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Global Update on Wastewater Surveillance for SARS-CoV-2

Christobel Ferguson, PhD
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Overview

Rapid Development & Adoption

Wide Variety of Approaches

Use Cases

Trends, Variants, and Early Warning

Lessons Learned

Global Update

Knowledge gaps

Next Steps
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Rapid Development & Adoption

Wide Variety of Approaches

Methods to detect SARS-CoV-2 using wastewater surveillance.
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Rapid Water Sector Response & Collaboration • Interlaboratory and Methods Assessment of the SARS-CoV-2 Genetic Signal in 

Wastewater (#5089) DOI: 10.1039/d0ew00946f

• Method SOPs available on the WRF website

https://www.waterrf.org/research/projects/interlaboratory-and-methodsassessment-sars-cov-2-genetic-signal-wastewater

• Understanding the Factors that Affect the Detection and Variability of SARS-CoV-2 

in Wastewater (#5093) – due August 2021

• DHS and CDC Project with AquaVitas

• NSF Research Coordination Network on SARS-CoV-2 wastewater surveillance 

• CDC National Wastewater Surveillance System

• Water Research Australia ColoSSuS project

• US EPA Research with Cincinnati Ohio

• WRC (South Africa) Pilot Projects on method development 

• Canadian Water Network Method evaluation

• EU Umbrella study under European Health Emergency Preparedness and Response 

Authority (HERA)
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Implementation across the globe

https://www.covid19wbec.org/covidpoops19 @covidpoops19
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Use Cases

Trends, Variants and Early Warning

Selecting the approach that meets the community need.
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Lazuka, Soyeux & Lacroix, Veolia, France, 2021
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Trends

Borrego, Collado, Corominas, Guerrero & Pueyo

Catalan Surveillance Network, 2021
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Jay Bhagwan, WRC, South Africa, 2021
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Krista Wigginton, University of Michigan, California, USA 2021
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Goldman-Torres, Werth & Fielder, Colorado, USA2021
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Goldman-Torres, Werth & Fielder, Colorado, USA2021
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Habib Yakubu, Emory University, Ghana, 2021
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Ryan Ziels, University of British Colombia, British Colombia, 

Canada 2021

Variants
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Daniel Gerrity, Southern Nevada Water Authority, Nevada, USA 2021
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Devrim Kaya, Oregon State University, Oregon, USA 2021
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Frederic Beén, KWR Water Research Institute, Netherlands 2021
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Tim Julian, Eawag, Switzerland 2021
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Early Warning

McCarthy, Crosbie, Poon & Nolan, Monash Uni, Australia, 2021
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McCarthy, Crosbie, Poon & Nolan, Monash Uni, Australia, 2021
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Zenah Bradford-Hartke, NSW Health, Australia 2021
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Mami Taniuchi, University of Virginia, Bangladesh 2021
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Roper and Weidhaas, Utah State University and University of Utalh, Utah, USA 2021
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Roper and Weidhaas, Utah State University and University of Utalh, Utah, USA 2021
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Lessons Learned

Global Update

Innovation through Collaboration
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Lessons Learned 

• Early warning (KWR & CDC ~ 6 days, 

WRC ~ 2 weeks)

• Objective population surveillance, 

independent of human test behavior

• Feasible for emergence of variants 

(signature mutations of) 

• Fast (ddPCR within days, compared to 3-

4 weeks for clinical surveillance)

• Efficient: on population sample, allowing 

high resolution surveillance

• Population size affects sewer signal 

dynamics

Medema, KWR, 

Netherlands, 2021

• Decentralized wastewater systems will 

not be captured

– ~25% of US residences are not connected 

to sewer

– Onsite treatment increasingly common at 

correctional facilities, universities

• Negative results do not indicate 

absence of cases

• Low incidence may be below the limit 

of detection

• Cannot be used to “clear” a 

community or facility

• May be impacted by pre-treatment of 

sewage for odor or worker safety

Amy Kirby, CDC, 2021
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Method Changes over time

• By April 2021 approx 50% of survey respondents were using WBE 

with recovery controls to track trends and ~60% of those were using 

Bovine CoV, with human OC43 next most common

• Most results are not adjusted for recovery efficacy

• Most groups use at least one of the CDC N gene primers

• Groups needing high throughput and short TAT are using ddPCR

• Many WBE programs are using commercially available kits

• Passive samplers are being used to detect low levels and/or to 

capture infrequent events to “monitor” for hotspots
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Knowledge gaps

Next steps

Priorities for further Research
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Research Needs

• Define ways to account for factors that impact interpretation at 

different scales and across different methodologies

• Improve TAT for real-time management of early warning use case

• Increased sensitivity to detect decreases in levels as case loads 

decline and to pick up hot spots for early warning

• Standardization of internal controls and reporting – should results be 

adjusted for matrix recovery and/or fecal strength – or not?

• Development of standard reporting – Effective Reproductive number 

(Re) value?
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Thank You