Environmental Microbiome Engineering and Biotechnology Lab, Center for Environmental Engineering Research, Department of Civil Engineering, The University of Hong Kong, Hong Kong 999077, China
Kathy Leung
WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China; Laboratory of Data Discovery for Health Litd. (D24H), Hong Kong 999077, China; The University of Hong Kong–Shenzhen Hospital, Hong Kong 999077, China
Xiaoqing Xu
Environmental Microbiome Engineering and Biotechnology Lab, Center for Environmental Engineering Research, Department of Civil Engineering, The University of Hong Kong, Hong Kong 999077, China
Yu Deng
Environmental Microbiome Engineering and Biotechnology Lab, Center for Environmental Engineering Research, Department of Civil Engineering, The University of Hong Kong, Hong Kong 999077, China
Yulin Zhang
Environmental Microbiome Engineering and Biotechnology Lab, Center for Environmental Engineering Research, Department of Civil Engineering, The University of Hong Kong, Hong Kong 999077, China
Xi Chen
Environmental Microbiome Engineering and Biotechnology Lab, Center for Environmental Engineering Research, Department of Civil Engineering, The University of Hong Kong, Hong Kong 999077, China
Chung In Yau
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China
Kenny W.K. Hui
Drainage Services Department, The Government of the Hong Kong Special Administrative Region, Hong Kong 999077, China
Eddie Pak
Drainage Services Department, The Government of the Hong Kong Special Administrative Region, Hong Kong 999077, China
Ho-Kwong Chui
Environmental Protection Department, The Government of the Hong Kong Special Administrative Region, Hong Kong 999077, China
Ron Yang
Environmental Protection Department, The Government of the Hong Kong Special Administrative Region, Hong Kong 999077, China
Hein Min Tun
The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China
Gabriel Matthew Leung
WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China; Laboratory of Data Discovery for Health Litd. (D24H), Hong Kong 999077, China
Joseph Tsz Kei Wu
WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China; Laboratory of Data Discovery for Health Litd. (D24H), Hong Kong 999077, China; The University of Hong Kong–Shenzhen Hospital, Hong Kong 999077, China
Malik Peiris
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China; HKU-Pasteur Research Pole, The University of Hong Kong, Hong Kong 999077, China
Leo Lit Man Poon
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China; HKU-Pasteur Research Pole, The University of Hong Kong, Hong Kong 999077, China
Tong Zhang
Environmental Microbiome Engineering and Biotechnology Lab, Center for Environmental Engineering Research, Department of Civil Engineering, The University of Hong Kong, Hong Kong 999077, China; School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China; Corresponding author.
Wastewater surveillance (WWS) can leverage its wide coverage, population-based sampling, and high monitoring frequency to capture citywide pandemic trends independent of clinical surveillance. Here we conducted a nine months daily WWS for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from 12 wastewater treatment plants (WWTPs), covering approximately 80% of the population, to monitor infection dynamics in Hong Kong, China. We found that the SARS-CoV-2 virus concentration in wastewater was correlated with the daily number of reported cases and reached two pandemic peaks three days earlier during the study period. In addition, two different methods were established to estimate the prevalence/incidence rates from wastewater measurements. The estimated results from wastewater were consistent with findings from two independent citywide clinical surveillance programmes (rapid antigen test (RAT) surveillance and serology surveillance), but higher than the cases number reported by the Centre for Health Protection (CHP) of Hong Kong, China. Moreover, the effective reproductive number (Rt) was estimated from wastewater measurements to reflect both citywide and regional transmission dynamics. Our findings demonstrate that large-scale intensive WWS from WWTPs provides cost-effective and timely public health information, especially when the clinical surveillance is inadequate and costly. This approach also provides insights into pandemic dynamics at higher spatiotemporal resolutions, facilitating the formulation of effective control policies and targeted resource allocation.
