The Lancet Regional Health. Americas (Mar 2023)
Safer at school early alert: an observational study of wastewater and surface monitoring to detect COVID-19 in elementary schoolsResearch in context
- Rebecca Fielding-Miller,
- Smruthi Karthikeyan,
- Tommi Gaines,
- Richard S. Garfein,
- Rodolfo A. Salido,
- Victor J. Cantu,
- Laura Kohn,
- Natasha K. Martin,
- Adriane Wynn,
- Carrissa Wijaya,
- Marlene Flores,
- Vinton Omaleki,
- Araz Majnoonian,
- Patricia Gonzalez-Zuniga,
- Megan Nguyen,
- Anh V. Vo,
- Tina Le,
- Dawn Duong,
- Ashkan Hassani,
- Samantha Tweeten,
- Kristen Jepsen,
- Benjamin Henson,
- Abbas Hakim,
- Amanda Birmingham,
- Peter De Hoff,
- Adam M. Mark,
- Chanond A. Nasamran,
- Sara Brin Rosenthal,
- Niema Moshiri,
- Kathleen M. Fisch,
- Greg Humphrey,
- Sawyer Farmer,
- Helena M. Tubb,
- Tommy Valles,
- Justin Morris,
- Jaeyoung Kang,
- Behnam Khaleghi,
- Colin Young,
- Ameen D. Akel,
- Sean Eilert,
- Justin Eno,
- Ken Curewitz,
- Louise C. Laurent,
- Tajana Rosing,
- Rob Knight,
- Nathan A. Baer,
- Tom Barber,
- Anelizze Castro-Martinez,
- Marisol Chacón,
- Willi Cheung,
- Evelyn S. Crescini,
- Emily R. Eisner,
- Lizbeth Franco Vargas,
- Abbas Hakim,
- Charlotte Hobbs,
- Alma L. Lastrella,
- Elijah S. Lawrence,
- Nathaniel L. Matteson,
- Karthik Gangavarapu,
- Toan T. Ngo,
- Phoebe Seaver,
- Elizabeth W. Smoot,
- Rebecca Tsai,
- Bing Xia,
- Stefan Aigner,
- Catelyn Anderson,
- Pedro Belda-Ferre,
- Shashank Sathe,
- Mark Zeller,
- Kristian G. Andersen,
- Gene W. Yeo,
- Ezra Kurzban
Affiliations
- Rebecca Fielding-Miller
- Division of Infectious Disease and Global Public Health, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA; Corresponding author.
- Smruthi Karthikeyan
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Tommi Gaines
- Division of Infectious Disease and Global Public Health, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Richard S. Garfein
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Rodolfo A. Salido
- Department of Bioengineering, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Victor J. Cantu
- Department of Bioengineering, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Laura Kohn
- Kohn Education Consulting, San Diego, CA, USA
- Natasha K. Martin
- Division of Infectious Disease and Global Public Health, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Adriane Wynn
- Division of Infectious Disease and Global Public Health, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Carrissa Wijaya
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Marlene Flores
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Vinton Omaleki
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Araz Majnoonian
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA; University of California San Diego and San Diego State University Joint Doctoral Program in Public Health, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Patricia Gonzalez-Zuniga
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Megan Nguyen
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA; Johns Hopkins University Bloomberg School of Public Health, International Health Social and Behavioral Interventions, 615 N Wolfe St, Baltimore, MD 21205, USA
- Anh V. Vo
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA; Johns Hopkins University Bloomberg School of Public Health, International Health Social and Behavioral Interventions, 615 N Wolfe St, Baltimore, MD 21205, USA
- Tina Le
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Dawn Duong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Ashkan Hassani
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Samantha Tweeten
- County of San Diego, Health and Human Services Agency, 1600 Pacific Highway, San Diego, CA, 92101, USA
- Kristen Jepsen
- Institute for Genomic Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Benjamin Henson
- Institute for Genomic Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Abbas Hakim
- Department of Obstetrics Gynecology and Reproductive Sciences, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Amanda Birmingham
- Center for Computational Biology & Bioinformatics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Peter De Hoff
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Adam M. Mark
- Center for Computational Biology & Bioinformatics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Chanond A. Nasamran
- Center for Computational Biology & Bioinformatics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Sara Brin Rosenthal
- Center for Computational Biology & Bioinformatics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Niema Moshiri
- Department of Computer Science & Engineering, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Kathleen M. Fisch
- Department of Obstetrics Gynecology and Reproductive Sciences, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA; Center for Computational Biology & Bioinformatics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Greg Humphrey
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Sawyer Farmer
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Helena M. Tubb
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Tommy Valles
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Justin Morris
- Department of Computer Science & Engineering, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA; Department of Electrical and Computer Engineering, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA
- Jaeyoung Kang
- Department of Electrical and Computer Engineering, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Behnam Khaleghi
- Department of Computer Science & Engineering, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Colin Young
- Department of Computer Science & Engineering, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Ameen D. Akel
- Micron Technology, Inc., 7220 Trade Street, San Diego, CA 92121, USA
- Sean Eilert
- Micron Technology, Inc., 7220 Trade Street, San Diego, CA 92121, USA
- Justin Eno
- Micron Technology, Inc., 7220 Trade Street, San Diego, CA 92121, USA
- Ken Curewitz
- Micron Technology, Inc., 7220 Trade Street, San Diego, CA 92121, USA
- Louise C. Laurent
- University of California San Diego and San Diego State University Joint Doctoral Program in Public Health, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Tajana Rosing
- Department of Computer Science & Engineering, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Rob Knight
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA; Department of Bioengineering, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Nathan A. Baer
- Tom Barber
- Anelizze Castro-Martinez
- Marisol Chacón
- Willi Cheung
- Evelyn S. Crescini
- Emily R. Eisner
- Lizbeth Franco Vargas
- Abbas Hakim
- Charlotte Hobbs
- Alma L. Lastrella
- Elijah S. Lawrence
- Nathaniel L. Matteson
- Karthik Gangavarapu
- Toan T. Ngo
- Phoebe Seaver
- Elizabeth W. Smoot
- Rebecca Tsai
- Bing Xia
- Stefan Aigner
- Catelyn Anderson
- Pedro Belda-Ferre
- Shashank Sathe
- Mark Zeller
- Kristian G. Andersen
- Gene W. Yeo
- Ezra Kurzban
- Journal volume & issue
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Vol. 19
p. 100449
Abstract
Summary: Background: Schools are high-risk settings for SARS-CoV-2 transmission, but necessary for children's educational and social-emotional wellbeing. Previous research suggests that wastewater monitoring can detect SARS-CoV-2 infections in controlled residential settings with high levels of accuracy. However, its effective accuracy, cost, and feasibility in non-residential community settings is unknown. Methods: The objective of this study was to determine the effectiveness and accuracy of community-based passive wastewater and surface (environmental) surveillance to detect SARS-CoV-2 infection in neighborhood schools compared to weekly diagnostic (PCR) testing. We implemented an environmental surveillance system in nine elementary schools with 1700 regularly present staff and students in southern California. The system was validated from November 2020 to March 2021. Findings: In 447 data collection days across the nine sites 89 individuals tested positive for COVID-19, and SARS-CoV-2 was detected in 374 surface samples and 133 wastewater samples. Ninety-three percent of identified cases were associated with an environmental sample (95% CI: 88%–98%); 67% were associated with a positive wastewater sample (95% CI: 57%–77%), and 40% were associated with a positive surface sample (95% CI: 29%–52%). The techniques we utilized allowed for near-complete genomic sequencing of wastewater and surface samples. Interpretation: Passive environmental surveillance can detect the presence of COVID-19 cases in non-residential community school settings with a high degree of accuracy. Funding: County of San Diego, Health and Human Services Agency, National Institutes of Health, National Science Foundation, Centers for Disease Control.
