From pandemic to endemic: Divergence of COVID-19 positive-tests and hospitalization numbers from SARS-CoV-2 RNA levels in wastewater of Rochester, Minnesota
Ramanath Majumdar,
Biruhalem Taye,
Corey Bjornberg,
Matthew Giljork,
Danielle Lynch,
Fadumasahra Farah,
Intisar Abdullah,
Kristin Osiecki,
Iris Yousaf,
Aaron Luckstein,
Wendy Turri,
Priya Sampathkumar,
Ann M. Moyer,
Benjamin R. Kipp,
Roberto Cattaneo,
Caroline R. Sussman,
Chanakha K. Navaratnarajah
Affiliations
Ramanath Majumdar
Advanced Diagnostics Laboratory, Mayo Clinic, Rochester, MN, USA
Biruhalem Taye
Department of Molecular Medicine, Mayo Clinic, Rochester, MN, USA
Corey Bjornberg
Water Reclamation Plant, Rochester, MN, USA
Matthew Giljork
Olmsted County Public Health Services, Rochester, MN, USA
Danielle Lynch
University of Minnesota, Rochester, MN, USA
Fadumasahra Farah
University of Minnesota, Rochester, MN, USA
Intisar Abdullah
University of Minnesota, Rochester, MN, USA
Kristin Osiecki
University of Minnesota, Rochester, MN, USA
Iris Yousaf
Department of Molecular Medicine, Mayo Clinic, Rochester, MN, USA
Aaron Luckstein
Water Reclamation Plant, Rochester, MN, USA
Wendy Turri
Water Reclamation Plant, Rochester, MN, USA
Priya Sampathkumar
Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
Ann M. Moyer
Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
Benjamin R. Kipp
Advanced Diagnostics Laboratory, Mayo Clinic, Rochester, MN, USA; Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
Roberto Cattaneo
Department of Molecular Medicine, Mayo Clinic, Rochester, MN, USA
Caroline R. Sussman
Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
Chanakha K. Navaratnarajah
Department of Molecular Medicine, Mayo Clinic, Rochester, MN, USA; Corresponding author. 200 First Street SW, 55905, Rochester, MN, USA.
Traditionally, public health surveillance relied on individual-level data but recently wastewater-based epidemiology (WBE) for the detection of infectious diseases including COVID-19 became a valuable tool in the public health arsenal. Here, we use WBE to follow the course of the COVID-19 pandemic in Rochester, Minnesota (population 121,395 at the 2020 census), from February 2021 to December 2022. We monitored the impact of SARS-CoV-2 infections on public health by comparing three sets of data: quantitative measurements of viral RNA in wastewater as an unbiased reporter of virus level in the community, positive results of viral RNA or antigen tests from nasal swabs reflecting community reporting, and hospitalization data. From February 2021 to August 2022 viral RNA levels in wastewater were closely correlated with the oscillating course of COVID-19 case and hospitalization numbers. However, from September 2022 cases remained low and hospitalization numbers dropped, whereas viral RNA levels in wastewater continued to oscillate. The low reported cases may reflect virulence reduction combined with abated inclination to report, and the divergence of virus levels in wastewater from reported cases may reflect COVID-19 shifting from pandemic to endemic. WBE, which also detects asymptomatic infections, can provide an early warning of impending cases, and offers crucial insights during pandemic waves and in the transition to the endemic phase.
