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It is difficult to correlate wastewater results with actual numbeo of people infected, but wastewater viral titers have been observed to precede trends from clinical surveillance.
November 2020, researchers at UC Davis and Stanford University have been collaborating on a project to monitor wastewater in the City of Davis for COVID-19. In November 2020, researchers at UC Davis and Stanford University collaborated on a project in Davis to monitor wastewater for SARS-CoV-2, the virus that causes COVID-19 disease. See Healthy Davis Together.
A Michigan study study sought to understand how accurately wastewater monitoring represented the actual burden of disease between communities. Two communities varying in size and demographics in Michigan were monitored for SARS-CoV-2 in wastewater between March of 2020 and February of 2022.
The virus loading (total amount of virus per day adjusted by population) in the wastewater from both communities followed the same trends as the case data consistent with the waves of COVID-19 cases in Michigan during the pandemic.
See Understanding the efficacy of wastewater surveillance for SARS-CoV-2 in two diverse communities | PubMed NIH
A test in March 2020 through May 2021 in Massachusetts by MIT and the Massachusetts Water Resources Authority showed there was a correlation between wastewater results and clinical data.
wastewater titers could be a predictive indicator of COVID-19 deaths.
wastewater viral titers reflect the number of new cases regardless of the demographics or severity of cases.
See:Metrics to relate COVID-19 wastewater data to clinical testing dynamics | MIT and Massachusetts Water Resources Authority