Wastewater Surveillance for SARS-CoV-2 in an Atlanta, Georgia Jail: A study of the feasibility of wastewater monitoring and correlation of building wastewater and individual testing results.

BackgroundWastewater-based surveillance (WBS) on an institutional level was implemented during the COVID-19 pandemic, including carceral facilities. In this study of a mega-jail, we examined the relationship between COVID-19 diagnostic test results from jail residents and the PCR signal for SARS-CoV-2 detection in weekly samples of jail wastewater over a 28-week period. MethodsThis study in a Georgia Jail (average population [~]2,700) was conducted October 2021-May 2022. Weekly on-site wastewater samples were collected (Moore Swabs) and tested for SARS-CoV-2 RNA using RTqPCR. The source of wastewater was identified using a tracer dye. The jail offered residents rapid antigen testing at entry. We conducted periodic mass screenings via RT-PCR of nasal swabs. We aggregated individual test data, calculated the Spearman correlation coefficient, and performed logistic regression to examine the relationship between the strength of the SARS-CoV-2 PCR signal (Ct value) in wastewater and the proportion of the jail population that tested positive for COVID-19. ResultsOverall, 3770 individual nasal specimens were collected; 3.4% were COVID-positive. Weekly diagnostic test positivity ranged from 0%-29.5%. Dye tests demonstrated that a single wastewater collection point was sufficiently representative of the jails aggregate viral load. Twenty-five wastewater samples were collected. RT-qPCR Ct values for wastewater samples with SARS-CoV-2 RNA ranged from 28.1-39.9. A strong inverse correlation was observed between diagnostic test positivity and Ct value (r= -0.67, p < 0.01). ConclusionWBS was shown to be an effective strategy for surveilling COVID-19 in a large jail. Strong partnerships with the jail administration are essential to the success of WBS surveillance. Key PointsO_LIMonitoring the wastewater of a large jail can be effective for infectious disease surveillance. C_LIO_LITo diagnose COVID-19, jail residents used self-collected nasal specimens. C_LIO_LIThere was a strong correlation between the prevalence of COVID-19 cases and the SARS-CoV-2 PCR signal in wastewater samples from the jail. C_LI