Wastewater and surface monitoring to detect COVID-19 in elementary school settings: The Safer at School Early Alert project

Creators: Fielding-Miller, Rebecca; Karthikeyan, Smruthi; Gaines, Tommi; Garfein, Richard S.; Salido, Rodolfo; Cantu, Victor; Kohn, Laura; Martin, Natasha K.; Wijaya, Carrissa; Flores, Marlene; Omaleki, Vinton; Majnoonian, Araz; Gonzalez-Zuniga, Patricia; Nguyen, Megan; Vo, Anh V.; Le, Tina; Duong, Dawn; Hassani, Ashkan; Dahl, Austin; Tweeten, Samantha; Jepsen, Kristen; Henson, Benjamin; Hakim, Abbas; Birmingham, Amanda; Mark, Adam M.; Nasamran, Chanond A.; Rosenthal, Sara Brin; Moshiri, Niema; Fisch, Kathleen M.; Humphrey, Greg; Farmer, Sawyer; Tubb, Helena M.; Valles, Tommy; Morris, Justin; Kang, Jaeyoung; Khaleghi, Behnam; Young, Colin; Akel, Ameen D.; Eilert, Sean; Eno, Justin; Curewitz, Ken; Laurent, Louise C.; Rosing, Tajana; Knight, Rob; SEARCH

Abstract

Schools are high-risk settings for SARS-CoV-2 transmission, but necessary for children's educational and social-emotional wellbeing. While wastewater monitoring has been implemented to mitigate outbreak risk in universities and residential settings, its effectiveness in community K-12 sites is unknown. We implemented a wastewater and surface monitoring system to detect SARS-CoV-2 in nine elementary schools in San Diego County. Ninety-three percent of identified cases were associated with either a positive wastewater or surface sample; 67% were associated with a positive wastewater sample, and 40% were associated with a positive surface sample. The techniques we utilized allowed for near-complete genomic sequencing of wastewater and surface samples. Passive environmental surveillance can complement approaches that require individual consent, particularly in communities with limited access and/or high rates of testing hesitancy.One sentence summaryPassive wastewater and surface environmental surveillance can identify up to 93% of on-campus COVID-19 cases in public elementary schools; positive samples can be sequenced to monitor for variants of concerns with neighborhood level resolution.

Additional Information

The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license. Paper in collection COVID-19 SARS-CoV-2 preprints from medRxiv and bioRxiv. We are deeply grateful to the leadership, staff, students, and families at our partner school districts and school sites across San Diego County. This project would not have been possible without their enthusiasm and generosity. We thank our colleagues at the County of San Diego, Health and Human Services Agency for their vision and support, particularly John Malone, Sarah Stous, and Rorick Luepton. At UCSD, Isabella Cuturrofo, Jeanessa Mendoza, Kristine Ngo, Jessica Ni, and Elizabeth Frost all provided vital support with project implementation. RFM thanks Ms. Esther Krohne for inspiring the project. The opinions and assertions expressed herein are those of the authors and do not necessarily reflect the official policy or position of the County of San Diego Health and Human Services Agency. County of San Diego, Health and Human Services Agency (RFM) National Institutes of Health Grant K01MH112436 (RFM) National Institute of Health Grant UL1TR001442 National Institute of Health Grant S10OD026929 (Jepsen) NSF Grants Numbers 1730518, 1826967, 1659104, 2100237, 2112167, 2052809, 2028040 (Rosing) Centers for Disease Control BAA Contract 75D30120C09795 (Andersen) This work was supported in part by CRISP, one of six centers in JUMP, an SRC program sponsored by DARPA (Rosing). Authors declare they have no competing interests. Data and materials availability: School-level data are available from the first author on reasonable request. All wastewater and nasal-swab sequencing data have been deposited to GISAID and their accession details provided in Supplemental File Data S1.

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Wastewater and surface monitoring to detect COVID-19 in elementary school settings: The Safer at School Early Alert project

Abstract

Additional Information

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