Wastewater epidemiology using SARS-CoV-2 as an example biomarker to assess COVID-19 infections at a population scale (Biomarker CoV2)

In the recent past, there is increasing interest in using wastewater-based epidemiology (WBE) as a diagnostic tool to assess the consumption of illicit drugs and pharmaceuticals across an entire sewershed. In the ongoing pandemic, even SARS-CoV-2 could be used as a biomarker as part of WBE to detect not only early changes in the infection pattern, to estimate the number of COVID-19 infected people with asymptomic effects, but also to assess the overall infection pattern in a community including the efficacy of counter measures. The main goals of this study are a) the development of quantitative methods for the identification of SARS-CoV-2 and other viruses in raw sewage, b) a comprehensive assessment of the infection pattern at a population level using WBE based on a novel SARS-CoV-2 biomarker model, c) the development and validation of strategies to identify local infection hot spots in a community, d) the exact assessment and prediction of COVID-19 infections in a community based on the presence of enveloped viruses in municipal wastewater, as well as e) the transfer of the developed strategy and biomarker model to other pathogenic viruses. The overarching hypothesis of this study is that the quantification of SARSCoV- 2 as a biomarker in raw sewage enables the exact assessment and prediction of COVID-19 infections at the population level in a given community. The developed WBE strategy will be expanded to other pathogenic viruses. In addition, based on the developed WBE strategy we will provide guidance regarding appropriate sampling strategies, analysis and the assessment of positive results for wastewater treatment plant operators, health officials, and local decision makers.