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Volume 29, Number 8—August 2023
Research

Predicting COVID-19 Incidence Using Wastewater Surveillance Data, Denmark, October 2021–June 2022

Oliver McManus, Lasse Engbo Christiansen, Maarten Nauta, Lene Wulff Krogsgaard, Naja Stolberg Bahrenscheer, Lene von Kappelgaard, Tobias Christiansen, Mikkel Hansen, Nicco Claudio Hansen, Jonas Kähler, Anders Rasmussen, Stine Raith Richter, Lasse Dam Rasmussen, Kristina Træholt Franck, and Steen EthelbergComments to Author 
Author affiliations: European Centre for Disease Prevention and Control, Solna, Sweden (O. McManus); Statens Serum Institut, Copenhagen, Denmark (O. McManus, L.E. Christiansen, M. Nauta, L.W. Krogsgaard, N.S. Bahrenscheer, L. von Kappelgaard, T. Christiansen, M. Hansen, N.C. Hansen, J. Kähler, A. Rasmussen, S.R. Richter, L.D. Rasmussen, K.T. Franck, S. Ethelberg); University of Copenhagen, Copenhagen, Denmark (S. Ethelberg)

Main Article

Table

Estimated coefficients from the national model, care personnel model, and regional model in study using wastewater surveillance data to predict COVID-19 incidence, Denmark, October 2021–June 2022*

Model Term Estimate (95% CI)
 p value
National AR (1) 0.46 (0.16–0.76) 0.004
Wastewater concentration 0.4 (0.34–0.46) <0.001
Testing rate 0.87 (0.81–0.94) <0.001
Wastewater concentration × Delta (%) −0.15 (−0.19 to −0.11) <0.001
Intercept
 −0.14 (−0.32 to 0.04)
 0.12
Care personnel AR (1) 0.32 (−0.06 to 0.70) 0.1
Wastewater concentration 0.52 (0.46–0.59) <0.001
Testing rate (care personnel) 0.84 (0.73–0.94) <0.001
Wastewater concentration × Delta (%) −0.17 (−0.21 to −0.13) <0.001
Intercept
 −2.45 (−2.83 to −2.07)
 <0.001
Regional
Capital Region AR (1) 0.31 (−0.07 to 0.70) 0.12
Wastewater concentration 0.31 (0.24–0.38) <0.001
Testing rate 1.03 (0.94–1.11) <0.001
Wastewater concentration × Delta (%) −0.15 (−0.19 to −0.12) <0.001
Intercept −0.11 (−0.34 to 0.12) 0.3
Central Denmark AR (1) −0.19 (−0.56 to 0.18) 0.3
Wastewater concentration 0.48 (0.45–0.52) <0.001
Testing rate 0.88 (0.84–0.92) <0.001
Wastewater concentration × Delta (%) −0.14 (−0.16 to −0.12) <0.001
Intercept −0.48 (−0.60 to −0.36) <0.001
North Denmark AR (1) −0.09 (−0.46 to 0.28) 0.6
Wastewater concentration 0.47 (0.43–0.51) <0.001
Testing rate 0.91 (0.86–0.96) <0.001
Wastewater concentration × Delta (%) −0.16 (−0.19 to −0.13) <0.001
Intercept −0.49 (−0.64 to −0.33) <0.001
Southern Denmark AR (1) 0.16 (−0.19 to 0.51) 0.4
Wastewater concentration 0.48 (0.44–0.52) <0.001
Testing rate 0.83 (0.78–0.88) <0.001
Wastewater concentration × Delta (%) −0.15 (−0.17 to −0.12) <0.001
Intercept −0.39 (−0.52 to −0.26) <0.001
Zealand AR (1) 0.07 (−0.34 to 0.47) 0.7
Wastewater concentration 0.42 (0.37–0.48) <0.001
Testing rate 0.8 (0.73–0.86) <0.001
Wastewater concentration × Delta (%) −0.14 (−0.17 to −0.11) <0.001
Intercept −0.11 (−0.26 to 0.04)
 0.2

*The response variable incidence, wastewater concentration, and testing rate are included after log10-transformation. AR (1) denotes the first-order autoregressive term.

Main Article

References
  1. Li  X, Zhang  S, Sherchan  S, Orive  G, Lertxundi  U, Haramoto  E, et al. Correlation between SARS-CoV-2 RNA concentration in wastewater and COVID-19 cases in community: A systematic review and meta-analysis. J Hazard Mater. 2023;441:129848. DOIPubMedGoogle Scholar
  2. Morvan  M, Jacomo  AL, Souque  C, Wade  MJ, Hoffmann  T, Pouwels  K, et al. An analysis of 45 large-scale wastewater sites in England to estimate SARS-CoV-2 community prevalence. Nat Commun. 2022;13:4313. DOIPubMedGoogle Scholar
  3. RIVM. Coronavirus monitoring in sewage research. 2022 [cited 2022 Sep 5]. https://www.rivm.nl/en/covid-19/sewage
  4. Cluzel  N, Courbariaux  M, Wang  S, Moulin  L, Wurtzer  S, Bertrand  I, et al.; Obépine consortium. A nationwide indicator to smooth and normalize heterogeneous SARS-CoV-2 RNA data in wastewater. Environ Int. 2022;158:106998. DOIPubMedGoogle Scholar
  5. Tiwari  A, Lipponen  A, Hokajärvi  AM, Luomala  O, Sarekoski  A, Rytkönen  A, et al. Detection and quantification of SARS-CoV-2 RNA in wastewater influent in relation to reported COVID-19 incidence in Finland. Water Res. 2022;215:118220. DOIPubMedGoogle Scholar
  6. Michlmayr  D, Hansen  CH, Gubbels  SM, Valentiner-Branth  P, Bager  P, Obel  N, et al. Observed protection against SARS-CoV-2 reinfection following a primary infection: A Danish cohort study among unvaccinated using two years of nationwide PCR-test data. Lancet Reg Health Eur. 2022;20:100452. DOIPubMedGoogle Scholar
  7. Gram  MA, Emborg  HD, Schelde  AB, Friis  NU, Nielsen  KF, Moustsen-Helms  IR, et al. Vaccine effectiveness against SARS-CoV-2 infection or COVID-19 hospitalization with the Alpha, Delta, or Omicron SARS-CoV-2 variant: a nationwide Danish cohort study. Beeson JG, editor. PLOS Med. 2022;19:e1003992.
  8. Hasell  J, Mathieu  E, Beltekian  D, Macdonald  B, Giattino  C, Ortiz-Ospina  E, et al. A cross-country database of COVID-19 testing. Sci Data. 2020;7:345. DOIPubMedGoogle Scholar
  9. Statens Serum Institut. When COVID-19 struck the world and Denmark—see the timeline here [in Danish]. 2022 [cited 2023 Jun 23]. https://www.ssi.dk/aktuelt/nyheder/2022/da-covid-19-ramte-verden-og-danmark-se-tidslinjen-her
  10. Danish Health Authority. Guidance about prevention of infection with new coronavirus in care homes, residential facilities, etc. and in home care [in Danish]. 2022 [cited 2022 Jul 14]. https://www.sst.dk/da/Udgivelser/2022/Vejledning-om-forebyggelse-af-smitte-med-ny-coronavirus-paa-plejehjem-mv-og-i-hjemmeplejen
  11. Bertels  X, Demeyer  P, Van den Bogaert  S, Boogaerts  T, van Nuijs  ALN, Delputte  P, et al. Factors influencing SARS-CoV-2 RNA concentrations in wastewater up to the sampling stage: A systematic review. Sci Total Environ. 2022;820:153290. DOIPubMedGoogle Scholar
  12. Li  X, Zhang  S, Shi  J, Luby  SP, Jiang  G. Uncertainties in estimating SARS-CoV-2 prevalence by wastewater-based epidemiology. Chem Eng J. 2021;415:129039. DOIPubMedGoogle Scholar
  13. Bivins  A, Greaves  J, Fischer  R, Yinda  KC, Ahmed  W, Kitajima  M, et al. Persistence of SARS-CoV-2 in water and wastewater. Environ Sci Technol Lett. 2020;7:937–42. DOIGoogle Scholar
  14. Wilder  ML, Middleton  F, Larsen  DA, Du  Q, Fenty  A, Zeng  T, et al. Co-quantification of crAssphage increases confidence in wastewater-based epidemiology for SARS-CoV-2 in low prevalence areas. Water Res X. 2021;11:100100. DOIPubMedGoogle Scholar
  15. Kitajima  M, Sassi  HP, Torrey  JR. Pepper mild mottle virus as a water quality indicator. Npj Clean Water. 2018;1:19. DOIGoogle Scholar
  16. Schmidt  M, Pedersen  L, Sørensen  HT. The Danish Civil Registration System as a tool in epidemiology. Eur J Epidemiol. 2014;29:541–9. DOIPubMedGoogle Scholar
  17. Voldstedlund  M, Haarh  M, Mølbak  K; MiBa Board of Representatives. The Danish Microbiology Database (MiBa) 2010 to 2013. Euro Surveill. 2014;19:20667. DOIPubMedGoogle Scholar
  18. Statens Serum Institut. COVID-19 inventories [in Danish]. 2021 [cited 2022 Aug 1]. https://covid19.ssi.dk/overvagningsdata/download-fil-med-overvaagningdata
  19. States Serum Institut. Weekly trends: COVID-19 and other respiratory infections, week 28, 2022 [cited 2022 Sep 30]. https://www.ssi.dk/-/media/cdn/files/covid19/tendensrapport/rapport/ugentlige-tendenser-covid19-andre-luftvejs-uge28-2022_fdj1.pdf
  20. Danish Covid-19 Genome Consortium. Genomic overview of SARS-CoV-2 in Denmark. 2022 [cited 2022 Sep 9]. https://www.covid19genomics.dk/statistics
  21. Espenhain  L, Funk  T, Overvad  M, Edslev  SM, Fonager  J, Ingham  AC, et al. Epidemiological characterisation of the first 785 SARS-CoV-2 Omicron variant cases in Denmark, December 2021. Euro Surveill. 2021;26:2101146. DOIPubMedGoogle Scholar
  22. Mathieu  E, Ritchie  H, Ortiz-Ospina  E, Roser  M, Hasell  J, Appel  C, et al. A global database of COVID-19 vaccinations. Nat Hum Behav. 2021;5:947–53. DOIPubMedGoogle Scholar
  23. McMahan  CS, Self  S, Rennert  L, Kalbaugh  C, Kriebel  D, Graves  D, et al. COVID-19 wastewater epidemiology: a model to estimate infected populations. Lancet Planet Health. 2021;5:e874–81. DOIPubMedGoogle Scholar
  24. Nauta  M, McManus  O, Træholt Franck  K, Lindberg Marving  E, Dam Rasmussen  L, Raith Richter  S, et al. Early detection of local SARS-CoV-2 outbreaks by wastewater surveillance: a feasibility study. Epidemiol Infect. 2023;151:e28. DOIPubMedGoogle Scholar
  25. Fenton  L. The sum of log-normal probability distributions in scatter transmission systems. IEEE Trans Commun. 1960;8:57–67. DOIGoogle Scholar
  26. Medema  G, Been  F, Heijnen  L, Petterson  S. Implementation of environmental surveillance for SARS-CoV-2 virus to support public health decisions: Opportunities and challenges. Curr Opin Environ Sci Health. 2020;17:49–71. DOIPubMedGoogle Scholar
  27. Statens Serum Institut. Expert report October 23, 2020 - Incidence and projection of COVID-19 cases [in Danish]. 2020 [cited 2022 Sep 30]. https://covid19.ssi.dk/-/media/ssi-files/ekspertrapport-af-den-23-oktober-2020-incidens-og-fremskrivning-af-covid19-tilflde.pdf

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Page updated: July 19, 2023
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