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Volume 30, Number 9—September 2024
Dispatch

Participatory, Virologic, and Wastewater Surveillance Data to Assess Underestimation of COVID-19 Incidence, Germany, 2020–2024

Anna Loenenbach1, Ann-Sophie Lehfeld1, Peter Puetz1, Barbara Biere1, Susan Abunijela, Silke Buda, Michaela Diercke, Ralf Dürrwald, Timo Greiner, Walter Haas, Maria Helmrich, Kerstin Prahm, Jakob Schumacher, Marianne Wedde, and Udo BuchholzComments to Author 
Author affiliation: Authors affiliation: Robert Koch Institute, Berlin, Germany

Main Article

Figure

Incidence and underestimation factors in a study of participatory, virologic, and wastewater surveillance data to assess underestimation of COVID-19 incidence, Germany, 2020–2024. A) Smoothed and unsmoothed surveillance data on COVID-19 incidence (cases/100,000 adult population) compared with wastewater viral load. SARS-CoV-2 variant phases in Germany are labeled. B) Two different UEFs plus common piecewise trendline of smoothed UEF and timeframes for phases calendar week 40 of 2020 through calendar week 4 of 2024. Vertical lines mark the breakpoints between COVID-19 phases with different degrees of underestimation. GNS-I, incidence from German notification system; GW-SR-I, GrippeWeb self-reported incidence; GW-VPR-I, GrippeWeb and virologic positivity rate incidence; SC2-VL-WW, aggregated SARS-CoV-2 viral load in wastewater; UEF, underestimation factor.

Figure. Incidence and underestimation factors in a study of participatory, virologic, and wastewater surveillance data to assess underestimation of COVID-19 incidence, Germany, 2020–2024. A) Smoothed and unsmoothed surveillance data on COVID-19 incidence (cases/100,000 adult population) compared with wastewater viral load. SARS-CoV-2 variant phases in Germany are labeled. B) Two different UEFs plus common piecewise trendline of smoothed UEF and timeframes for phases calendar week 40 of 2020 through calendar week 4 of 2024. Vertical lines mark the breakpoints between COVID-19 phases with different degrees of underestimation. GNS-I, incidence from German notification system; GW-SR-I, GrippeWeb self-reported incidence; GW-VPR-I, GrippeWeb and virologic positivity rate incidence; SC2-VL-WW, aggregated SARS-CoV-2 viral load in wastewater; UEF, underestimation factor.

Main Article

1These first authors contributed equally to this article.

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