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Volume 32, Supplement –Summer 2026

SUPPLEMENT ISSUE
Supplement

Temporal Alignment of Wastewater Signals with Clinical Indicators of Respiratory Illness Postpandemic, Texas, USA

Kaiming BiComments to Author , Micaela Sandoval, Thuy Nguyen, Isrrael Perez, Lopita Ghosh, Trudy Krause, Cecilia Ganduglia Cazaban, Remy Pasco, Lauren Meyers, Fuqing Wu, Janelle Rios, Michael Tisza, Justin Clark, Anthony Maresso, Eric Boerwinkle, and Cici Bauer
Author affiliation: University of Texas Health Science Center at Houston, Houston, Texas, USA (K. Bi, M. Sandoval, T. Nguyen, I. Perez, L. Ghosh, T. Krause, C. Ganduglia Cazaban, F. Wu, J. Rios, E. Boerwinkle, C. Bauer); Texas Epidemiologic Public Health Institute, Houston (K. Bi, M. Sandoval, T. Nguyen, F. Wu, J. Rios, E. Boerwinkle, C. Bauer); University of Colorado Boulder, Boulder, Colorado, USA (R. Pasco); The University of Texas at Austin, Austin (L. Meyers); Baylor College of Medicine, Houston, Texas, USA (M. Tisza, J. Clark, A. Maresso)

Main Article

Table 6

Pearson correlation coefficients between RPMF and 2 ED visit data sources for SARS-CoV-2 during the combined EG.5, HV.1, and JN.1 SARS-CoV-2 variant period across 10 counties, daily NSSP ED visit rates and weekly TX-APCD ED claims rates, Texas, USA, 2024

County RPMF versus NSSP ED visit
 RPMF versus TX-APCD ED claims
Original r Optimal lag, d rmax Original r Optimal lag, wk rmax
Cameron 0.86 −4 0.87 0.5 0 0.5
Chambers 0.43 −14 0.56 0.22 2 0.35
El Paso 0.67 0 0.67 0.36 1 0.5
Fort Bend 0.75 −3 0.76 0.61 1 0.62
Harris 0.65 −15 0.85 0.49 −2 0.51
Hays 0.71 −11 0.8 0.62 0 0.62
Lubbock 0.72 −8 0.74 0.35 0 0.35
Travis 0.75 −9 0.81 0.63 0 0.63
Wichita 0.26 7 0.27 0.32 1 0.41
Williamson 0.77 −11 0.84 0.54 −1 0.57

*Optimal lag is reported relative to the clinical indicator. A negative value indicates that the wastewater signal leads the clinical indicator; a positive value indicates that it lags. The table shows the correlation at 0 (original), the optimal shift required to maximize the association (lag), and the resulting rmax. ED, emergency department; NSSP, National Syndromic Surveillance Program; rmax, maximum correlation; RPMF, reads per million filtered; TX-APCD, Texas All-Payer Claims Database.

Main Article

Page created: July 17, 2026
Page updated: September 15, 2026
Page reviewed: September 15, 2026
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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