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

Fielding-Miller, Rebecca and Karthikeyan, Smruthi and Gaines, Tommi and Garfein, Richard S. and Salido, Rodolfo and Cantu, Victor and Kohn, Laura and Martin, Natasha K. and Wijaya, Carrissa and Flores, Marlene and Omaleki, Vinton and Majnoonian, Araz and Gonzalez-Zuniga, Patricia and Nguyen, Megan and Vo, Anh V. and Le, Tina and Duong, Dawn and Hassani, Ashkan and Dahl, Austin and Tweeten, Samantha and Jepsen, Kristen and Henson, Benjamin and Hakim, Abbas and Birmingham, Amanda and Mark, Adam M. and Nasamran, Chanond A. and Rosenthal, Sara Brin and Moshiri, Niema and Fisch, Kathleen M. and Humphrey, Greg and Farmer, Sawyer and Tubb, Helena M. and Valles, Tommy and Morris, Justin and Kang, Jaeyoung and Khaleghi, Behnam and Young, Colin and Akel, Ameen D. and Eilert, Sean and Eno, Justin and Curewitz, Ken and Laurent, Louise C. and Rosing, Tajana and Knight, Rob (2021) Wastewater and surface monitoring to detect COVID-19 in elementary school settings: The Safer at School Early Alert project. . (Unpublished)

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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.

Item Type:Report or Paper (Discussion Paper)
Related URLs:
URLURL TypeDescription Paper CentralDiscussion Paper ItemJournal Article
Fielding-Miller, Rebecca0000-0002-5099-0589
Karthikeyan, Smruthi0000-0001-6226-4536
Garfein, Richard S.0000-0003-3663-7153
Salido, Rodolfo0000-0003-0631-2817
Martin, Natasha K.0000-0001-8344-1810
Omaleki, Vinton0000-0003-4639-2241
Hassani, Ashkan0000-0001-7863-559X
Birmingham, Amanda0000-0002-4117-3317
Rosenthal, Sara Brin0000-0002-6548-9658
Moshiri, Niema0000-0003-2209-8128
Fisch, Kathleen M.0000-0002-0117-7444
Kang, Jaeyoung0000-0003-1048-1285
Khaleghi, Behnam0000-0002-3655-0501
Young, Colin0000-0002-1907-8276
Rosing, Tajana0000-0002-6954-997X
Knight, Rob0000-0002-0975-9019
Alternate Title:Safer at school early alert: an observational study of wastewater and surface monitoring to detect COVID-19 in elementary schools
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.
Funding AgencyGrant Number
Centers for Disease Control and Prevention75D30120C09795
Defense Advanced Research Projects Agency (DARPA)UNSPECIFIED
PubMed Central ID:PMC8547528
Record Number:CaltechAUTHORS:20221215-540378000.16
Persistent URL:
Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:118352
Deposited By: George Porter
Deposited On:16 Dec 2022 22:49
Last Modified:13 Mar 2023 21:01

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