Volta

Challenges for COVID-19 surveillance through wastewater-based epidemiology in post-pandemic era: A retrospective study in 222 USA counties

<title>Abstract</title> The post-pandemic world still faces ongoing COVID-19 infections, where wastewater-based epidemiology (WBE) is recognized as an efficient tool for the population-wide surveillance of COVID-19 infections. Utilizing weekly county-level wastewater-surveillance data during pandemic across 222 counties from 49 states in United States of America (USA) from June 2021-November 2022 and covering 104 M populations, we retrospectively evaluated the correlation between SARS-CoV-2 RNA concentrations in wastewater (<italic>C</italic>_RNA) and reported cases as well as the impacts of demographics, socioeconomical, test accessibility, epidemiological, environmental factors and international air travelling on reported cases under the corresponding <italic>C</italic>_RNA. The lift of travel restrictions in June 2022, a milestone for the post-pandemic era, shifted the correlation<italic> </italic>between <italic>C</italic>_RNA and COVID-19 incidence in following 7-day and 14-day …

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