biostudies-literatureAmirali ANCATS NIH HHSNIDA NIH HHSNIAID NIH HHSAlfred P Sloan FoundationNational Institutes of Health170452https://www.ebi.ac.uk/biostudies/studies/S-EPMC10923133biostudies-literatureUnknown918Clinical testing has been a vital part of the response to and suppression of the COVID-19 pandemic; however, testing imposes significant burdens on a population. College students had to contend with clinical testing while simultaneously dealing with health risks and the academic pressures brought on by quarantines, changes to virtual platforms, and other disruptions to daily life. The objective of this study was to analyze whether wastewater surveillance can be used to decrease the intensity of clinical testing while maintaining reliable measurements of diseases incidence on campus. Twelve months of human health and wastewater surveillance data for eight residential buildings on a university campus were analyzed to establish how SARS-CoV-2 levels in the wastewater can be used to minimize clinical testing burden on students. Wastewater SARS-CoV-2 levels were used to create multiple scenarios, each with differing levels of testing intensity, which were compared to the actual testing volumes implemented by the university. We found that scenarios in which testing intensity fluctuations matched rise and falls in SARS-CoV-2 wastewater levels had stronger correlations between SARS-CoV-2 levels and recorded clinical positives. In addition to stronger correlations, most scenarios resulted in overall fewer weekly clinical tests performed. We suggest the use of wastewater surveillance to guide COVID-19 testing as it can significantly increase the efficacy of COVID-19 surveillance while reducing the burden placed on college students during a pandemic. Future efforts should be made to integrate wastewater surveillance into clinical testing strategies implemented on college campuses.The Science of the total environmentWastewater based surveillance can be used to reduce clinical testing intensity on a university campus.PMC10923133P30 AI073961U01 DA053941R01 AI125416R21 AI129851R01 AI151059UM1 TR004556Boone MMBabler KMCurrall BBLamar WEKumar NBeaver CCSharkey MEStevenson MLaine JRoca MAGrills GSWilliams SLSolle NSYin XMason CEShukla BSAmirali AGoodman KWReding BDSchurer SCComerford SSolo-Gabriele HMTallon JJVidovic DCooper DRyon KKobetz EfalseWastewater based surveillance can be used to reduce clinical testing intensity on a university campus.Clinical testing has been a vital part of the response to and suppression of the COVID-19 pandemic; however, testing imposes significant burdens on a population. College students had to contend with clinical testing while simultaneously dealing with health risks and the academic pressures brought on by quarantines, changes to virtual platforms, and other disruptions to daily life. The objective of this study was to analyze whether wastewater surveillance can be used to decrease the intensity of clinical testing while maintaining reliable measurements of diseases incidence on campus. Twelve months of human health and wastewater surveillance data for eight residential buildings on a university campus were analyzed to establish how SARS-CoV-2 levels in the wastewater can be used to minimize clinical testing burden on students. Wastewater SARS-CoV-2 levels were used to create multiple scenarios, each with differing levels of testing intensity, which were compared to the actual testing volumes implemented by the university. We found that scenarios in which testing intensity fluctuations matched rise and falls in SARS-CoV-2 wastewater levels had stronger correlations between SARS-CoV-2 levels and recorded clinical positives. In addition to stronger correlations, most scenarios resulted in overall fewer weekly clinical tests performed. We suggest the use of wastewater surveillance to guide COVID-19 testing as it can significantly increase the efficacy of COVID-19 surveillance while reducing the burden placed on college students during a pandemic. Future efforts should be made to integrate wastewater surveillance into clinical testing strategies implemented on college campuses.2024-01-01T00:00:00Z2024 Mar2025-07-05T03:04:39.964Z2025-07-05T03:04:39.964ZS-EPMC109231333829608510.1016/j.scitotenv.2024.170452