Wastewater based epidemiology was employed to track the spread of SARS-CoV-2 within the sewershed areas of 10 wastewater treatment plants (WWTPs) in Catalonia, Spain. A total of 185 WWTPs inflow samples were collected over the period consisting of both the first wave (mid-March to June) and the second wave (July to November). Concentrations of SARS-CoV-2 RNA (N1 and N2 assays) were quantified in these wastewaters as well as those of Human adenoviruses (HAdV) and JC polyomavirus (JCPyV), as indicators of human faecal contamination. SARS-CoV-2 N gene daily loads strongly correlated with the number of cases diagnosed one week after sampling i.e. wastewater levels were a good predictor of cases to be diagnosed in the immediate future. The conditions present at small WWTPs relative to larger WWTPs influence the ability to follow the pandemic. Small WWTPs (<24,000 inhabitants) had lower median loads of SARS-CoV-2 despite similar incidence of infection within the municipalities served by the different WWTP (but not lower loads of HAdV and JCPyV). The lowest incidence resulting in quantifiable SARS-CoV-2 concentration in wastewater differed between WWTP sizes, being 0.11 and 0.82 cases/1000 inhabitants for the large and small sized WWTP respectively.
Monitoring waves of the COVID-19 pandemic: Inferences from WWTPs of different sizes