Wastewater and seroprevalence for pandemic preparedness: variant analysis, vaccination effect, and hospitalization forecasting for SARS-CoV-2, in Jefferson County, Kentucky

Rochelle H Holm; Grzegorz A Rempala; Boseung Choi; J Michael Brick; Alok R Amraotkar; Rachel J Keith; Eric C Rouchka; Julia H Chariker; Kenneth E Palmer; Ted Smith; Aruni Bhatnagar

doi:10.1101/2023.01.06.23284260

Wastewater and seroprevalence for pandemic preparedness: variant analysis, vaccination effect, and hospitalization forecasting for SARS-CoV-2, in Jefferson County, Kentucky

medRxiv [Preprint]. 2023 Nov 28:2023.01.06.23284260. doi: 10.1101/2023.01.06.23284260.

Authors

Rochelle H Holm^{1

2}, Grzegorz A Rempala^{3

2}, Boseung Choi^{4

5

2}, J Michael Brick⁶, Alok R Amraotkar¹, Rachel J Keith¹, Eric C Rouchka^{7

8}, Julia H Chariker^{7

8}, Kenneth E Palmer^{9

10}, Ted Smith^{1

11}, Aruni Bhatnagar^{1

11}

Affiliations

¹ Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY 40202, USA.
² These authors contributed equally: Rochelle H Holm, Grzegorz A Rempala, Boseung Choi.
³ Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210, USA.
⁴ Division of Big Data Science, Korea University, Sejong, South Korea.
⁵ Biomedical Mathematics Group, Institute for Basic Science, Daejeon, South Korea.
⁶ Westat, Inc., Rockville, MD 20850, USA.
⁷ Department of Biochemistry and Molecular Genetics, University of Louisville, Louisville, KY 40292, USA.
⁸ KY INBRE Bioinformatics Core, University of Louisville, Louisville, KY 40202, USA.
⁹ Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville, Louisville, KY 40202, USA.
¹⁰ Department of Pharmacology and Toxicology, School of Medicine, University of Louisville, Louisville, KY 40202, USA.
¹¹ These authors jointly supervised this work: Ted Smith, Aruni Bhatnagar.

Abstract

Despite wide scale assessments, it remains unclear how large-scale SARS-CoV-2 vaccination affected the wastewater concentration of the virus or the overall disease burden as measured by hospitalization rates. We used weekly SARS-CoV-2 wastewater concentration with a stratified random sampling of seroprevalence, and linked vaccination and hospitalization data, from April 2021-August 2021 in Jefferson County, Kentucky (USA). Our susceptible $(S)$ , vaccinated $(V)$ , variant-specific infected $(I_{1})$ and $(I_{2})$ , recovered $(R)$ , and seropositive $(T)$ model $(S V I_{2} R T)$ tracked prevalence longitudinally. This was related to wastewater concentration. The 64% county vaccination rate translated into about 61% decrease in SARS-CoV-2 incidence. The estimated effect of SARS-CoV-2 Delta variant emergence was a 24-fold increase of infection counts, which corresponded to an over 9-fold increase in wastewater concentration. Hospitalization burden and wastewater concentration had the strongest correlation (r = 0.95) at 1 week lag. Our study underscores the importance of continued environmental surveillance post-vaccine and provides a proof-of-concept for environmental epidemiology monitoring of infectious disease for future pandemic preparedness.

Keywords: seroprevalence; vaccination; wastewater.

Publication types

Preprint

Grants and funding

P20 GM103436/GM/NIGMS NIH HHS/United States