Viral loads of sewage can provide an advance wa


image: Wastewater sample taken from a manhole in the village (Photo: Masaaki Kitajima).
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Scientists show that there is a strong association between clinical cases of COVID-19 and viral loads in wastewater, with viral loads increasing up to two days before cases are detected.

The Tokyo 2020 Olympic and Paralympic Games were held on July 21 and September 21, 2021, a time when the incidence and spread of COVID-19 was widespread. Thus, a rigorous and multi-pronged testing approach was adopted in order to limit the spread of the virus while allowing the Games to take place.

Following previous research, a team led by Associate Professor Masaaki Kitajima of Hokkaido University showed the association between SARS-CoV-2 viral loads in sewage and reported cases at the Olympic and Paralympic Village . Their findings were published in the journal Open JAMA Network.

Athletes and support staff in the Olympic and Paralympic Village were tested daily; in addition, wastewater in the sewage system was also sampled and tested (wastewater-based epidemiology, WBE) daily for viral loads. The results have been communicated to the Tokyo 2020 Organizing Committee.

In this study, the authors wanted to examine the association between clinically reported cases and viral loads in wastewater. They correlated the results of 360 samples taken from manholes in 7 separate areas of the village with confirmed cases of COVID-19 obtained from the organizing committee, and with testing data from close contacts of a previous report.

The researchers found that SARS-CoV-2 was present in 151 wastewater samples, including 53 from the Olympics and 98 from the Paralympics. The number of confirmed cases was also higher at the Paralympic Games. The strongest correlation between SARS-CoV-2 RNA load in wastewater and the presence of clinically positive areas was found in areas that had maximum viral loads in wastewater over a three-day period. (two days before the day of the clinically positive zone).

The study suggests that WBE and clinical testing are complementary, and that the testing strategy has played a role in preventing COVID-19 clusters in the Village. This study of one of the largest mass gatherings in the world provides new evidence on the implementation and use of WBE in communities where all members are tested daily, and could be used to trace and monitor the COVID-19 clusters in the future.

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