Wastewater Assessment for Coronavirus in Kentucky: Implementing Enhanced Surveillance Technology

Developing next generation technology to simplify wastewater RNA extraction and quantification will make wastewater surveillance feasible and scalable in facilities and rural communities. Wastewater testing for SARS-CoV-2 in rural communities using field-friendly technology will provide important information to local authorities and citizens about the spread and trend of SARS-CoV-2 infection in their communities. Our project will accomplish two aims: 1) Develop next generation wastewater assessment technology and 2) Implement and evaluate the next generation wastewater assay. For Aim 1 we adapt technology invented by our team termed exclusion-based sample preparation (ESP) to simplify and improve RNA extraction from wastewater. We will pair ESP with loop-mediated isothermal amplification (LAMP) technology for RNA detection to create a sensitive, robust, and field-friendly platform for testing wastewater for SARSCoV-2 RNA. We will compare the next generation assay with established techniques on metrics of sensitivity, specificity, and usability (e.g., assay time, number of assay steps). For Aim 2 we will first validate the next generation assay in the field at congregate living facilities in a side-by-side comparison with conventional wastewater surveillance. Next, building on existing relationships in Eastern Kentucky, we will recruit and train a purposive group of wastewater treatment plant operators, watershed watch citizen scientists, and school science teachers to test wastewater in their communities and schools using the field-friendly next generation wastewater assay. Field results will be validated in the lab. A robust mixed methods evaluation using the RE-AIM framework will assess community perceptions of feasibility, acceptability, and utility of wastewater surveillance for SARS-CoV-2 and identify community measures taken in response to test results.