The amount of SARS-CoV-2 RNA in wastewater relates to the development of the pandemic and its burden on the health system. Hao et al

Virus surveillance in wastewater can be a useful indicator of the development of the COVID-19 pandemic in communities. However, knowledge about how the amount of SARS-CoV-2 RNA in wastewater relates to different data on the burden on the health system is still limited. Herein, we monitored the amount of SARS-CoV-2 RNA and the spectrum of virus variants in weekly pooled wastewater samples for two years from mid-February 2020 and compared with several clinical data. The two-year monitoring showed the weekly changes in the amount of viral RNA in wastewater preceded the hospital care needs for COVID-19 and the number of acute calls on adult acute respiratory distress by 1-2 weeks during the first three waves of COVID-19. Our study demonstrates that virus surveillance in wastewater can predict the development of a pandemic and its burden on the health system, regardless of society's test capacity and possibility of tracking infected cases.污水病毒监测可作为社区新型冠状病毒肺炎（COVID-19）大流行发展态势的有效指示指标。然而，目前学界对于污水中新型冠状病毒（SARS-CoV-2）RNA载量与医疗卫生系统负担相关各类数据间的关联认知仍较为有限。本研究自2020年2月中旬起，对每周混合采集的污水样本开展了为期两年的监测，检测其中新型冠状病毒（SARS-CoV-2）RNA载量及病毒变异株谱系，并与多项临床数据进行对比分析。为期两年的监测结果显示，在新冠疫情前三次流行浪潮期间，污水中病毒RNA载量的周度变化，较新冠住院救治需求及成人急性呼吸窘迫综合征急诊接诊量分别提前1至2周显现。本研究证实，无论社会检测能力与感染者追踪可行性如何，污水病毒监测均可预测疫情发展态势及其对医疗卫生系统造成的负担。