Forecasting SARS-CoV-2 outbreak through wastewater analysis: a success in wastewater-based epidemiology

Abstract The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), triggered a global emergency that exposed the urgent need for surveillance approaches to monitor the dynamics of viral transmission. Several epidemiological tools that may help anticipate outbreaks have been developed. Wastewater-based epidemiology is a non-invasive and population-wide methodology for tracking the epidemiological evolution of the virus. However, thorough evaluation and understanding of the limitations, robustness, and intricacies of wastewater-based epidemiology are still pending to effectively use this strategy. The aim of this study was to train highly accurate predictive models using SARS-CoV-2 virus concentrations in wastewater in a region consisting of several municipalities. The chosen region was Catalonia (Spain) given the availability of wastewater SARS-CoV-2 quantification from the Catalan surveillance network and healthcare data (clinical cases) from the regional government. By using various feature engineering and machine learning methods, we developed a model that can accurately predict and successfully generalize across the municipalities that make up Catalonia. Explainable Machine Learning frameworks were also used, which allowed us to understand the factors that influence decision-making. Our findings support wastewater-based epidemiology as a potential surveillance tool to assist public health authorities in anticipating and monitoring outbreaks.