Wastewater‐Based Epidemiology for Monitoring SARS‐CoV‐2 Dynamics and Variants in Nagpur: Insights From a 16‐Month Study

ABSTRACT This 16‐month longitudinal study in Nagpur, India, evaluated wastewater‐based epidemiology (WBE) for monitoring SARS‐CoV‐2. From March 2023 to June 2024, 1424 wastewater samples were collected from 25 urban sites; 39% were positive for SARS‐CoV‐2 RNA. Viral concentrations significantly correlated with clinical case trends ( r = 0.417; p < 0.05), closely aligning with clinical case surges, demonstrating its utility as a complementary surveillance tool. Sequencing of 69 genomes revealed multiple lineages, including prevalent VOIs like BA.2.86 and XBB.1.16, alongside lower abundance variants. No high‐impact VOCs were detected. Unique local mutational patterns in ORF1ab and Spike genes, including rare stop‐gain and frame shift mutations, suggest ongoing viral evolution. Environmental factors did not significantly influence detection. WBE is a feasible tool for public health, enabling early outbreak detection and genomic surveillance for future SARS‐CoV‐2 threats.