确定COVID-19基于废水的流行病学的交付周期
Defining the lead time of wastewater-based epidemiology for COVID-19
摘要：
感染SARS-CoV-2（导致COVID-19的病毒）的个体在出现症状之前可能会在粪便中排出病毒，这表明废水中SARS-CoV-2浓度的测量可能是COVID-19流行的“领先指标”。多项研究证实了领先指标的概念，表明当病例数滞后时，废水测量与COVID-19病例数之间的相关性最大。然而，“领先指标”的含义将取决于基于废水的流行病学的具体应用，相关性分析并不适用于所有应用。事实上，领先指标的量化将取决于流行病学、生物学和卫生系统因素。因此，基于废水的COVID-19监测没有单一的“前置时间”。为了说明这种复杂性，我们列举了COVID-19基于废水的流行病学的三种不同应用：定性“预警”系统;对疾病流行率的独立定量估计;以及对疾病发病率爆发的定量警报。领先指标的概念在每个应用中有不同的定义和效用。
英文摘要：
Individuals infected with SARS-CoV-2, the virus that causes COVID-19, may shed the virus in stool before developing symptoms, suggesting that measurements of SARS-CoV-2 concentrations in wastewater could be a "leading indicator" of COVID-19 prevalence. Multiple studies have corroborated the leading indicator concept by showing that the correlation between wastewater measurements and COVID-19 case counts is maximized when case counts are lagged. However, the meaning of "leading indicator" will depend on the specific application of wastewater-based epidemiology, and the correlation analysis is not relevant for all applications. In fact, the quantification of a leading indicator will depend on epidemiological, biological, and health systems factors. Thus, there is no single "lead time" for wastewater-based COVID-19 monitoring. To illustrate this complexity, we enumerate three different applications of wastewater-based epidemiology for COVID-19: a qualitative "early warning" system; an independent, quantitative estimate of disease prevalence; and a quantitative alert of bursts of disease incidence. The leading indicator concept has different definitions and utility in each application.
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