In the earliest days of the COVID-19 outbreak, Dave Larsen stood on the Syracuse University campus and proposed an unconventional idea: look to the wastewater to see what the virus was really doing. Three years later, that instinct has yielded something remarkable. A new study published in Science reveals that genetic diversity in wastewater viruses predicts community COVID-19 infections with extraordinary accuracy—outperforming traditional methods that rely on crude measurements of virus volume alone.
The discovery matters because it transforms wastewater surveillance from a simple detection tool into a genuine forecasting instrument. Public health officials have long understood that testing wastewater could reveal what pathogens are circulating in a community. But predicting how many people are actually infected has always been guesswork, relying on assumptions drawn from sheer virus concentration. Dustin Hill, the study's lead author and a Maxwell postdoctoral scholar, and his collaborators from Syracuse University, SUNY Upstate Medical University, SUNY College of Environmental Science and Forestry, and the New York State Department of Health found something elegant: the more genetic variation in the viral material, the more infections are happening. As Hill explains it with striking simplicity: "Not only do infections rise when diversity of the virus increases, infections decline as diversity declines."
The team analyzed wastewater samples collected during New York State's COVID-19 emergency, measuring genetic variation through the tiny, seemingly insignificant mutations that accumulate across the virus genome. They tested three different ways of measuring viral diversity in wastewater, and all three predicted infection levels with what Hill describes as "extremely high statistical power." This is not incremental progress—it is a methodological shift. Where old approaches measured virus quantity and guessed at transmission, the new approach reads the virus's genetic fingerprint and knows.
The implications ripple far beyond COVID-19. Professor Dave Larsen notes that these findings "open up new areas of exploration in genetic epidemiology," making it possible to "estimate transmission from sequencing data, something that has previously not been possible." The same principle that works for COVID-19 could be applied to influenza, measles, polio, and any other pathogen that sheds genetic material into wastewater. This is not speculative—it is a toolkit waiting to be deployed.
What makes this story remarkable is how it unfolded. The wastewater surveillance program grew from a partnership that began in March 2020, in those chaotic early months when little was known about the virus's behavior. Larsen assembled researchers from Syracuse and nearby universities to develop monitoring technology that would become critical to New York State's pandemic response and eventually grow into the New York State Wastewater Surveillance Network. In 2022, the work was further refined when sequencing capacity was added through a five-site consortium established by the Wadsworth Center's Virology Laboratory.
This is how transformative public health science unfolds: not from a master plan, but from asking the right question at the right moment, assembling collaborators who believe in the answer, and staying committed through what doesn't work until arriving at findings that protect communities. A simple wastewater sample, a genetic sequence, and the ability to predict what comes next—that is power.