Scientific Publications

Published research spanning wastewater epidemiology, COVID-19 surveillance, variant monitoring, and public health dashboards.

Epidemics
Water & Health
ES: Water Research & Technology
Frontiers in Public Health
Emerging Infectious Diseases
Wastewater Surveillance Nowcasting Rt Estimation Variant Monitoring Health Equity CalCAT Shedding Models
2025
2025

Keeping a modeling-driven public health dashboard relevant — lessons learned from the California Communicable Diseases Assessment Tool

Mugdha Thakur, Lauren A White, John Pugliese, David Crow, Phoebe Lu, Natalie Linton, Ryan McCorvie, Sindhu Ravuri, et al.

Frontiers in Public Health DOI: 10.3389/fpubh.2025.1658645
This study documents the operational challenges and strategic decisions involved in sustaining a modeling-driven state public health dashboard — the California Communicable Diseases Assessment Tool (CalCAT) — across the evolving phases of the COVID-19 pandemic and beyond. Lessons include adaptive model selection, stakeholder communication, and transitioning from crisis-mode to sustainable infrastructure.
2024
2024

Real-time county-aggregated wastewater-based estimates for the SARS-CoV-2 effective reproduction number

Sindhu Ravuri, Elisabeth Burnor, Isobel Routledge, Natalie Linton, Lauren White & Tomás León

This paper presents a framework for estimating the effective reproduction number (Rt) of SARS-CoV-2 in real-time using county-aggregated wastewater surveillance data from California. The approach leverages wastewater concentration trends as leading indicators of transmission dynamics, enabling timely public health response without relying solely on clinical case counts. Models were validated against known variant waves and hospitalization data across California's largest sewersheds.
2024

Wastewater for Public Health: Timely, sensitive, and reliable SARS-CoV-2 Omicron variant monitoring in California

Alexander T. Yu, Elisabeth Burnor, Marlene Wolfe, Rose Kantor, Tomas Leon, Sindhu Ravuri, et al.

Environmental Science: Water Research & Technology DOI: 10.1039/D4EW00845F
This study evaluates the performance of wastewater-based epidemiology as a sentinel surveillance tool for Omicron sub-variant detection across California. The analysis demonstrates that wastewater signals reliably preceded clinical case surges, providing actionable lead-time for public health response during rapidly evolving variant landscapes.
2023
2023

Correlation between wastewater and COVID-19 case incidence rates in major California sewersheds across three variant periods

Angela M. Rabe & Sindhu Ravuri, Rose S. Kantor, Samuel Choi, Joshua A. Steele, et al.

This paper quantifies the strength and timing of correlations between SARS-CoV-2 wastewater concentrations and clinical case incidence rates across California's National Wastewater Surveillance System (NWSS) sewersheds, spanning Delta, Omicron BA.1, and Omicron BA.2/BA.5 variant periods. Results highlight how the wastewater-to-case correlation shifted across variants and over the course of the pandemic.
2022
2022

Estimating Relative Abundance of 2 SARS-CoV-2 Variants through Wastewater Surveillance at 2 Large Metropolitan Sites, United States

Alexander T. Yu, Bridgette Hughes, Marlene K. Wolfe, Tomas Leon, Dorothea Duong, Angela Rabe, Lauren C. Kennedy, Sindhu Ravuri, et al.

Emerging Infectious Diseases DOI: 10.3201/eid2805.212488
This study uses ddPCR and sequencing of wastewater samples from two major metropolitan sewersheds to estimate the relative prevalence of SARS-CoV-2 variants (Delta and Omicron). It demonstrates the utility of wastewater genomic surveillance as an early, population-level indicator of variant emergence — preceding clinical surveillance by several days.
In Progress
In Progress

Using Modeled Fecal Shedding Distributions to Understand Variations in 90-Day Rolling Correlations Between Wastewater Concentrations of SARS-CoV-2 and COVID-19 Cases — California, Feb 2022–Feb 2023

Cassandra O. Schember, Isobel Routledge, Elisabeth Burnor, Andrew Abram, Madhura Rane, Sindhu Ravuri, et al.

Manuscript in Preparation

"Translating wastewater signals into real-time public health insights — from nowcasting transmission to monitoring emerging variants — requires both rigorous methodology and the courage to communicate uncertainty clearly to decision-makers."

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