Methods

Data collection

Monthly vital events data from the province of Alberta were collected from the Government of Alberta's open datasets. (Government of Alberta, 2024)
SARS-CoV-2 wastewater data was collected from the Government of Alberta's Respiratory virus dashboard. (Alberta Health, 2025)
For the analysis, R was used, including the software packages ggplot2, scales, geomtextpath, lme4, dplyr, plyr, and emmeans (R Core Team, 2025)

The monthly vital statistics information is collected by the Government and is available publicly, and includes data on births, deaths, marriages, and stillbirths, spanning from 2001-2024. The data comprises the totals for the entire province, by month, and it data is divided between residents and non-residents. As the data for stillbirths per municipality is not publicly available, we took the average of this total based on the number of municipalities analyzed (ten), and varied it with a random number generator (rnorm) in R.

As the available stillbirth data is not specific enough for our desired analysis, we are instead creating a model, that could be used on real data were it available. Our end results will be only hypothetical, with no real interpretive significance, as the data is simulated.

(Brandt, 2022)

This data has been collected in many municipalities across Alberta for the duration of the ongoing COVID-19 pandemic. The date that collection of data began varies depending on location, however, Edmonton began in July 2020, Calgary in September 2020. This was a joint effort between the University of Alberta (U of A) and the University of Calgary (U of C), who were both responsible for the collection, processing, and reporting of different municipalities between 2020 and 2023. The U of A was generally responsible for Northern Alberta, and the U of C was responsible for Southern Alberta.

In July 2023, Alberta Health (AH) and Alberta Precision Laboratories (APL) took over the effort, and began monitoring 10 key municipalities (Edmonton, Fort Saskatchewan, Fort McMurray, Grande Prairie, Jasper, Red Deer, Calgary, Banff, Medicine Hat, and Lethbridge). We used both the university-collected data and the AH/APL data, and compared them and their period of overlap. In that initial wastewater collection period, different sites should also not be compared, as they can have different proportions of industrial and residential wastewater, skewing the results.

(ACWA, 2023)

(Orsagos, 2024)

Wastewater testing is currently the the least intrusive and most consistent form of tracking COVID-19 trends that we have. Rigorous PCR testing is no longer occurring, and it is difficult for the average person to attain one of these tests. Rapid antigen tests (which have a lower accuracy rate than PCR tests) are no longer being freely distributed in Alberta as of October 1, 2024, reducing their accessibility greatly (Matthews, 2024). Wastewater testing requires no self-reporting, no self-testing, and while not perfect, is one of the only metrics we have that can inform us of the severity of the ongoing pandemic (Flood et al., 2023).

Experimental and sampling design

Wastewater data from 2020-2023 (collected by U of A and U of C) were compared to newer wastewater data (2023-2025) with Estimated Marginal Means (emmeans) in R, to splice the two datasets together.
SARS-CoV-2 wastewater data was compared to simulated municipal stillbirth rates, on a monthly basis, with a linear mixed model. The units of wastewater data are viral copies per person.
SARS-CoV-2 wastewater data was compared to simulated municipal stillbirth rates in a correlation plot.

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