 The correlation between concentrations of SARS-CoV-2 RNA in wastewater and reported laboratory confirmed COVID-19 incidences has changed since May 2022 due to changes in test availability and test-seeking behavior. The parameters describing this relationship are different than those observed prior to May 2022. Assuming SARS-CoV-2 RNA shedding remains relatively stable among those infected with the virus as different variants emerge, wastewater concentrations of SARS-CoV-2 RNA can still be used to estimate COVID-19 cases by using the historical relationship between SARS-CoV-2 RNA and COVID-19 case data. This article was authored by Alexandria B. Bone, Marlene K. Wolfe, Bradley White and others.