The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the coronavirus disease (COVID-19), is shed in feces and the viral ribonucleic acid (RNA) is detectable in wastewater . A nine-week wastewater epidemiology study of ten wastewater facilities, serving 39% of the state of Utah or 1.26 M individuals was conducted in April and May of 2020 . COVID-19 cases were tabulated from within each sewershed boundary . RNA from SARS-CoV-2 was detectable in 61% of 126 wastewater samples . Urban sewersheds serving> 100,000 individuals and tourist communities had higher detection frequencies . An outbreak of COVID-19 across two communities positively correlated with an increase in wastewater SARS-CoV-2 RNA, while a decline in COVID-19 cases preceded a decline in RNA . SARS-CoV-2 RNA followed a first order decay rate in wastewater, while 90% of the RNA was present in the liquid phase of the influent . Infiltration and inflow, virus decay and sewershed characteristics should be considered during correlation analysis of SAR-CoV-2 with COVID-19 cases . These results provide evidence of the utility of wastewater epidemiology to assist in public health responses to COVID-19.