COVID-19 virus concentration in Boise sewage predicts rises in clinical cases, hospitalizations and deaths. This is done through wastewater-based epidemiology, which provides a convenient and rapid method of testing pooled samples from over 200,000 residents. Wastewater viral counts prepare health care services for spikes in cases. COVID-19 continues to be a major health concern as it undergoes mutations, resulting in new variants that have produced several spikes in COVID-19 cases over the past two years. Spikes can cause care shortages in testing, treatment and hospitalization. Wastewater testing (unlike patient testing) can detect asymptomatic infections and symptomatic non-testing individuals, leading to improved tracking of viral spread (Layton et al, 2021). Wastewater counting is done primarily by extracting and measuring the concentration of SARS-CoV-2 RNA in the wastewater. In this project, two local wastewater treatment facilities were tested for SARS-CoV-2 RNA on a tri-weekly basis. Wastewater viral counts mirror trends in Idaho case counts and provide a significant lead time ahead of changes in hospitalization rates. Early results indicate that spikes of SARS-CoV-2 RNA concentrations in wastewater occur 1-2 weeks before spikes in COVID-19 related hospitalizations. This study demonstrates why wastewater-based epidemiology is an effective tool for tracking the COVID-19 pandemic, and can be used to improve public health responses to future outbreaks.