Important Safety Information for Users of FreeStyle Libre 2 Readers: If you received an “Incompatible Sensor” message on your FreeStyle Libre 2 Reader, please follow these instructions to learn more on actions you can take to address it.

Important safety information for users of freestyle libre, freestyle libre 14 day or freestyle libre 2 readers: to learn how to safely store, charge and use your reader, please visit  www.freestylebattery.com  for more info..

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ADC-29936 v7.0

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FreeStyle Libre 14 day system:  Failure to use FreeStyle Libre 14 day system as instructed in labeling may result in missing a severe low or high glucose event and/or making a treatment decision, resulting in injury. If readings do not match symptoms or expectations, use a fingerstick value from a blood glucose meter for treatment decisions. Seek medical attention when appropriate or contact Abbott at  855-632-8658  or  FreeStyleLibre.us  for safety info.

FreeStyle Libre 2 and FreeStyle Libre 3 systems:  Failure to use FreeStyle Libre 2 or FreeStyle Libre 3 systems as instructed in labeling may result in missing a severe low or high glucose event and/or making a treatment decision, resulting in injury. If glucose alarms and readings do not match symptoms or expectations, use a fingerstick value from a blood glucose meter for treatment decisions. Seek medical attention when appropriate or contact Abbott at  855-632-8658  or  FreeStyleLibre.us  for safety info.

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There are several ways to contact Three’s customer support team, including by phone, live chat, using the 3 app or by visiting your local 3 store.

Different options are available depending on whether you are a personal or business customer, and there is even a dedicated support team for broadband customers.

We've put together all the information together in one place to help you get the support you need.

Call centre numbers

If you’d like to speak to Three on the phone then the number you’ll need to call will depend on the type of plan you’re calling about, and whether or not you’re calling from a Three phone. There are also different numbers if you’re calling from abroad, but you’ll find all of the options below.

Opening Times

If you need to speak to Three on the phone, be aware that its call centres aren’t open 24 hours a day, but they are open seven days a week. Three's call centre opening times are:

  • Monday - Friday: 8am - 8pm
  • Saturday and Sunday: 9am - 6pm

These opening times only apply to the call centre – opening times for Three’s stores vary, and details can be found below.

Personal customers

If you’re on a phone plan with Three – meaning one which includes a phone, or is a SIM Only or Pay As You Go plan that you’re using with a phone, then you should contact Three using one of the numbers in the left hand column of the table above.

If you have a mobile broadband product from Three (such as a tablet or mobile broadband router) then you should use one of the numbers in the right hand column of the table above.

Business customers

Three has a team of customer service agents dedicated to helping business customers. 

Three’s live chat service lets you speak to the network online by typing messages.

This service is available from 8am to 10pm Monday to Friday, and from 9am to 8pm Saturday and Sunday. It can be accessed  here .

Local Three Store

If you’d rather contact your local Three store that’s an option too. There are over 300 of these across the UK, so there’s likely to be one near you.

Store staff can assist you with purchase decisions, support for devices or services you’ve already bought from Three, top-ups, or network and allowance queries. Some stores also offer Three Store Now, which allows you to connect with store staff online.

Exact services and opening times vary from store to store, but you can find all of those details, along with store addresses and phone numbers, in Three’s store directory .

Accessibility team

Three also offers several contact options for customers with accessibility needs. These are as follows:

  • Textphone - 0800 033 8011
  • Video Relay Service
  • http://www.three.co.uk/Accessibility

Three always tries to provide the best possible experience, whether you’re a new, existing or potential customer. However, if you haven’t been fully satisfied with Three’s service then the network would always want to hear about it so that it can put things right.

To file a complaint you can use Three’s complaints form , give the network a call, or use live chat. You can also file a complaint on behalf of somebody else – as long as Three gets confirmation of their consent. For full details of how to file a complaint, head here .

Helpful guides

A suite of guides are available which may help answer the questions you have without needing to contact customer service.

The information contained on this website has been written to assist our readers. We do not represent Three or speak on its behalf and are entirely independent of Three.

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Customer service faqs.

Fifth Third mobile app

  • To reset your User ID or Password on the mobile app, select the "Forgot Login" link under the login box upon launching the app, and follow the prompts.

Online banking

  • If you are using a desktop or laptop computer on 53.com, click to expand the green "LOG IN" box at the top right-hand side of the screen and select, "Forgot Login" and follow the prompts.

For more tips on how to keep your accounts safe, watch this video .

One of the best defenses against fraud is education. There are several organizations offering resources on fraud and current scams that are available to the public:

  • Federal Trade Commission (FTC)
  • Identity Theft Resource Center (ITRC)
  • Internet Crime Complaint Center
  • Federal Bureau of Investigation

Business Related Scams

  • Better Business Bureau

Elderly Scams

  • Department of Justice

Soldier Scams

Protect yourself from fraud and scams with these tips.

To report fraudulent or suspicious activity with your account, call 1‑800‑972‑3030 , Monday through Friday, 7 a.m.‑8 p.m. and Saturday, 8:30 a.m.‑5 p.m., ET.

How do I get a payoff for one of my Fifth Third loans?

  • You may request a payoff letter by using the messaging function within online and mobile banking.
  • Log in on either 53.com or your Fifth Third mobile app and click the blue messaging icon in the lower right of the screen.
  • Follow the prompts to ask for a payoff letter. You may also call the customer service center to request a payoff letter.

To make a payment to a Fifth Third account, log into 53.com or the Fifth Third mobile app.

Fifth Third mobile app, on Android and iPhone

  • Log in to the mobile app and select "Move Money" from the bottom navigation.
  • Tap "Make a Payment."
  • Tap the account you want to make a payment to.
  • Then tap the account you want to pay from.
  • Tap how much you want to pay, select the date of payment.
  • Review and submit.
  • Log on to 53.com, click on the account you would like to make a payment to and then select "Make a Payment" within the account summary bar.
  • Then select the account that you’ll transfer fund from and follow the prompts.

There are several ways to make a deposit into your Fifth Third Bank account:

  • Direct deposit allows your paycheck to be deposited directly into your account.
  • Mobile deposit lets you deposit checks anywhere, anytime from your phone.
  • ATM deposit allows you to deposit checks and cash at a Fifth Third ATM.

You can also make deposits at a Fifth Third bank location.

Learn more about your deposit options here .

Account and routing numbers are viewable in your account online, or in the Fifth Third mobile app.

  • Log in and from the home screen tap your account.
  • Tap "Account & Routing Numbers."
  • On a desktop or laptop computer, log into your account.
  • Select the account
  • Select "More Details."
  • Select "View Account/Routing Numbers."

Your routing number is also the first set of numbers printed on the bottom left of your Fifth Third checks.

You can also find a complete list of Fifth Third Bank affiliate routing numbers here: Fifth Third Bank Affiliate Routing Numbers

To receive funds through a wire transfer into a Fifth Third account, you’ll need the routing and transit numbers below. For international wire transfers, provide the International Wire Transfer routing number and Swift Code. Fifth Third Bank does not have an International Banking Account Number (IBAN).

Routing Number: 042000314 Swift Code (International Wire Transfers): FTBCUS3C Wire Transfer Address: 38 Fountain Square Plaza, Cincinnati OH 45263 Wire Transfer Phone Number: 800-972-3030

To report a lost or stolen card, please immediately call 1-800-782-0279 . Customer Service Representatives are available at this line 24/7. You may also report your card as lost or stolen online or via the Fifth Third mobile app.

  • Log in and from the home screen tap the three dots next to the account.
  • Tap "Manage Card."
  • Select the card.
  • Tap "Card Lost, Stolen or Damaged" and follow the prompts.
  • Select the account associated with the lost or stolen card.
  • Click on the "Services" option under the available balance at the top of the account screen.
  • Then, select "Card Management."
  • Click on "Lost or Stolen" and follow the prompts to report your card as lost or stolen.

You can update your address and phone number by logging into  your account online, or via the Fifth Third mobile app. You can also call us toll free at 1-800-972-3030   or visit a  Fifth Third Branch  near you.

  • Fron the Fifth Third mobile app, log into your account.
  • Tap the "Profile" icon in the top left corner.
  • Tap "Personal Information," to access and edit your personal contact information.
  • On a desktop or laptop computer, log into your account on 53.com.
  • Select "Settings."
  • From here, you can update your personal information.

The first step in getting assistance is not being afraid to ask.

  • Tap "Hardship Assistance" and follow the prompts.
  • Select the auto or personal loan, or credit card that you would like payment options for.
  • Then click "Hardship Assistance" once in account details and follow the prompts.

Mortgage financial hardship assistance

  • If you're experiencing financial hardship regarding your Fifth Third mortgage, we're here to help.
  • We've partnered with the LoanSolutionCenter to help us process your mortgage hardship assistance request.
  • It will take you through all the steps needed to complete your hardship request. Then you will need to complete an application and send it to us along with verification of your income and other required documentation.
  • You may also call us toll free at 800-457-0839

Live Customer Service

You can reach our call center at 1-800-972-3030 , Mon.–Fri, 8 a.m.–6 p.m. ET and Sat., 10 a.m.–4 p.m. ET. Our call center is closed Sunday.

24/7 Message Support

You can message live agents during extended hours, or get help anytime from our digital agent. Log in to your account, either through our mobile app or online banking, to get message support.

From a desktop or laptop computer, log into your account on 53.com and click the blue text bubble on the bottom lower-right-hand side of any screen to 'send a message' to a Fifth Third representative.

You can also start a conversation with a customer service representative by clicking the “Ask Us” option at the bottom of any screen within the Fifth Third mobile app.

Live agents: Mon.–Fri., 6 a.m.–9 p.m. ET, Sat. and Sun. 8:30 a.m.–5 p.m. ET

After hours: Request agent chat support, and a live agent will reply the next day

Virtual assistant: Available 24/7

Messaging

Log in to your account and select the floating icon at the bottom of the page to get started.

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24/7 messaging support.

Get support 24/7 online and through our mobile app. Simply log in to your account and select the floating icon at the bottom of the page to get started.

Customer Service Call Center

1-800-972-3030

Mon.–Fri, 8 a.m.–6 p.m. ET Sat., 10 a.m.–4 p.m. ET Closed Sunday

Lost or Stolen Bank Card

1-800-782-0279 Available 24/7

Toll-Free International Fraud Support

1-513-900-3080

Apply for a Home Loan or Refinance

1-866-351-5353

Mon.–Thurs., 8 a.m.–8 p.m. ET Fri., 8 a.m. –6 p.m. ET Sat., 9 a.m. –3 p.m. ET

Existing customers

1-877-534-2264

To open a new account

1-866-531-4249

Mon.–Fri, 7 a.m.–10 p.m. ET Saturday, 8:30 a.m.–5 p.m. ET

1-800-546-7068

Mon.–Fri, 7 a.m.–10 p.m. ET

International

1-513-579-5353

1-800-546-7068 Monday through Friday, 8 a.m. to 6 p.m. EST Saturday, 10 a.m. to 4 p.m. EST Closed Sunday

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Three Contact Number: How To Contact Three in Ireland

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Looking for the best way to contact Three? Call 1800 949 546! Find the right contact number or email address can be difficult so we've put together this Three contact guide. We've laid out all the Three contact numbers, email addresses, and live chat options you can take advantage of. With our Three contact guide, you'll be talking to a Three customer agent in no time!

Our broadband specialists are ready to help you get the best broadband deal for your home!

Mon-Thurs 9am-6pm & Fri 9am-5.30pm

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We're currently closed but please leave us your number and we'll give you a free callback as soon as we'open!

Mon-Thurs 8.30am-6pm & Fri 9am-5.30pm

What Is the Three Contact Number?

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Customer service is very important when comparing broadband providers . Let's take a dive into how exactly you can contact Three Ireland . While having a wide range of contact methods can be useful, sometimes it is best to call the Three contact number directly to talk over your query with a real person in order to save time, or better explain the purpose of your call.

Three have streamlined their available contact numbers by having six simple options for domestic customers, and two options for business clients.

Whether your query is regarding your broadband speed , Three Plus rewards , mobile, Three mobile broadband , or another Three broadband service, when you dial one of the above Three contact numbers you will be required to input certain information. Before making your call, it is important to have all of the relevant documentation you need ready. When you call the Three contact number, you'll get the following options:

  • Select 1 for payments and billing queries.
  • Select 2 for upgrades.
  • Select 3 for coverage, mobile broadband and unlock code queries.
  • Select 4 for SIM swaps.
  • Select 5 for everything else

Is There a Three's Email Address?

If you are looking for the Three Ireland Contact email as an existing or new customer, then you have one simple option - [email protected] . If you have concerns about the privacy of your data, or represent a media outlet, then you can also make contact over the following email addresses:

  • [email protected]

When you send your email it will be forwarded to the appropriate team for the nature of your query. In order to save yourself a game of email ping-pong, it is important to keep your email orderly , concise , and ensure that it contains useful information for the receiving agent. Doing so will increase the speed at which the agent can identify your account, understand the problem, and get back to you with a solution.

Does Three Have a Postal Address?

Although this may not be the quickest or most efficient manner of communication, sometimes it may be appropriate to end a letter to Three, for example in the instance of complaint escalations. If this is the case, then you have two address options.

Three Customer Care PO Box 333 Dublin 2

Three Corporate Office 28/29 Sir John Rogerson's Quay Dublin 2

Is There a Three Ireland Live Chat?

Image of two chat-bubbles

If you would prefer not to contact Three Ireland over the phone, then their webchat may be of interest to you. This is available to both domestic and commercial customers , and can be found by navigating to the bottom of the home page and selecting the “Contact Us” button. You can then have a conversation with a Three agent by typing on a computer or mobile device, somewhat like texting.

Agents are available to help seven days a week, from 7am-midnight . Outside of these hours, a bot will also be available to provide advice and basic troubleshooting assistance.

Can I Contact Three Ireland on Social Media?

Social media is a great way to connect with friends, interests and businesses. Three Ireland has developed social media channels on Facebook , Instagram , and Twitter to enable them to publish service updates, advertisements and advice to their customer base.

These platforms also allow customers to publish queries or seek support from agents by either directly messaging or posting a question in an appropriate channel. If you wish to contact Three Ireland over one of these services, their staffed hours are 9am - 8pm Monday to Friday and 10am - 6pm Saturday, Sunday and Bank Holidays.

Can I Use the My3 App To Contact Three?

The My3 app, as the name suggests, is an application available on Apple and Google stores enabling customers to interact with their Three login accounts , and seek further support. From within this application customers are able to:

Image of a mobile phone

  • Make bill payments
  • Manage accounts
  • Add or remove services
  • Top-up accounts
  • Contact Three Ireland via a live chat
  • Access support and FAQ documentation

This simple tool effectively provides you with the ability to manage your account fully on the go, a great convenience if you need to make contact while you aren't at home. You can check out the Three reviews and the My3 ratings in our guide.

How Can I Complaint to Three?

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If you are looking for the Three Ireland contact details regarding raising a complaint, compliment or general query for both business or domestic purposes, but don’t have the time to wait around in a call queue, then the Three contact form might be a quicker way of doing it. The contact form can be found by navigating the following routes:

  • Head over to the Contact Us page
  • Click the Feedback tab , followed by the How do I make a complaint/give a complement sections
  • From within these, select the “ raise a complaint/compliment here ” link, to be taken to the contact form.

For business customers , this process is a step simpler.

  • On the Three homepage, select the business tab at the top
  • Once this opens, select the Contact Us button at the bottom of the page
  • The contact form will be midway down the page that opens

What Is 3Money?

3Money has ceased its operations , and as of the 31st of December 2021, all cards and accounts have been closed. If you have queries about a past account or the closing of an account you had, you can contact the 3Money care team on +353 61 203 357, or by emailing [email protected]

If you are seeking to better manage your cash flow or save money on your household utilities, then take a look at our energy comparison guide

Three Ireland FAQs

What is the 3community.

As with many modern companies, Three has an extensive FAQ and support section available to customers on their website. Three, however, also have a very well developed help-board or forum called 3Community . This community is managed and moderated by Three support agents, and allows customers to post queries within set topics. Members of the community and moderators will then respond to these with direct answers, or with the provision of support documentation in order to provide further guidance.

Will I speak to a human when I call?

Yes. Though you may need to go through several automated call filtering processes to ensure that you arrive at the correct department before reaching a Three customer care member.

My phone has been stolen, what should I do?

If your phone has been stolen or lost, you should contact Three on 1913 , or use the three.ie/chat to report the loss. A member of staff will then provide guidance about what you should do next, and what you can expect in the next few days.

How can I track my order?

Details of your order will be provided to you by email. If you wish to track your order status, head over to the Three Ireland tracking page , and select the "Track your Order" button. This will take you to the portal of Threes delivery partners, where you will need to input your tracking ID or order number, which can be found in your order confirmation email.

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If you’re a reporter working on a story about Lively, Best Buy or Geek Squad, you can contact Best Buy Media Relations at [email protected] .

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We have other great support channels available to help.

You can also message us via your My3 App. No need to call, just message us with your questions whenever it suits you.

Message with our team directly in-app and respond when it suits you.

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Our support section is filled with answers to your questions.

Our friendly forum is the place to get help and talk about all things Three with our community experts.

Manage your account from anywhere with My3 App.

customer care number 3

customer care number 3

Kilimall customer care

2024-01-25 15:25:19

Kilimall

How to contact Kilimall customer care service and what's Kilimall customer care number? 

To contact Kilimall customer care service, you can reach us through the following main methods. Our support is available from  Monday to Friday, 8:30 AM to 5:30 PM , and on  Saturday from 8:30 AM to 12:30 PM.

1. Kilimall Kenya Customer care number:

+254 (0)73 073 1888 (official contact)

2. Kilimall online Live chat:

  • Kilimall APP >message > contact us
  • Kilimall site  www.kilimall.ke , find the chat icon at the bottom right corner
  • Directly Livechat link:  http://k.kili.co/gtk6

customer care number 3

3. Ticket followup 

For the following concerns you can also  apply a ticket

  •   Place an order
  •  Product Inquiry
  •   Account Setting
  •  Payment & Refund 
  •   Delivery & Shipping
  •   After-sale 

N.B: If your issue is not resolved satisfactorily, you can refer to our  Dispute Policy for more assistance.  Click here

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Three Customer Service

  • Three Complaint

Three

List of Three Social Media

  • Three Mobile Facebook Three Mobile Twitter Three Mobile Instagram Three Mobile YouTube

List of Three Customer Service Numbers

  • 3 customer service (from three mobile) 333
  • 3 customer service (From all phones/mobile) 0333 338 1001
  • Buying from 3 mobile contact UK 0333 338 1001
  • Customer care inquiries 0330 686 8000
  • Sales team service 0800 033 8009
  • Buying from 3 mobile contact outside UK 0778 233 3333
  • Sales inquiries contact 0800 033 8001
  • Mobile broadband account inquiries UK 0333 338 1003
  • Mobile broadband account inquiries outside UK 0778 233 3500
  • Top up contact 0800 033 8002
  • Media contact 0745 495 9715
  • Accessibility team contact 0333 338 1012
  • CPP phonesafe claims line 0845 123 2333
  • Customer service for business customers 0800 033 8022
  • Business help and support 0800 033 8033
  • Broadband sales service contact 0330 686 6000
  • Business mobile phones support 0333 338 1026

List of Three Service Email Address

  • Customer care broadband email Email: [email protected]
  • Media inquiries email Email: [email protected]
  • Accessibility service email Email: [email protected]
  • Wholesale team email Email: [email protected]

Important Links

  • Three Mobile store locator Check Now
  • Three Mobile Login Check Now
  • Three Mobile registration Check Now

Three Service Postal Address

How can I reach the Three Mobile customer service team through the phone?

You can contact the Three Mobile customer service team by calling Three Mobile customer support number 0333 338 1001 or dial free 333 if you are calling from any other not Three phone). You can ask all phone-related queries at this number and get the best solution. If you are not residing in the UK and want to contact the Three Mobile service team, you can call on Three Mobile contact number 0778 233 3333 . The customer service can also be contacted through post by writing a letter at Three Mobile contact address as follows:

Three Customer Services, Hutchison 3G UK Ltd, PO Box 333, Glasgow, G2 9AG

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The Best Ways to Resolve an Issue with Amazon

Last Updated: March 24, 2023 Fact Checked

This article was co-authored by wikiHow staff writer, Sophia Latorre . Sophia Latorre is a Content Manager on the wikiHow team. Before joining wikiHow, Sophia worked as a technical editor and was published in six International Energy Agency (IEA) Wind Annual Reports. Now, she writes, edits, and reviews articles for the wikiHow Content Team, working to make the content as helpful as possible for readers worldwide. Sophia holds a BA in English from Colorado State University. This article has been fact-checked, ensuring the accuracy of any cited facts and confirming the authority of its sources. This article has been viewed 2,791,142 times. Learn more...

Have a problem with Amazon and can’t figure out how to talk to an actual person? Trust us, we’ve been there and know exactly how frustrating it can be. That’s why we’ve created a comprehensive guide to contacting Amazon. Although they don’t have an email address you can send requests or complaints to, we’ve rounded up the phone numbers, chat URL, support pages, and customer service options you can use to get your issue resolved ASAP.

Things You Should Know

  • Call Amazon at 1-888-280-4331 for 24/7 customer service.
  • Try Amazon’s chat feature to solve your problem.
  • Use Amazon’s customer support page to find answers to common questions, tutorials, and troubleshooting tips.

Phone Numbers, Chats, Social Media, and Help Library

Step 1 Call 1-888-280-4331 for 24/7 customer service.

  • If you’re outside the U.S, call 1-206-266-0927.
  • Audible: 1-888-283-5051
  • Accessibility: 1-888-283-1678
  • Payments: 1-866-216-1075
  • Pharmacy: 1-855-745-5725.

Step 2 Request a call...

  • If you can't get to the chat feature from this link, use the customer support page. Click the category and item that pertain to your issue, then select “I need more help,” which will direct you to a page with an option to start a chat.

Step 4 Contact Amazon on...

  • Where’s my stuff
  • Shipping and Delivery
  • Returns and Refunds
  • Managing Your Account
  • Security & Privacy
  • Payment, Pricing and Promotions
  • Devices & Digital Solutions
  • Amazon Business Accounts
  • Large Items and Heavy-Bulky Services
  • Other topics & Help Sites

Customer Support Page

Step 1 Navigate to Amazon’s...

  • If you don’t have access to your account, reset your password.

Step 2 Choose what you need help with from the options presented.

  • A delivery, order or return : Your recent orders will be displayed. Choose the item you need help with or use the search box at the top of the page to search your ordered items and find the one you have a question about or problem with.
  • Login, address, security & privacy : Login and security, Addresses, Suspicious phone call, email or SMS received, Data Privacy Queries
  • eBooks, Prime Videos or Music : Kindle eBooks/Digital Content/Comics, Prime Video, Freevee, Amazon Music, Luna, Appstore for Android, Alexa Voice Services, Prime Gaming/Twitch Purchases, Amazon Games, Softwater/Video Games (Digital Downloads), Amazon Photos, Amazon Kids+, Audible
  • Prime: Manage or cancel Prime membership, Set Prime renewal reminder, Prime Video, Amazon Fresh and Whole Foods, Update Payment Information, Share Prime benefits, or Amazon Music
  • Memberships, subscriptions or communications : Manage Memberships & subscriptions, Check messages from Amazon and sellers, Manage Rentals, Other Amazon account settings, Manage Subscribe & Save, Manage email and mail communications, Manage Amazon Household
  • Accessibility : Digital Services and Device Support or Something else like orders, accounts, payments, memberships, and more
  • Payment, charges or gift cards : Unknown or incorrect charges, Payment declined, Update payment methods, Shop with Points, Problem with a Gift Card, Amazon Credit Cards
  • Kindle, Fire, Alexa or other Amazon devices : Fire Tablet, Echo & Alexa enabled Amazon devices, Kind E-reader, Fire TV Devices, Other Devices
  • If you select “I need more help,” you’ll be redirected to a chat feature.

Step 3 Go back to the main menu or select “I need more help” if you haven’t resolved the problem.

  • The phone number (if there is one) and chat feature may be specific to the category you selected.

Resolving Disputes Effectively

Step 1 Explain your issue and how you would like it fixed as clearly as possible.

  • For example, if you got the wrong product in your order, you could say, “On October 28th, I placed an order for a red bath towel. When I received my package today, I opened it immediately to see that I got a gray bathrobe instead. I’d like to return the bathrobe and get the towel that I ordered. Can you help me correct this?”
  • Remember to remain calm and speak clearly . Let Amazon know exactly why you're contacting them and what you think the best solution is to the problem at hand.

Step 2 Keep all records, confirmation numbers, and shipping notes on hand.

  • If you've needed to contact Amazon multiple times, get the name of the representative you’ve been talking to and the tracking number for your complaint. This can save you a lot of time when you need to contact them again.

Step 3 Ask politely to speak to a manager if your representative can't help you.

  • You can try saying something like, "I'm sorry, but I think I need to talk to someone else who can more directly help me. Would you be able to transfer me to your manager?”

Step 4 Be kind and civil in all of your interactions.

Talking to Customer Service

If you’re having trouble staying calm, try repeating some of these phrases to communicate politely and effectively with the expert.

"I know this isn't your fault, I just want to find a way to resolve this fairly."

"Thank you so much for your help so far, I know this wasn't your issue or mistake."

"I know this was just an accident, I'm just hoping to find a way we can make sure things end well."

"I really enjoy using Amazon, which is why I'm confident we can find a way to fix this issue."

Community Q&A

wikiHow Staff Editor

  • If you have a complaint about Amazon’s customer service, please direct it to Amazon, not wikiHow. We’re simply here to help you navigate Amazon’s customer service options. Thanks Helpful 1 Not Helpful 4
  • Patience is key with customer service at big companies like Amazon. Stay level-headed and take your time for the best results. Thanks Helpful 1 Not Helpful 2
  • After you interact with the chatbot or have a conversation with a human representative, you’ll have an opportunity to rate your experience and provide feedback or suggestions about how to make the customer service experience more helpful. Thanks Helpful 1 Not Helpful 2

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You Might Also Like

Call Amazon

  • ↑ https://www.amazon.com/hz/contact-us/foresight/hubgateway
  • ↑ https://www.businessinsider.com/how-to-get-what-you-want-when-you-call-customer-service-2015-1

About This Article

Sophia Latorre

If you want to contact Amazon, you can call their customer service by dialing 1-888-280-4331. Another way to contact Amazon is to use their online contact form. To do this, first visit the Contact Us page on their website. When you’re on the page, answer their questions about your problem so they know what to help you with. Once you’ve explained your issue, choose whether you want to chat with a representative or speak to someone on the phone. If you have a simple problem, like you want to track a package, then you should use their online messenger. Alternatively, if your problem is a little more complicated, such as issues with billing, then you should choose the phone option so they can better assist you. When you select to be contacted by phone, be prepared to receive a phone call from their customer service within a few minutes. For more help, including how to contact Amazon through social media, keep reading! Did this summary help you? Yes No

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More From Forbes

The human element: how to personalize customer interactions.

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Cathleen Anthony is the owner of LifeSpring Home Nutrition , which has delivered millions of medically tailored meals in Southern California.

Innovative products, strategic pricing and all-star marketing are important tools for any business. But it’s easy for CEOs and business owners to get caught up in the details of running a business and, over time, lose the human touch that made the business so competitive in the first place.

Owners have an opportunity to rededicate themselves to personalizing customer interactions in 2024. I believe business isn’t just about transactions but also relationships—and most customers agree. In fact, three-quarters of customers expect more personalization from businesses.

This approach might require more resources, but my team has reaped dividends from personalizing interactions for each customer. Here are some tips out of our book that can help you make one-on-one relationships possible at scale this year.

1. Know your audience and your company.

What does your company stand for? What experience do you want every customer to have? Self-awareness is important for personalization because it helps you understand the best ways to add a human touch. For example, if you run a bookstore, you could offer personalized reading recommendations based on a customer’s previous interests. A fitness studio brand could also offer tailored workshops based on customers’ interests, like yoga for stress relief or strength training for beginners.

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Once you know the type of experience you want to provide, stay in constant contact with your customers. For my team, it comes down to old-fashioned chats with the families using our product. Research shows that 88% of people would rather speak to a human customer service agent than a phone menu. Staying in touch with clients can give your team a better sense of customers' needs and how you can personalize their experience as the market changes.

2. Give back when you can.

Adding a human touch to your business requires more than adding a customer’s name to your marketing emails. I believe a business is only truly human if it improves the world and gives back. Do good things for people when you have time or money to give and expect nothing in return.

Donating to charity, offering free products or services to people in need, or volunteering in the community are all great ways to humanize your brand. In an era when customers are increasingly wary of businesses, I recommend sharing these charitable activities with your customers. Whether they benefit from your generosity or not, doing good deeds is an easy way to win customers’ hearts. When you do what’s right because it’s who you are, you can continually grow closer with your clients and their families.

3. Follow the golden rule.

Treat your customers how you would want your kids to be treated. Putting yourself in the client’s shoes is the best way to identify what is and isn’t valuable in the customer experience—and make changes ASAP. For my team, this means keeping our heads down, helping clients the way we would want our parents or grandparents to be treated, and constantly tweaking our services to be as helpful to our community as possible.

Customers notice when you treat others well, whether you think they’re watching or not. Whether it’s a phone call with an angry client, responding to a less-than-stellar Yelp review or managing sarcastic comments on social media, treating others well is important for adding a human touch to your business.

4. Build the right infrastructure for customer service.

It’s hard to provide a human touch if you don’t have the staff to support it. I recommend hiring a friendly, well-trained customer service team to engage with customers. The key is to staff enough people to manage demand; otherwise, you risk stressing out your employees and frustrating customers. Offering consistent customer service training to all employees can help reduce miscommunications and ensure a consistent experience every time.

Many business owners hesitate to invest more resources in customer support, but I believe it’s worthwhile. My team works harder and smarter to provide the best customer service. It may take longer or cost more, but it shows your customers you care and know their needs. Eighty-one percent of companies see customer experience as a competitive advantage, so why not dedicate a portion of the budget to ensure your customer service team is top-notch?

5. Oversee the customer experience personally.

It’s possible to offer customers a personal, humanity-centered experience at scale as long as you have the right systems in place. However, that doesn’t mean you should sequester yourself in the corner office away from your team. Be out there with your employees, engaging with customers. Not only can this reassure you that everything is going how it should, but it can also help you understand customer expectations and solve any problems that might arise. Get in the trenches with your employees to better understand your customers’ needs and make tough decisions based on what they need.

The Human Factor: Where Business Meets Empathy

I have seen the power of human-centric leadership in my own business. Every successful business needs a solid product or service, but they also need relationships built on a foundation of genuine care. Going into a challenging economic climate in 2024, I suggest that company leaders come together to revitalize the customer experience. After all, when you treat people well, they often return the favor.

Forbes Business Council is the foremost growth and networking organization for business owners and leaders. Do I qualify?

Cathleen Anthony

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Volume 30, Number 3—March 2024

Wastewater Surveillance for Identifying SARS-CoV-2 Infections in Long-Term Care Facilities, Kentucky, USA, 2021–2022

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Persons living in long-term care facilities (LTCFs) were disproportionately affected by COVID-19. We used wastewater surveillance to detect SARS-CoV-2 infection in this setting by collecting and testing 24-hour composite wastewater samples 2–4 times weekly at 6 LTCFs in Kentucky, USA, during March 2021–February 2022. The LTCFs routinely tested staff and symptomatic and exposed residents for SARS-CoV-2 using rapid antigen tests. Of 780 wastewater samples analyzed, 22% (n = 173) had detectable SARS-CoV-2 RNA. The LTCFs reported 161 positive (of 16,905) SARS-CoV-2 clinical tests. The wastewater SARS-CoV-2 signal showed variable correlation with clinical test data; we observed the strongest correlations in the LTCFs with the most positive clinical tests (n = 45 and n = 58). Wastewater surveillance was 48% sensitive and 80% specific in identifying SARS-CoV-2 infections found on clinical testing, which was limited by frequency, coverage, and rapid antigen test performance.

Persons living in long-term care facilities (LTCFs) have experienced disproportionate illnesses and deaths from the COVID-19 pandemic. By June 2020, >50,000 COVID-19 deaths had occurred in LTCF residents in the United States, an estimated 43% of all US COVID-19 deaths in a group comprising <1% of the US population ( 1 ). Nearly 2 years later, the COVID-19 pandemic continues to cause disproportionate illnesses and deaths in this vulnerable population and is responsible for >200,000 LTCF resident deaths in the United States ( 2 ).

Early detection of SARS-CoV-2 infection in LTCF staff or residents is an important strategy to mitigate SARS-CoV-2 transmission. Routine symptom screening of LTCF employees and residents was the primary strategy to detect infections early in the pandemic. However, symptom screening misses persons with presymptomatic or asymptomatic SARS-CoV-2 infection ( 3 ) and performs similarly to the flip of a coin for identifying persons with SARS-CoV-2 infection ( 4 ). Clinical testing, which was heavily constrained early in the pandemic, became the preferred screening approach as testing capacity increased in 2020. Federal and state guidance encouraged routine clinical testing of unvaccinated asymptomatic LTCF staff with the frequency determined by the level of community transmission ( 5 ). However, routine clinical testing of large numbers of asymptomatic persons is expensive, invasive, and inefficient and may be inaccurate depending on the type of clinical test used.

Wastewater surveillance provides an alternative strategy for SARS-CoV-2 detection by evaluating samples of wastewater for the presence of viral biomarkers like RNA ( 6 ). Persons infected with SARS-CoV-2 shed virus in their feces ( 7 ); early in the pandemic, scientists reported detecting the virus in the wastewater of urban areas ( 8 , 9 ). Many municipalities across the United States surveilled wastewater at treatment plants for SARS-CoV-2, while universities tested wastewater at the building level; researchers used the collected data to trigger enhanced clinical testing that led to identifying persons with previously unknown SARS-CoV-2 infections ( 10 , 11 ). We implemented wastewater surveillance to detect SARS-CoV-2 infection at LTCFs and assessed its performance using routine clinical testing data.

Study Population and Site Selection

We collaborated with a LTCF organization that manages >100 LTCFs across the upper Midwest of the United States. We identified LTCF study sites on the basis of their proximity to our research laboratory in Lexington, Kentucky; their sewer system design allowing for facility-specific sampling; and presence of SARS-CoV-2 infections. We selected 3 LTCFs in Lexington and 3 LTCFs in Louisville, Kentucky; each facility served 67–160 residents and had 76–117 staff. The University of Kentucky Institutional Review Board approved this study (IRB no. 62384).

Wastewater Collection

We collected 24-hour composite LTCF effluent wastewater samples 2–3 times/week at Louisville sites and 3–4 times/week at Lexington sites. We initiated wastewater sampling in both cities on March 19, 2021, and concluded wastewater collection on December 17, 2021, at the Louisville sites and on February 18, 2022, at the Lexington sites. We installed Teledyne ISCO GLS composite autosamplers ( https://www.teledyneisco.com/water-and-wastewater/gls-compact ) with 12V batteries in effluent sewer pipes via the manhole access closest to the LTCF. The autosamplers collected 100 mL of wastewater effluent every 20 minutes for 24 hours. Ice packed around the autosampler collection jug cooled the wastewater to a target temperature <4°C to minimize degradation of nucleic acids. After a 24-hour cycle of composite sampling, we transported 250 mL of the composite wastewater sample on ice to the laboratory for analysis and disposed of the remaining sample in the sewer.

Before initiating wastewater surveillance at one LTCF, we flushed RNA encoding for jellyfish-derived enhanced green fluorescent protein (eGFP) into a toilet and collected 5-minute fractionated wastewater samples to measure the durability of the RNA signal in the wastewater effluent. We used real-time PCR to measure eGFP RNA in the fractionated wastewater samples. We detected eGFP in the initial wastewater fraction collected 3 minutes after flushing and in most of the wastewater fractions (11/16) over the 2-hour collection window; those findings supported the use of a 20-minute sampling cadence.

Quantification of SARS-CoV-2 in Wastewater

We extracted RNA from wastewater samples on the same day as sample collection. To address the heterogeneous distribution of biologic material in wastewater, we analyzed 8 replicates of 250 μL from each wastewater sample. We used exclusion-based sample preparation (ESP) to extract nucleic acids from the wastewater replicates. We previously published a detailed description of this method for analysis of SARS-CoV-2 RNA in wastewater ( 12 ). In brief, we lysed samples and added paramagnetic particles (PMPs) (SeraSil-Mag; Cytiva, https://www.cytivalifesciences.com ). We vortexed the samples, heated them at 50°C for 20 minutes, and then tumbled them for 20 minutes. We loaded these samples into an ESP device (Extractman; Gilson, Inc., https://www.gilson.com ) with wash buffers and processed the replicates as previously described. We heated the purified PMP-RNA complexes for 20 minutes at 70°C to elute the RNA. We tracked RNA extraction efficiency using negative wastewater samples spiked with known concentrations of whole SARS-CoV-2 virus (BEI Resources, https://www.beiresources.org ).

We amplified and quantified ESP-purified RNA via real-time quantitative PCR using the CDC-recommended SARS-CoV-2 N1 gene primer and probe sequences ( 13 ). We used positive and negative controls with each PCR plate for quality assurance of the PCR process. For the positive control, we added SARS-CoV-2 RNA (BEI Resources) to the reaction. We calculated wastewater SARS-CoV-2 concentrations on the basis of quantification cycle (Cq) values and the Roche LightCycler 2nd derivative maximum algorithm ( https://diagnostics.roche.com ). We translated Cq values into SARS-CoV-2 genomic concentrations using a standard curve (r 2  = 0.985) constructed from serial dilutions of the BEI positive-control RNA. We reported wastewater SARS-CoV-2 values as the arithmetic average of 8 aliquots (or the number of aliquots with valid results) from a given sample in units of genome copies per milliliter of wastewater (gc/mL).

Clinical Testing

Clinical testing of LTCF staff and residents for SARS-CoV-2 occurred in accordance with LTCF policy and at the discretion of individual staff choosing to test outside the workplace. We received deidentified positive and negative clinical test results from staff and residents during the study period from the 6 facilities with wastewater testing. The LTCF organization used antigen-based point of care SARS-CoV-2 tests (Binax Now; Abbott, https://www.abbott.com ) for routine staff screening. Employees who sought SARS-CoV-2 testing outside of their employer’s testing program were required to report their test results to the LTCF organization.

Testing frequency of staff and residents followed federal and state guidance ( https://chfs.ky.gov/cv19/LTCFSurveillanceTestingFAQs.pdf ). In accordance with that guidance, LTCF-based clinical testing happened routinely for unvaccinated staff working onsite, for symptomatic residents and employees, and for all residents and staff after a positive test result in a resident or staff member at the facility. Frequency of testing asymptomatic unvaccinated staff depended on the level of SARS-CoV-2 transmission in the county in which the facility was located and varied from 2 times/week (high transmission) to weekly (substantial transmission) to monthly (moderate/low transmission) according to a color-coded map ( https://chfs.ky.gov/agencies/os/oig/dhc/Pages/cvltc.aspx ) based on CDC transmission risk criteria ( https://covid.cdc.gov/covid-data-tracker/#county-view ).

Data Analysis

We provide a descriptive summary of the wastewater RNA concentrations and clinical test data using counts, proportions, means, medians, and SDs. When a person had 2 consecutive SARS-CoV-2 positive clinical test results within 21 days of each other, we excluded the second test result from the final analytic dataset because it likely represented the same SARS-CoV-2 infection. We defined a cluster of cases when >1 LTCF resident from the same facility tested positive for SARS-CoV-2 within 14 days. To evaluate whether wastewater testing identified SARS-CoV-2 in LTCFs earlier than routine clinical screening, we conducted a lead/lag time correlational analysis. We estimated the correlation between the wastewater RNA concentration and the number of identified positive clinical SARS-CoV-2 infections at each LTCF and offset clinical testing data by 1‒7 days before and after the wastewater data collection date.

We estimated the SARS-CoV-2 wastewater contribution per known clinical case by dividing wastewater concentrations by the number of clinical cases to obtain an average wastewater viral concentration per clinical case. We used weekly averaged wastewater SARS-CoV-2 concentrations and total weekly clinical cases for this calculation to moderate differences in sampling and testing frequency between facilities. We excluded weeks when there were no clinical cases because this would result in dividing by 0.

We estimated the concentration of SARS-CoV-2 RNA in wastewater corresponding to > 1 clinically confirmed case at an LTCF by fitting a negative binomial regression model to the weekly average number of positive clinical tests ( Appendix ). During the model fitting procedure, we used the log-link function and the total number of LTCF residents as the exposure variable.We used the incidence density ratios for positive SARS-CoV-2 test results for each LTCF to estimate the incidence rate or probability of identifying a clinical case in an LTCF during the surveillance period based on the wastewater signal. We assumed that SARS-CoV-2 RNA detected in the wastewater during the surveillance day correlated with symptomatic or asymptomatic persons infected and shedding SARS-CoV-2 virus into the wastewater. We used weekly RNA wastewater averages because of the limited number of wastewater samples collected during the week.

Last, we evaluated the sensitivity and specificity of wastewater surveillance for detecting SARS-CoV-2 infections identified through clinical testing. We categorized wastewater samples categorized as either positive or negative using various SARS-CoV-2 RNA concentration threshold values (0–250 gc/mL). In our analysis, we defined clinical test positivity as a positive clinical test result observed during the 1-week window after each wastewater measurement at that facility. We constructed 2 × 2 contingency tables to allocate positive and negative wastewater and clinical testing results and calculated the sensitivity and specificity of wastewater testing at each wastewater SARS-CoV-2 RNA concentration threshold. The primary analysis used SARS-CoV-2 infections identified in staff and residents; a secondary analysis used only resident case data because staff may not defecate at work and they isolated at home following a positive test. We used SAS version 9.4 (SAS Institute Inc., https://www.sas.com ) for the statistical analyses.

Wastewater SARS-CoV-2 concentrations (genome copies/mL; blue line) and incident cases of positive clinical SARS-CoV-2 tests (red bars for residents, gray bars for staff) from 6 long-term care facilities (A‒F), Kentucky, USA, March 2021‒February 2022.

Figure 1 . Wastewater SARS-CoV-2 concentrations (genome copies/mL; blue line) and incident cases of positive clinical SARS-CoV-2 tests (red bars for residents, gray bars for staff) from 6 long-term care facilities (A‒F), Kentucky,...

During March 19, 2021–February 18, 2022, we collected and analyzed 780 composite wastewater samples from the 6 LTCFs (98–160 samples per facility ( Table 1 ). An additional 31 wastewater samples were collected but not processed due to reagent shortages (n = 21), processing delays following winter storms (n = 9), or contamination during laboratory extraction (n = 1). We identified SARS-CoV-2 RNA in 18%–27% of wastewater samples at each facility at levels of 0–1,726 gc/mL. The SARS-CoV-2 wastewater signal varied over time and across facilities ( Figure 1 ); positivity was greater during December 2022–January 2023, which also was when most of the positive SARS-CoV-2 clinical tests were reported from facilities A–C that had ongoing wastewater surveillance.

During the wastewater surveillance period, the LTCF organization reported the results of 16,905 COVID-19 tests from residents (n = 5,268) and staff (n = 11,637) at the 6 facilities ( Table 1 ). Residents had 42 (0.8%) positive tests and staff had 119 (1.0%) positive tests. In 4 instances, >1 LTCF resident from the same facility tested positive for SARS-CoV-2 within 14 days, which we designated as a cluster of cases. Clusters included 4–14 residents and lasted 13–47 days. Wastewater positivity varied in these clusters; 25%–75% of samples had measurable SARS-CoV-2 RNA ( Table 2 ).

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Figure 2 . Time shifted (−7 to +7 days) correlation between wastewater SARS-CoV-2 signal and positive SARS-CoV-2 clinical tests at 3 long-term care facilities with >20 positive clinical tests (facility A = 27, facility B = 58,...

The wastewater signal had a statistically significant correlation with clinical testing results. Facilities with <20 positive clinical tests showed poor correlation with the wastewater signal. However, at the 3 facilities with >20 known cases, we observed significant correlations across time shifts of the wastewater data from 7 days before to 6 days after clinical test dates ( Figure 2 ). The strongest correlations occurred with the wastewater signal shifted 1–6 days before the clinical test dates.

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Figure 3 . The probability of a positive SARS-CoV-2 clinical test by long-term care facility as a function of the average weekly wastewater SARS-CoV-2 concentration (genome copies/mL) at that facility, Kentucky, USA, March...

On average, each identified clinical case corresponded to a wastewater concentration of 26.9 gc/mL. Using a log-linear incidence density model, we estimated the wastewater concentration associated with a probability of > 0.5 clinically confirmed cases to 206–743 gc/mL ( Figure 3 ); the estimate at the 3 facilities with the largest number of clinically confirmed cases was 206–336 gc/mL.

Sensitivity and specificity of SARS-CoV-2 wastewater surveillance for identifying positive SARS-CoV-2 clinical tests as a function of the wastewater SARS-CoV-2 signal strength in 6 long-term care facilities, Kentucky, USA, March 2021‒February 2022. A) Staff and residents; B) residents only. Shaded areas indicate 95% CIs.

Figure 4 . Sensitivity and specificity of SARS-CoV-2 wastewater surveillance for identifying positive SARS-CoV-2 clinical tests as a function of the wastewater SARS-CoV-2 signal strength in 6 long-term care facilities, Kentucky, USA, March...

A positive wastewater SARS-CoV-2 signal (>0 gc/mL) was 30.6% (95% CI 24.4%–36.9%) sensitive and 79.7% (95% CI 76.4%–82.9%) specific in identifying a positive clinical test result when we included test data from staff and residents ( Figure 4 ). Wastewater sensitivity improved to 48.0% (95% CI 36.5%–59.4%) and specificity to 79.9% (95% CI 77.0%–82.9%) when we considered only clinical test data from residents. Higher wastewater signal thresholds resulted in lower sensitivity and higher specificity. A wastewater signal threshold of 30 gc/mL resulted in a sensitivity of 39.7% (95% CI 28.5%–51.0%) and specificity of 92% (95% CI 89.5%–93.6%) for identifying a LTCF resident with a positive SARS-CoV-2 test.

We collected and analyzed >700 wastewater samples for SARS-CoV-2 from 6 LTCFs during the second year of the COVID-19 pandemic. By pairing the wastewater data with clinical testing results from staff and residents at the 6 facilities, we evaluated the performance of wastewater surveillance for detecting clinical SARS-CoV-2 cases in this vulnerable population. Wastewater surveillance demonstrated statistically significant correlations with clinical test results, and the estimated correlation was stronger when considering the wastewater signal as leading clinical case identification; those findings suggest its potential as an early warning indicator of infection in a facility. Wastewater surveillance performance in discriminating the presence of a positive clinical SARS-CoV-2 test varied depending on the wastewater signal threshold selected and it demonstrated better specificity than sensitivity.

Several factors affected the performance of LTCF wastewater surveillance and challenged the interpretation of the wastewater data. The population that contributed to the wastewater at an LTCF was dynamic and difficult to track. Residents were admitted and discharged, staff turnover was frequent, staff worked across multiple facilities, residents were visited by family members and friends, and visitors passed through the facilities. The frequency with which staff, visitors, and residents contributed waste to the LTCF sewer system was not known. In addition, the sewer access at facility B was where the facility’s effluent sewage joined the sewage from an adjacent apartment complex. Facility B wastewater samples may have inadvertently included wastewater from persons living in or visiting the apartment complex, which is the likely reason for the high SARS-CoV-2 RNA concentrations measured in June 2021 in the absence of identified SARS-CoV-2 infections at the facility ( 14 ).

Negative wastewater samples observed at facilities with known SARS-CoV-2‒infected residents could be attributed to residents wearing adult briefs secondary to fecal incontinence. For example, during a cluster of 10 resident SARS-CoV-2 infections over 13 weeks ( Table 2 ), 3 of the residents were completely incontinent and wore adult briefs. The feces from those residents were disposed in biomedical waste receptacles rather than in the sewer system. Three other residents were partially incontinent. Feces from those residents also may not have entered the sewer system. Diversion of LTCF resident waste may reduce the sensitivity of wastewater surveillance in this setting.

Another likely cause of a negative wastewater signal in the presence of known infections is the variability with which SARS-CoV-2‒infected persons shed virus in their feces. Studies done early in the pandemic detected virus in stool samples of 29%–59% of persons with COVID-19 ( 15 – 17 ). The patients in those studies were hospitalized and presumably infected with nonvariant SARS-CoV-2 virus. Shedding frequency may differ in persons with milder or asymptomatic illness, of different ages, or infected with SARS-CoV-2 variants. In addition, it is unknown how vaccination status and previous SARS-CoV-2 infection affect fecal shedding. Viral shedding frequency, intensity, and duration may have outsized effects on building-level wastewater surveillance because of the small numbers of persons contributing to the wastewater.

To optimize our ability to detect SARS-CoV-2 in LTCF wastewater, we collected 24-hour composite samples using a 20-minute sampling cadence. As described in the Methods section, the results of our spiking experiment suggested that a 20-minute sampling cadence would capture RNA associated with a bowel movement flushed into the sewer system at an LTCF. Our sample collection schedule meant that we obtained wastewater samples from 37% of days in Louisville and 47% of days in Lexington during our surveillance period. Because an infected person shedding virus is likely to do so for many days, a sampling frequency of 3–4 days per week should detect the case-patients who shed virus into a facility’s wastewater system if they remain onsite during the duration of their illness.

Two additional properties of the wastewater samples may have affected our results. First, there were likely inhibitors (i.e., factors that degrade RNA, reduce PCR efficiency, or both) in the wastewater of the LTFCs because of laundry, kitchen, and janitorial activities. Detergents decreased the detectable signal of extracted RNA by ≈100-fold in 1 study ( 18 ), and detergents used by LTCF staff may have degraded RNA in the sewer system. We did not assess for the presence of specific inhibiting compounds and do not know how substantial their burden and effects were on our laboratory analyses. Second, wastewater is a highly heterogeneous matrix, and although we made reasonable efforts to homogenize wastewater samples (collecting composite samples, mixing composite sample before aliquoting sample for laboratory analysis, mixing laboratory sample before aliquoting for replicate analysis), variation in RT-PCR results across the 8 replicates from each composite sample suggests a heterogeneous distribution of SARS-CoV-2 virus within wastewater. Strike et al. demonstrated that our laboratory method combined with 8 replicates reliably detected SARS-CoV-2 RNA concentrations down to 100 gc/mL, and lower concentrations were observed after averaging zero and nonzero datapoints ( 12 ). In our study, many samples contained a mixture of positive and negative replicates. In those cases, positive replicates were averaged together with negative measurements (e.g., 0 gc/mL), often yielding average values <100 gc/mL.

We evaluated the performance of wastewater surveillance against the results of intermittent and incomplete clinical testing of LTCF staff and residents. Our LTCF partner implemented clinical testing strategies that aligned with state and federal COVID-19 guidance, which yielded pragmatic clinical testing data. Two limitations of the clinical testing protocols may have affected data quality and completeness. First, asymptomatic LTCF residents were not routinely tested; testing occurred when the resident had a known or suspected contact with a case-patient, such as a facility staff member who had tested positive. Similarly, vaccinated staff were not routinely screened. Untested but infected asymptomatic residents or vaccinated staff or a visitor to the facility may have caused a positive wastewater signal that was interpreted as a false positive, given the absence of known cases at the facility. This scenario would decrease the estimated specificity of wastewater surveillance. The second limitation was the LTCF organization’s use of rapid antigen-based SARS-CoV-2 tests for screening staff and residents. The poor sensitivity of antigen-based tests, particularly in asymptomatic persons (58% by a Cochrane meta-analysis [ 19 ]), likely resulted in some false-negative clinical screening tests, which would decrease the estimated specificity of wastewater surveillance.

Our study adds to the sparse literature on SARS-CoV-2 wastewater surveillance at LTCFs. A team in Italy surveilled wastewater from 5 LTCFs for several months at the end of 2020 and intermittently detected SARS-CoV-2 RNA in the wastewater of 4 of the facilities ( 20 ). As in our study, the presence of residents with identified COVID-19 infection only intermittently resulted in a positive wastewater signal. Researchers in Spain consistently detected SARS-CoV-2 in the wastewater effluent from an elderly residence when there were known clinical cases in the building; however, the number of known cases in a week was typically >10 ( 21 ). An alternative environmental surveillance approach in Canada using analysis of floor swab samples for SARS-CoV-2 demonstrated good discriminatory ability to identify COVID-19 outbreaks LTCFs ( 22 ).

In summary, we found that wastewater surveillance for SARS-CoV-2 performed moderately well when compared with clinical testing. Our correlational analysis indicated that a SARS-CoV-2 wastewater signal may precede the identification of clinical cases at LTCFs, which suggests that such testing could provide an early warning to trigger enhanced clinical testing or infection prevention activities, such as physical distancing. Optimizing wastewater collection and analysis methods may improve surveillance performance; however, viral and contextual factors such as fecal shedding rates, PCR inhibitors in the LTCF wastewater, and use of adult briefs likely limit wastewater surveillance performance in this setting. Improved understanding of the many potential contributors to wastewater signal variability will enhance the interpretation of this emerging surveillance strategy, which can augment traditional infection detection and prevention activities in vulnerable LTCF populations.

Dr. Keck was faculty in the department of family and community medicine at the University of Kentucky during this study and is now based in Alaska at the Alaska Native Tribal Health Consortium and University of Alaska Anchorage. His primary research interest is environmental disease surveillance, to protect the health of vulnerable, remote, and rural communities.

Acknowledgments

This work was funded by the Centers for Disease Control and Prevention (contract BAA 75D301-20-R-68024).

S.B. has an ownership interest in Salus Discovery, LLC, which has licensed the ESP technology described in the text.

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  • Figure 1 . Wastewater SARS-CoV-2 concentrations (genome copies/mL; blue line) and incident cases of positive clinical SARS-CoV-2 tests (red bars for residents, gray bars for staff) from 6 long-term care facilities (A‒F),...
  • Figure 2 . Time shifted (−7 to +7 days) correlation between wastewater SARS-CoV-2 signal and positive SARS-CoV-2 clinical tests at 3 long-term care facilities with >20 positive clinical tests (facility A = 27, facility...
  • Figure 3 . The probability of a positive SARS-CoV-2 clinical test by long-term care facility as a function of the average weekly wastewater SARS-CoV-2 concentration (genome copies/mL) at that facility, Kentucky, USA,...
  • Figure 4 . Sensitivity and specificity of SARS-CoV-2 wastewater surveillance for identifying positive SARS-CoV-2 clinical tests as a function of the wastewater SARS-CoV-2 signal strength in 6 long-term care facilities, Kentucky, USA,...
  • Table 1 . Characteristics of clinical and wastewater testing for SARS-CoV-2 at 6 long-term care facilities, Kentucky, USA, 2021–2022
  • Table 2 . SARS-CoV-2 case clusters and associated wastewater signal characteristics at 4 long-term care facilities, Kentucky, USA, 2021–2022

Suggested citation for this article : Keck JW, Adatorwovor R, Liversedge M, Mijotavich B, Olsson C, Strike WD, et al. Wastewater surveillance for identifying SARS-CoV-2 infections in long-term care facilities, Kentucky, USA, 2021–2022. Emerg Infect Dis. 2024 Mar [ date cited ]. https://doi.org/10.3201/eid3003.230888

DOI: 10.3201/eid3003.230888

Original Publication Date: February 12, 2024

1 Current affiliation: WWAMI School of Medical Education, University of Alaska Anchorage, Anchorage, Alaska, USA.

2 Current affiliation: College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.

Table of Contents – Volume 30, Number 3—March 2024

Please use the form below to submit correspondence to the authors or contact them at the following address:

James W. Keck, WWAMI School of Medical Education, University of Alaska Anchorage, 3900 Ambassador Dr, Ste 201, Anchorage, AK 99508, USA

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    This website and the information contained herein is intended for use by residents of the United States. ADC-29111 v24.0. Contact our customer care team to help answer your questions about your FreeStyle Libre portfolio product, including sensor support. Available 7 days a week 8 AM to 8 PM Eastern Time; excluding holidays.

  4. Three Customer Service

    Business customers. Three has a team of customer service agents dedicated to helping business customers. All Business customers. 337. from a Three phone. 0 333 033 8003. from any phone. +44 7782 333 333. from abroad.

  5. Contact Us: Customer Service & FAQs

    Long Term Care Insurance; Term Life Insurance; Universal Life Insurance; Variable Life Insurance; ... What is the contact number for questions about my existing mortgage loan such as payment, monthly statement, or escrow questions? ... Customer Service Call Center. 1-800-972-3030. Mon.-Fri, 8 a.m.-6 p.m. ET Sat., 10 a.m.-4 p.m. ET

  6. Three Contact Number: How To Contact Three in Ireland

    Three Customer Care Contact Methods; Contact Type. Three Contact Number. Availability. Existing Customer. 1913 (Freephone) Monday to Friday 8am-8pm, Saturday and Sunday 9am-6pm, Bank Holidays 9.30am-6pm. Calling from Abroad +35383 333 3333.

  7. Contact Us

    Please don't provide any of your credit card information with your email. If your question is related to billing, call us directly at 800-733-6632 and Customer Service will be happy to help you. *Required Fields. Department*. First Name*. Last Name*. Mobile Phone*. Home Phone. Email Address*.

  8. Chat With Our Teams To Get Your Problem Solved

    Manage your account from anywhere with My3 App. Our Chat agents are here to support seven days a week from 7am to midnight and our Three Support Bot is available 24/7.

  9. Contact Us

    Contact Options. Does Customer Support have a phone number? ... Skip to main content

  10. Kilimall Help Center

    To contact Kilimall customer care service, you can reach us through the following main methods. Our support is available from Monday to Friday, 8:30 AM to 5:30 PM, and on Saturday from 8:30 AM to 12:30 PM. 1. Kilimall Kenya Customer care number:

  11. Three Customer Service Contact Number: 333 or 0333 338 1001 (Not 3 #)

    Customer care inquiries 0330 686 8000. Sales team service 0800 033 8009. Buying from 3 mobile contact outside UK 0778 233 3333. Sales inquiries contact 0800 033 8001. Mobile broadband account inquiries UK 0333 338 1003. Mobile broadband account inquiries outside UK 0778 233 3500. Top up contact 0800 033 8002. Media contact 0745 495 9715.

  12. Contact Us

    You can contact Customer Care for assistance from 7 a.m. to 6 p.m. E.T. Monday through Friday and from 7 a.m. to 3 p.m. E.T. on weekends and U.S. holidays. Still need help? Chat with Us or call us at +1 855-698-1157

  13. Support

    The Three app. Manage your account wherever, whenever. Check your bills, track your usage, top up, check when you can upgrade, and more. If you've got questions, we're here to answer them. Read through our Support categories, get advice on using your specific device or try our Troubleshooter if you get stuck.

  14. How to Contact Amazon: Phone Numbers, Chat Features, & More

    Dial this number at any time to call Amazon and speak to a customer service representative and get your issue resolved. If you're outside the U.S, call 1-206-266-0927. Amazon also has a few phone numbers specific to various departments and categories, including: Audible: 1-888-283-5051. Accessibility: 1-888-283-1678.

  15. Contact Us

    Purchasing at T-Mobile. Consumer Sales: 1-800- T-MOBILE. For T-Mobile For Business: 1-855-478-2195. General Customer Care & Technical Support. From the T-Mobile app, on a T-Mobile phone. From your T-Mobile phone: 611. Call: 1-800-937-8997. If you are calling about a technical issue with your T-Mobile service, please call from a different phone ...

  16. Contact Us

    Need PC support or help with data center, mobile & smart devices? Contact Lenovo Support for options on Lena Chat, YouTube support, Troubleshoot & Diagnose and more!

  17. Contact Us

    By Phone: If you have product or service questions, you may contact customer service at 800-785-5991 during these hours: Monday - Friday: 8:00 a.m. - 5:00 p.m. You can report your stolen or lost Debit card during business hours at 800-785-5991. You can report your stolen or lost Debit card After business hours at 800-417-8715.

  18. Help & Contact Us

    Visit the Amazon Customer Service site to find answers to common problems, use online chat, or call customer service phone number at 1-888-280-4331 for support. ... You can quickly take care of most things here, or connect with us when needed. A delivery, order or return.

  19. Call Capital One Customer Service

    Credit card customer service. For servicing of existing accounts only . 1-800-CAPITAL (227-4825) Credit card outside the US, call collect. 1-804-934-2001. ... write your Capital One credit card account number on your check. Capital One Attn: Payment Processing PO Box 71083 Charlotte, NC 28272-1083. Overnight payments*: Capital One Attn: Payment ...

  20. Contact Us

    More support options. Open a service request in the Microsoft 365 admin center. This service is free. Get help and support, whether you're shopping now or need help with a past purchase. Contact Microsoft Support. Find solutions to common problems, or get help from a support agent.

  21. Cricut Contact Information

    Our Member Care team is available via phone and chat to assist you. We also have a chatbot to help with frequently asked questions. Hours... Top. Help Center; ... Phone Number: Hours of Operation: Days of Operation: USA: 877 727 4288: 9:00 am - 8:00 pm EST: Monday - Saturday: Canada: 877 727 4288: 9:00 - 20:00 EST: Monday - Saturday: Brazil:

  22. Contact Us

    Call, chat, or visit a nearby store to talk to our customer support team for your wireless & home services and devices. We are here to help. Search for answers on our support pages and within our knowledge base. Need to talk to a representative? Try here for Sales: 1.800.225.5499 For Customer Service: 1.800.922.0204. Verizon Fios: 1.800.VERIZON, and Verizon Prepaid: 1.888.294.6804

  23. Nike Customer Service. Nike.com

    Nike Customer Service. Become a Nike Member for the best products, inspiration and stories in sport.

  24. Governor Hochul Announces New Law to Clarify Disclosure of Credit Card

    A convenience fee, service fee, administration fee, non-cash adjustment, technology fee, processing fee, etc., is charged to credit card users and added as a separate line item on a customer receipt. The price tag of an item shows "$10.00, + 4 percent if paying with a credit card." NOTE: This law does not apply to debit cards.

  25. The Human Element: How To Personalize Customer Interactions

    2. Give back when you can. Adding a human touch to your business requires more than adding a customer's name to your marketing emails. I believe a business is only truly human if it improves the ...

  26. Early Release

    Volume 30, Number 3—March 2024 Research Wastewater Surveillance for Identifying SARS-CoV-2 Infections in Long-Term Care Facilities, Kentucky, USA, 2021-2022 ... correlation between wastewater SARS-CoV-2 signal and positive SARS-CoV-2 clinical tests at 3 long-term care facilities with >20 positive clinical tests (facility A = 27, facility B ...