A new report from the Royal Society of Canada (RSC) makes a series of recommendations based on expert analysis and lessons learned from wastewater surveillance during the COVID-19 pandemic.
The report views wastewater surveillance as an objective and independent window that provided a valuable dataset on the persistence of COVID-19 infection as indicated by virus-shedding in the population through faeces.
The pandemic had caused some 6.4 million deaths worldwide, as of the end of July 2022.
One of the keys that made wastewater surveillance of SARS-CoV-2 RNA effective, the RSC found, was the level of collaboration among public health agencies, local wastewater treatment plant operators, and academic research laboratories.
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“Many public health officials were initially skeptical about whether or not actionable information could be provided by wastewater surveillance for SARS-CoV-2,” states the RSC report. “However, previous experience has shown that public health surveillance for a pandemic has no single, perfect, all-purpose tool to characterize all the important features of what is happening in a timely manner,” the report adds.
Ultimately, organizations such as the Public Health Agency of Canada, the World Health Organization, as well as the European Commission and the U.S. Centers for Disease Control and Prevention, recognized wastewater surveillance as an important tool in the pandemic.
The wastewater surveillance option also provided a much less expensive option on a per capita basis than other testing methods, the report states, particularly as clinical testing was overwhelmed in the face of variants such as Omicron.
Although initial emphasis was on monitoring at WWTPs serving large communities, researchers successfully monitored sewers directly serving priority locations such as long-term care facilities, hospitals, university residences, as well as industrial and correctional facilities.
Wastewater surveillance was also useful in capturing signals from asymptomatic individuals, the report states.
In April 2020, RSC established a task force to equip Canadians with accurate information about the country’s response and recovery to COVID-19.
Some of the key recommendations made in the report include the need to create structures and capacity to sustain capability and develop rapid response to future public health threats, as well as to build upon existing infrastructure and programs.
In addition to designing frameworks for surveillance programs, the report also recommends new frameworks for interpretation of the data. Maintaining and promoting academic partnerships and communication networks that will help identify new opportunities and threats is also considered a priority.