Wastewater, a mirror of our health – Quebec Science

Monitoring of SARS-CoV-2 in wastewater in Quebec was abandoned at the end of 2021, and started again. An overview of the capabilities of this monitoring tool for COVID-19 and other diseases.

The research project made it possible for CentrEau, Quebec’s Center for Research on Water Management, to follow the development of SARS-CoV-2 infection in wastewater in a few cities across Quebec in 2021. This method detects the virus in the stool of patients, even those without They show symptoms. But due to a lack of funding, the project ended in December 2021. We told you so in this column signed by Jean-François Klitsch: SARS-CoV-2 in Wastewater: The Missed Opportunity.

However, monitoring resumed a few weeks ago. In fact, on February 24, the Quebec government announced that the National Institute of Public Health of Quebec (INSPQ) was in the process of setting up a surveillance program to detect the COVID-19 virus in wastewater by collaborating with CentrEau scientists. The INSPQ program targets the waters of the cities of Quebec, Laval, Montreal and Gatineau. According to the Notification of Intent, the program will be extended to 16 municipalities by August 15. The first sewage samples were collected at the end of March, according to Aurèle Iberto-Mazzali, an INSPQ spokesperson. It was then sent for analysis to the CentrEau lab at McGill University.

For now, the data is not yet available on the INPSQ website, but Peter Vanrollgem, a water engineering researcher at Laval University and director of CentrEau, is sure that the follow-up will be posted online in the fall, the time of year when a spike in infections is expected. This technology is used to make up for the lack of data on COVID-19 since it is increasingly difficult to know the true rate of infection, with the majority of screening tests now being done at home.

The picture of the past few months will become clearer, since the data has been analyzed since the beginning of sampling, that is, since mid-March. “But it’s important that you do it right. Hence the delay between starting sampling and publishing the results. Plus, if there’s a new infectious variant somewhere, we’ll be able to detect its arrival through wastewater,” he says.

Points of strength and weakness

For Peter Vanrolleghem, the pandemic has clearly highlighted the full potential of wastewater to track COVID-19. It has become an important source of information for pandemic management. Last year, Europe introduced a directive that requires EU member states to implement an epidemiology system using wastewater,” says the researcher at CentrEau.

Wastewater monitoring networks are also regulated in the United States. The Centers for Disease Control and Prevention has surveillance of about 100 sites across the country, covering at least 100 million Americans. Cities like Houston monitor SARS-CoV-2 and its variants, and also take the opportunity to display data on influenza A and B and its infection trends by neighborhood on their dashboards. Therefore, wastewater has the potential to reflect the overall health of the urban population.

Because waste water does not lie. Everything we consume ends up in the toilet one day or another. This water reflects the consumption habits of the population: drugs, alcohol, antibiotics, medicines, etc. Their analysis over the years has shown that they are also an interesting epidemiological tool for detecting the presence of diseases such as polio and, most recently, COVID-19.

Peter Vanrolleghem also points out that this method of monitoring is inexpensive. “It really costs nothing. A city can get SARS-CoV-2 tracking for $500 a day.”

On the other hand, the detection of SARS-CoV-2 by wastewater does not establish an individual diagnosis, but it applies to an entire population. It can also be used to focus on a specific living environment. “By detecting the virus in CHSLD wastewater, we can then test and isolate the population to protect others who have not been infected,” says Peter Vanrolleghem, for example. This follow-up was performed in the McGill University residences.

As Dr. Caroline Hoot, a specialist in public health and preventive medicine at INSPQ, explained during a presentation at the Acfas conference, “The data obtained thanks to wastewater, combined with data from clinical cases, allow us to see trends and variables for the virus and determine what If there is an emergence or re-emergence of the virus in a population.This early detection of disease, even before the virus causes hospitalization, can influence public health decisions.However, it appears difficult to detect low incidences of infection with this tool.

Because testing wastewater for SARS-CoV-2 tracers is new, some of the steps are not yet standardized. Moreover, the results obtained in one city cannot be compared with another because the sewage networks are different, as is the case for the population.

In any case, Peter Vanrolleghem hopes that one day we can use “wastewater weather,” that is, using data from the software and mathematical models to predict the following pandemics: a new strain of influenza, a new drug, a mental health crisis due to the exacerbation of stress after a hurricane has passed. Then we will be able to respond quickly. So the future looks promising.

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