Early identification of a COVID-19 outbreak detected by wastewater surveillance at a large homeless shelter in Toronto, Ontario
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Published:2022-09-26
Issue:1
Volume:114
Page:72-79
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ISSN:0008-4263
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Container-title:Canadian Journal of Public Health
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language:en
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Short-container-title:Can J Public Health
Author:
Akingbola Samantha, Fernandes Reisha, Borden Susan, Gilbride Kimberley, Oswald Claire, Straus Sharon, Tehrani Amir, Thomas Janis, Stuart RebeccaORCID
Abstract
Abstract
Setting
Toronto (Ontario, Canada) is a large urban centre with a significant population of underhoused residents and several dozen shelters for this population with known medical and social vulnerabilities. A sizeable men’s homeless shelter piloted a facility-level SARS-CoV-2 wastewater surveillance program.
Intervention
Wastewater surveillance was initiated at the shelter in January 2021. One-hour composite wastewater samples were collected twice weekly from a terminal sanitary clean-out pipe. The genetic material of the SARS-CoV-2 virus was extracted from the solid phase of each sample and analyzed using real-time qPCR to estimate the viral level. Wastewater results were reported to facility managers and Toronto Public Health within 4 days.
Outcomes
There were 169 clients on-site at the time of the investigation. Wastewater surveillance alerted to the presence of COVID-19 activity at the site, prior to clinical detection. This notification acted as an early warning signal, which allowed for timely symptom screening and case finding for shelter managers and the local health unit, in preparation for the declaration of an outbreak.
Implications
Wastewater surveillance acted as an advanced notification leading to the timely deployment of enhanced testing prior to clinical presentation in a population with known vulnerabilities. Wastewater surveillance at the facility level is beneficial, particularly in high-risk congregate living settings such as shelters that house transient populations where clinical testing and vaccination can be challenging. Open communication, established individual facility response plans, and a balanced threshold for action are essential to an effective wastewater surveillance program.
Funder
MECP PHAC PHAC COVID Immunity Task Force
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health,General Medicine
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