I am deeply concerned about the loss of funding for Ontario’s Wastewater Surveillance Initiative. Please commit to funding Ottawa’s daily wastewater tool, with no gap after the expiry of the temporary funding. Ottawa’s residents and hospitals need continued access to timely data, with 7-day sampling and 5-day reporting.

As noted by delegates during the Ottawa Board of Health meeting on June 17, 2024, the daily wastewater monitoring program is an essential public health tool that merits continued funding. The estimated cost is only $370,000 annually. The popular public-facing health data tool is the leading metric for the assessment of viral infections. Ottawa’s wastewater surveillance program is a vital early warning system for SARS-CoV-2, influenza and RSV, as well as emerging health threats such as mpox and avian flu.

CHEO uses daily wastewater data to time public health interventions that keep vulnerable kids out of emergency rooms. Preventing infections results in substantial savings of hospital resources, and reduced demand for contact tracing. In Ontario, daily wastewater surveillance has enabled the optimization of public health interventions for RSV, preventing 295 children from being hospitalized and 950 medically attended hospital visits, saving the province $3.5 million.[1]

Some have claimed that the Public Health Agency of Canada (PHAC) could replace Ottawa’s daily monitoring, if it were to set up a wastewater surveillance site in Ottawa. However, the reality is that there are significant lags in the reporting of PHAC’s data. PHAC’s tool is designed for the analysis of historical trends – not daily risk assessments. One-month-old data would be inadequate for the risk assessment needs of Ottawa’s residents and hospitals. People with disabilities, the immunocompromised, and other equity-denied groups rely on daily wastewater data to time more risky activities such as medical and dental appointments, in facilities where universal masking has been dropped. It is also important to note that the scope of PHAC’s monitoring is limited – it does not track all the viruses monitored by the local research team. After adding new sites, PHAC’s network will cover only five cities in Ontario, compared to the Ontario Wastewater Initiative’s network of 58+ stations in 34 public health units.

I understand that the Ottawa Board of Health passed a motion on June 17, 2024, supporting efforts to secure funding from PHAC for local researchers at the University of Ottawa. If funding to continue the existing daily wastewater surveillance is not available from PHAC, the City of Ottawa should show leadership by continuing the program that many Ottawans depend on. The cost of maintaining the program is insignificant compared to the substantial savings associated with preventing infections and hospitalizations. Please follow the example of Peterborough. The Peterborough Board of Health has recognized the value of near real-time wastewater surveillance data for SARS-CoV-2, influenza, RSV, mpox and other viruses, and it has committed to funding the work of researchers at Trent University.[2]

Given that PHAC’s data reporting is inadequate for our needs, please commit to funding Ottawa’s daily wastewater monitoring, so that it can continue with its current team of experienced researchers. Please act now to ensure that Ottawa’s daily wastewater surveillance program continues without interruption. I look forward to your reply.

Notes: [1] Payne, Elizabeth. “‘I was shocked’: Ontario to cancel widely used wastewater surveillance program.” Ottawa Citizen, June 4, 2024. https://ottawacitizen.com/news/local-news/ontarios-groundbreaking-wastewater-testing-program-will-be-replaced-by-a-significantly-smaller-federal-program [2] Davis, Greg. “Peterborough health unit offers to cover wastewater surveillance costs after Ontario ends program.” Global News, June 14, 2024. https://globalnews.ca/news/10566687/peterborough-health-unit-wastewater-surveillance-costs-ontario-ends-program/

I am deeply concerned about the loss of funding for Ontario’s Wastewater Surveillance Initiative. Please commit to funding London’s wastewater monitoring, with no gap after the expiry of the temporary funding. Wastewater monitoring is an essential public health tool that provides insights into the spread of SARS-CoV-2 and other viruses in our communities.

I urge you to collaborate with local researchers at Western University, and provide permanent funding for wastewater monitoring in London. Please follow the example of Peterborough. The Peterborough Board of Health has recognized the value of near real-time wastewater surveillance data for SARS-CoV-2, influenza, avian flu, respiratory syncytial virus (RSV), mpox and other viruses, and it has committed to funding the work of researchers at Trent University. “This is not just about COVID-19. This a pandemic preparedness tool,” said Dr. Thomas Piggott, Peterborough’s medical officer of health.[1]

The Ontario government has claimed that the Public Health Agency of Canada (PHAC) will provide an expanded network to replace existing local monitoring. In reality, there are significant lags in the reporting of PHAC’s data, and the scope of the monitoring is very limited. After adding new sites, PHAC’s network will cover only five cities in Ontario, compared to the now-defunct Ontario Wastewater Initiative’s network of 58+ stations in 34 public health units.

PHAC’s network is designed for the analysis of historical trends – not daily risk assessments. Unlike London’s existing wastewater monitoring program, it does not provide near real-time data. Data reporting could be delayed by as much as a month. People with disabilities, the immunocompromised, and other equity-denied groups rely on daily wastewater data to time more risky activities such as medical and dental appointments, in facilities where universal masking has been dropped.

It is also important to recognize that the SARS-CoV-2 pandemic is not over. The virus is constantly evolving, and we need to maintain and expand our capacity to track waves of new subvariants of SARS-CoV-2. Unlike a common cold, SARS-CoV-2 can attack organs throughout the body. Contracting COVID-19 is associated with risks for developing long COVID, brain damage, strokes, heart failure, extreme fatigue, diabetes, an impaired immune system, and many other health issues.[2] With repeat infections, the risk of developing long COVID increases substantially.[3] An estimated 400 million people worldwide have had long COVID so far — leading to economic losses of $1 trillion USD annually.[4]

The City of London should show leadership by providing permanent funding for year-round, near real-time wastewater surveillance by London’s wastewater scientists. The cost of maintaining the program is insignificant compared to the substantial savings associated with preventing infections and hospitalizations. In Ontario, daily wastewater surveillance of RSV can be used to optimize public health interventions for vulnerable children, preventing 249 hospitalizations and 950 medically attended hospital visits per year. This results in savings of $13.7–16.6 million in healthcare costs over three years.[5]

Please act now to ensure that London’s wastewater monitoring continues with stable, permanent funding for local researchers. Wastewater surveillance is an essential tool in the public health toolbox. Monitoring for SARS-CoV-2, influenza, avian flu, RSV, mpox and other viruses helps decision-makers and the general public make choices informed by science.

Notes:

[1] Davis G. Peterborough health unit offers to cover wastewater surveillance costs after Ontario ends program. Global News. June 14, 2024. https://globalnews.ca/news/10566687/peterborough-health-unit-wastewater-surveillance-costs-ontario-ends-program/. Published June 14, 2024. [2] Davis HE, McCorkell L, Vogel JM, Topol EJ. Long COVID: major findings, mechanisms and recommendations [published correction appears in Nat Rev Microbiol. 2023 Jun;21(6):408. doi: 10.1038/s41579-023-00896-0]. Nat Rev Microbiol. 2023;21(3):133-146. doi:10.1038/s41579-022-00846-2 [3] Kuang, Sianne, Steven Earl, Janine Clark, Dianne Zakaria, Alain Demers and Samina Aziz. 2023. “Experiences of Canadians with long-term symptoms following COVID-19”. Insights on Canadian Society. December. Statistics Canada Catalogue no. 75-006-X. https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00015-eng.htm [4] Al-Aly Z, Davis H, McCorkell L, et al. Long COVID science, research and policy. Nat Med. 2024;30(8):2148-2164. doi:10.1038/s41591-024-03173-6 [5] Thampi N, Mercier E, Paes B, Edwards JO, Rodgers-Gray B, Delatolla R. Perspective: the potential of wastewater-based surveillance as an economically feasible game changer in reducing the global burden of pediatric respiratory syncytial virus infection. Front Public Health. 2024;11:1316531. Published 2024 Jan 12. doi:10.3389/fpubh.2023.1316531

Cc:

Mayor Josh Morgan; Dr. Alexander Summers, Medical Officer of Health; Dr. Joanne Kearon, Associate Medical Officer of Health; Peggy Sattler, MPP London West.

Wastewater monitoring is an essential public health tool that provides insights into the spread of SARS-CoV-2 and other viruses in Ontario’s communities. Unfortunately the Ontario government has cut funding for Ontario’s Wastewater Surveillance Initiative, effective July 31. Without funding, we will lose important information about the prevalence of SARS-CoV-2, influenza, respiratory syncytial virus (RSV), mpox and emerging health threats such as avian flu.

Researchers in Waterloo Region have helped pioneer the development of wastewater monitoring. I urge you to collaborate with local researchers and the University of Waterloo, and provide continued funding for wastewater monitoring in Waterloo Region, if funding is not available from the provincial or federal governments. Please follow the example of Peterborough. The Peterborough Board of Health has recognized the value of near real-time wastewater surveillance data for SARS-CoV-2, influenza, RSV, mpox and other viruses, and it has committed to funding the work of researchers at Trent University.[1]

The Ontario government has claimed that the Public Health Agency (PHAC) will provide an expanded network to replace existing local monitoring. In reality, there are significant lags in the reporting of PHAC’s data, and the scope of the monitoring is very limited – it does not track levels of influenza, RSV, mpox and other viruses. After adding new sites, PHAC’s network will cover only five cities in Ontario, compared to the Ontario Wastewater Initiative’s network of 58+ stations in 34 public health units.

PHAC’s tool is designed for the analysis of historical trends – not daily risk assessments. Unlike Ontario’s existing local monitoring programs, it does not provide near real-time data. People with disabilities, the immunocompromised, and other equity-denied groups rely on daily wastewater data to time more risky activities such as medical and dental appointments, in facilities where universal masking has been dropped.

It is also important to recognize that the SARS-CoV-2 pandemic is not over. The virus is constantly evolving, and we need to maintain and expand our capacity to track waves of new subvariants of SARS-CoV-2. Unlike a common cold, SARS-CoV-2 can attack organs throughout the body. Contracting COVID-19 is associated with risks for developing long COVID, brain damage, strokes, heart failure, extreme fatigue, diabetes, an impaired immune system, and many other health issues. With repeat infections, the risk of developing long COVID increases substantially.

I understand that Regional Council passed a motion on June 19, 2024, to “advocate to the federal government for the Region of Waterloo to be included as a sampling site in the federal wastewater surveillance program.”[2] At this point, it is unknown whether or not PHAC would support the experienced team of researchers at the University of Waterloo. Please advocate for continued provincial coordination and support of wastewater surveillance across Ontario, including the Region of Waterloo, or federal support for local wastewater surveillance. If funding is not available from the province or PHAC, Waterloo Region should show leadership by providing permanent funding for year-round, near real-time wastewater surveillance by the University of Waterloo’s wastewater scientists.

The cost of maintaining the program is insignificant compared to the substantial savings associated with preventing infections and hospitalizations. An example of how the data can be used to prevent hospitalizations: in Ontario, daily wastewater surveillance has enabled the optimization of public health interventions for RSV, preventing 295 children from being hospitalized and 950 medically attended hospital visits, saving the province $3.5 million.[3] Preventing infections results in substantial savings of hospital resources, and reduced demand for contact tracing.

Please act now to ensure that Waterloo Region’s wastewater monitoring continues with stable, permanent funding for researchers at the University of Waterloo. In the four years since the start of the pandemic, Ontario’s researchers have pioneered the development of a world-class wastewater surveillance system. We should support their efforts. Wastewater surveillance is an essential tool in the public health toolbox. Monitoring for SARS-CoV-2, influenza, RSV, mpox, avian flu and other viruses helps decision-makers and the general public make choices informed by science.

Notes:

[1] Davis, Greg. “Peterborough health unit offers to cover wastewater surveillance costs after Ontario ends program.” Global News, June 14, 2024. https://globalnews.ca/news/10566687/peterborough-health-unit-wastewater-surveillance-costs-ontario-ends-program/ [2] Council Addendum Agenda, Motion 16.4. Regional Municipality of Waterloo, June 19, 2024. https://pub-regionofwaterloo.escribemeetings.com/Meeting.aspx?Id=ac97693b-356e-4ab1-aa72-1ad47d3fea97&Agenda=Merged&lang=English [3] Payne, Elizabeth. “‘I was shocked’: Ontario to cancel widely used wastewater surveillance program.” Ottawa Citizen, June 4, 2024. https://ottawacitizen.com/news/local-news/ontarios-groundbreaking-wastewater-testing-program-will-be-replaced-by-a-significantly-smaller-federal-program

Cc:

Catherine Fife, MPP Waterloo; Aislinn Clancy, MPP Kitchener Centre; Mike Morrice, MP Kitchener Centre; Jess Dixon, MPP Kitchener South-Hespeler; Brian Riddell, MPP Cambridge; Valerie Bradford, MP Kitchener South-Hespeler; Brian May, MP Cambridge; Bardish Chagger, MP Waterloo.