OTTAWA — As Canada continues to struggle to keep up with the level of COVID-19 tests needed to fend off a potential second wave of the viral disease, researchers say the best early warning system for a second wave could be right beneath our feet — in the sewers.
Several other countries have taken to testing wastewater for signs of the novel coronavirus as an indication of flare-ups in their communities.
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Now researchers are beginning to look at the option in Canada.
Given that some people can pass the virus on without even knowing they have it, health officials say testing large portions of the population will be key to detecting and quashing any new community spread of COVID-19.
Several provinces have struggled to keep up with the volume of tests needed to do that, particularly in Ontario and Quebec where rates of infection remain high.
But the virus isn’t only detected in the back of people’s throats. It’s also found in waste. And while not everyone will get tested for COVID-19, most everyone uses the toilet.
“This is a tool that can actually provide an early alert to our public health in regards to re-emergence of infectivity in communities,” said Mike McKay, the executive director of the Great Lakes Institute for Environmental Research at the University of Windsor.
His research group is one of several across the country looking at whether sampling sewage could be a viable way to alert public health officials to new outbreaks.
Initially, he said researchers were excited about the possibility that measuring the amount of virus found in the pipes could provide some sense of the number of cases in a community.
But not enough is known about how much of the virus is shed in people’s waste to be able to draw many conclusions yet.
Instead, researchers hope they’ll be able to detect whether the viral load has gone up or down, allowing researchers to flag sudden spikes to public health who will be able to focus their efforts accordingly.
“If it does that, that means it’s saving lives,” said Bernadette Conant, CEO of the Canadian Water Network.
The network is in the early stages of trying to co-ordinate a pilot project in Canadian cities, including Ottawa, Windsor, Montreal and Edmonton, to develop an effective method and determine whether wastewater tests could have the public health applications they hope for.
The ultimate goal, as the technique evolves, is to use the method to root out new outbreaks in certain neighbourhoods, or even specific buildings, like long-term care homes.
That would allow public health authorities to tailor testing, lockdowns or other containment measures to that area.
“This is not a silver bullet and it’s not about replacing the basic testing and contact tracing surveillance,” Conant said. “What it does is offer the potential to fill a gap.”
The idea was tried in the Netherlands and France in the early days of the epidemic, and according to non-peer reviewed studies, both were able to detect traces of the virus in wastewater before widespread outbreaks were confirmed in those countries.
Several states in the U.S., as well as Australia and Israel, have also looked to the sewers to for signs of the virus.
It’s not a totally foreign concept in Canada either. Last year, Statistics Canada released a report on its use of wastewater samples to detect signs of increased drug use.
Accurate information about societal use of drugs, particularly from illegal sources, is difficult to get, the authors explained. So they ran a pilot project to see if sewer systems could give them a better picture.
There were limitations to what the data could tell them, but they said the advantage was the low cost, timeliness and the ability to monitor change over time at the city level — which is what researchers hope to achieve with COVID-19 tests.
Edmonton’s water utility company, Epcor, said in a statement that workers already take regular wastewater samples, so the effort and risk in gathering extra samples for testing is minimal.
As for creating a national sewage surveillance system in Canada, Conant said public health officials are beginning to show an interest but logistics, including lab capability and capacity, would still need to be worked out.
This report by The Canadian Press was first published May 22, 2020.
Some Ontario doctors have started offering a free shot that can protect babies from respiratory syncytial virus while Quebec will begin its immunization program next month.
The new shot called Nirsevimab gives babies antibodies that provide passive immunity to RSV, a major cause of serious lower respiratory tract infections for infants and seniors, which can cause bronchiolitis or pneumonia.
Ontario’s ministry of health says the shot is already available at some doctor’s offices in Ontario with the province’s remaining supply set to arrive by the end of the month.
Quebec will begin administering the shots on Nov. 4 to babies born in hospitals and delivery centers.
Parents in Quebec with babies under six months or those who are older but more vulnerable to infection can also book immunization appointments online.
The injection will be available in Nunavut and Yukon this fall and winter, though administration start dates have not yet been announced.
This report by The Canadian Press was first published Oct. 21, 2024.
-With files from Nicole Ireland
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
ISLAMABAD (AP) — Polio cases are rising ahead of a new vaccination campaign in Pakistan, where violence targeting health workers and the police protecting them has hampered years of efforts toward making the country polio-free.
Since January, health officials have confirmed 39 new polio cases in Pakistan, compared to only six last year, said Anwarul Haq of the National Emergency Operation Center for Polio Eradication.
The new nationwide drive starts Oct. 28 with the aim to vaccinate at least 32 million children. “The whole purpose of these campaigns is to achieve the target of making Pakistan a polio-free state,” he said.
Pakistan regularly launches campaigns against polio despite attacks on the workers and police assigned to the inoculation drives. Militants falsely claim the vaccination campaigns are a Western conspiracy to sterilize children.
Most of the new polio cases were reported in the southwestern Balochistan and southern Sindh province, following by Khyber Pakhtunkhwa province and eastern Punjab province.
The locations are worrying authorities since previous cases were from the restive northwest bordering Afghanistan, where the Taliban government in September suddenly stopped a door-to-door vaccination campaign.
Afghanistan and Pakistan are the two countries in which the spread of the potentially fatal, paralyzing disease has never been stopped. Authorities in Pakistan have said that the Taliban’s decision will have major repercussions beyond the Afghan border, as people from both sides frequently travel to each other’s country.
The World Health Organization has confirmed 18 polio cases in Afghanistan this year, all but two in the south of the country. That’s up from six cases in 2023. Afghanistan used a house-to-house vaccination strategy this June for the first time in five years, a tactic that helped to reach the majority of children targeted, according to WHO.
Health officials in Pakistan say they want the both sides to conduct anti-polio drives simultaneously.
WASHINGTON (AP) — Millions of people with private health insurance would be able to pick up over-the-counter methods like condoms, the “morning after” pill and birth control pills for free under a new rule the White House proposed on Monday.
Right now, health insurers must cover the cost of prescribed contraception, including prescription birth control or even condoms that doctors have issued a prescription for. But the new rule would expand that coverage, allowing millions of people on private health insurance to pick up free condoms, birth control pills, or “morning after” pills from local storefronts without a prescription.
The proposal comes days before Election Day, as Vice President Kamala Harris affixes her presidential campaign to a promise of expanding women’s health care access in the wake of the U.S. Supreme Court’s decision to undo nationwide abortion rights two years ago. Harris has sought to craft a distinct contrast from her Republican challenger, Donald Trump, who appointed some of the judges who issued that ruling.
“The proposed rule we announce today would expand access to birth control at no additional cost for millions of consumers,” Health and Human Services Secretary Xavier Becerra said in a statement. “Bottom line: women should have control over their personal health care decisions. And issuers and providers have an obligation to comply with the law.”
The emergency contraceptives that people on private insurance would be able to access without costs include levonorgestrel, a pill that needs to be taken immediately after sex to prevent pregnancy and is more commonly known by the brand name “Plan B.”
Without a doctor’s prescription, women may pay as much as $50 for a pack of the pills. And women who delay buying the medication in order to get a doctor’s prescription could jeopardize the pill’s effectiveness, since it is most likely to prevent a pregnancy within 72 hours after sex.
If implemented, the new rule would also require insurers to fully bear the cost of the once-a-day Opill, a new over-the-counter birth control pill that the U.S. Food and Drug Administration approved last year. A one-month supply of the pills costs $20.
Federal mandates for private health insurance to cover contraceptive care were first introduced with the Affordable Care Act, which required plans to pick up the cost of FDA-approved birth control that had been prescribed by a doctor as a preventative service.
The proposed rule would not impact those on Medicaid, the insurance program for the poorest Americans. States are largely left to design their own rules around Medicaid coverage for contraception, and few cover over-the-counter methods like Plan B or condoms.
