As the number of confirmed cases of COVID caused by the new XBB.1.5. subvariant continues to rise in Canada, taking a better approach to testing and monitoring wastewater could help detect early signs of new strains, some epidemiologists say.
“To think that we live in Canada … and yet if you’re sick, you can’t easily get tested for COVID — I think that’s just the antithesis of medicine,” Dr. Donald Winn, medical microbiologist at McGill University Health Center in Montreal reported to Global News.
“We don’t know exactly how much re-infection XXB.1.5. can cause… But if previous waves have ever been a lesson to us, it’s not to take options lightly,” Wynn said.
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“Every wave we’ve had has led to an increase in hospitalizations. And while we can buffer this increase, it comes at a cost to our health care system. So… we need to be very aggressive against XXB.1.5 going forward. or whatever other option comes up,” he added.
The Public Health Agency of Canada (PHAC) told Global News on Wednesday that it is aware of 21 detections of XBB.1.5. variant in Canada, but added that proportions and growth rates will not be reported until sufficient data are available.
XBB.1.5., which is a subvariant of Omicron, has been detected in 29 countries so far, according to the World Health Organization (WHO).
PHAC did not identify whether it considered this mutation to be a variant of concern, noting a number of complex factors that play a role in such a decision, including whether scientists and public health officials see an actual change in the virus’ behavior.
Making testing more accessible
Wynn says he’s currently “confused” by Canada’s COVID-19 testing strategy.
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“It could be argued that PCR testing on a mass scale exceeds our laboratory diagnostic capacity. And I do not deny this as a microbiologist. This is absolutely true. But we need to come up with alternative strategies instead of just limiting testing,” he added.
Vin also claims that it is not known how well the rapid tests perform against emerging variants such as XXB.1.5. and that’s why Canada should “reopen testing for people who have symptoms.”
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“I think that by providing diagnostic tests to sick people and looking for them, we will have a better understanding not only of their individual care, but also of the public health outlook,” he said.
Currently, PCR testing is more targeted and used for people who visit emergency rooms or doctor’s offices, Corey Neudorf, an epidemiologist at the University of Saskatoon, told Global News.
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That means not everyone with symptoms gets a detailed test like PCR, but there may still be enough people getting tested for public health officials to track cases, Neudorf said.
“You can look at what type of virus makes up the majority of COVID and look at these many different types of variants,” Neudorf added.
Meanwhile, Canada announced a new requirement for travelers from China, Hong Kong and Macau.
There has been an explosion of the COVID-19 disease since the Chinese government lifted strict restrictions. In a news release issued on December 31, PHAC said China had not provided enough “epidemiological and viral genome sequence data” for these cases.
This includes information about what variants are distributed and any new ones that appear.
As of Thursday, Canada is requiring travelers from these regions to provide proof of a negative COVID-19 test before boarding flights to Canada. The test must be taken no later than two days before departure.
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Use of wastewater monitoring
Wynn says the infrastructure for the wastewater monitoring system, although it exists in Canada, needs resources to keep it running.
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“The wastewater surveillance program actually allows for not only the surveillance of COVID, but actually has the potential to monitor or screen for a wide range of infections … the wastewater surveillance strategy is an excellent one that has been grossly underutilized,” Wynn said.
He says data generated from wastewater must be quickly analyzed and made available so that public health can prepare, if necessary, for whatever is found.
However, Gerald Evans, an infectious disease expert at Queen’s University, says not every place in Canada has the technology to detect sewage.
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“For example … we have good wastewater testing in the city of Kingston, but in other centers it doesn’t exist … However, wastewater can be really effective,” Evans said.
He explains that testing wastewater for variants can be a bit difficult because there is a lot of viral RNA — a macromolecule that functions to convert DNA’s genetic information into proteins — in the wastewater detection that needs to be separated out and looked at. .
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“Looking for and investigating these different variants or sub-variants is a bit more challenging than taking a single isolate that you would get from a patient, for example, which is a bit cleaner and you can do your sequencing a lot faster and with a lot greater accuracy,” Evans said.
However, he says that wastewater testing is still useful because it’s a method of finding variants before they actually cause infections in humans.
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“Wastewater is useful, but it takes a lot of resources, including financial resources, to do it effectively,” Evans said.
“XXB.1.5 tells us we have a little way to go to get out of the pandemic. Now we’re still seeing variants emerge, and all that sequencing data, whether it’s from samples we get from patients or from wastewater, is still really important during this pandemic,” he added.
“People want to get out of the pandemic. I certainly do as much as anyone else. But one of those ways is that we need to invest in the ability to use scientific methodology to help us understand that path.
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Canadian scientists are now stepping up testing of aircraft effluent to try to get an early warning of potential new variants.
The method will be used at Vancouver International Airport and Toronto Pearson International Airport starting Friday.
Fecal matter coming from the plane’s toilets will be sampled to help scientists identify what variants and sub-variants of the coronavirus passengers and crew may be carrying into Canada.
“A surveillance system for new variants — that’s really where we see the added value of airport testing,” Dr. Guillaume Poliquin, vice-president of the Public Health Agency at the National Microbiology Laboratory of Canada, told The Canadian Press.
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“Airports do represent a large portion of people — many of whom are international travelers coming into the country,” said Lawrence Goodridge, a University of Guelph professor who is one of the researchers.
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“Variants that have so far been major public health concerns have originated outside of Canada. So it’s a great way to understand what’s coming, and that data can then be used to make public health decisions.
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Goodridge, of the Pearson Airport Wastewater Testing Project, specializes in food microbiology and used wastewater monitoring to detect foodborne illnesses before the COVID-19 pandemic.
Historically, it was also used to detect polio, he said.
Sewage…
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