WC136 MayJune 2024 - Magazine - Page 35
itate peer-to-peer learning and knowledge sharing among the
public health practitioners. Additionally, the program benefits
from the insights of invited guests. Notable experts, such as Dr.
Amy Kirby from the Centers for Disease Control and Prevention (CDC) in the U.S., Dr. Gertjan Medema from the KWR
Watercycle Research Institute in the Netherlands, and Dr. Doug
Manuel from the University of Ottawa in Canada, contribute
valuable perspectives. Their input is further informed by advice
from an expert advisory group that includes Dr. Michael Becker
from PHAC, Dr. David Patrick from the University of British
Columbia, and Dr. Wendy Pons from Conestoga College.
Recognizing that rural, remote, and isolated Indigenous communities face unique challenges related to WBS, the program
carves out dedicated space for these contexts. Public health
providers serving these regions delve into their distinctive opportunities and obstacles. This exploration includes ethical considerations surrounding wastewater surveillance. As part of this effort,
participants engage in training sessions on Ownership, Control,
Access & Possession (OCAP) principles, which are facilitated by
the First Nations Information Governance Centre.
Practitioner needs related to interpreting and communicating
WBS data
Through a needs assessment conducted in Spring 2023,
several needs were identified by practitioners related to the
interpretation and communication of WBS data:
Finding a signal in the noise: Examining external data
collection factors that influence analysis for trends (e.g.,
behavioural, environmental, technical, methodological, etc.).
Complementary data: How to use WBS data in conjunction
with other public health surveillance streams, especially clinical
data.
Translating data trends into action: Identifying trigger
points for action.
Sampling solutions: Specific to remote and isolated
WAT E R C A N A D A . N E T
indigenous communities, sharing strategies
to overcome challenges in obtaining,
testing, and transporting samples.
Ethical considerations: Examining
privacy and data granularity in small
communities, how to build relationships
with communities, and understanding
ethical principles of data governance.
Public health participants emphasized
that wastewater surveillance significantly complements existing public health
data. Unlike clinical data, which may lag
behind, WBS provides an early warning
signal to hospitals, public health and congregant settings by detecting the presence
of pathogens in the community up to a
week in advance. During the OMICRON wave, when clinical
testing capacity was overwhelmed, WBS remained the sole source
of community infection trend data. Wastewater data can also
detect genetic mutations in pathogens, which can trigger changes
in treatment.
At the local level, WBS dashboards and websites have emerged
as effective tools for communication with the public. These tools
can be quickly updated to present the latest results. The proliferation of public health dashboards has fuelled public demand for
access to near real-time WBS data. Having unbiased, easy-to-understand WBS information and clear messaging on risk has been
a game changer. They have proven critical for effective decision
making in weighing risk and taking appropriate protective measures by individuals in congregant settings like student dorms,
long term care homes, and religious institutions.
Future outlook of WBS programs in Canada
A looming question for public health practitioners is the
sustainability of WBS programs in their communities. Since
WBS is not a mandatory program at the provincial level, the
lack of core funding and the temporary nature of the provincial
mandates puts this important tool at risk.
Provincial health agencies are currently making decisions
regarding whether to continue their WBS programs. If they are
looking at continuing their program, they are looking at the
scale (i.e., in how many communities) and scope (i.e., respiratory
illnesses only, or expand to other diseases and even illicit drugs).
CWN and NCCID are continuing the WBS program with
new program participants in the 2024-25 fiscal year. The new
program has a learning stream focused on Northern Indigenous
communities. It also has a series of forums to build a dialogue
amongst the provincial health authorities on their current experiences and future plans for centrally funded and coordinated
WBS programs in their respective jurisdictions. For more information, please visit CWN’s website at cwn-rce.ca.
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