Long-term care (LTC) residents are particularly vulnerable to respiratory infections such as influenza, RSV, and pneumonia due to factors like advanced age, existing health conditions, and congregate living environments. The knowledge-to-action series on the cost-benefits of wastewater surveillance in long-term care looks at cost and benefit elements associated with wastewater-based surveillance in long-term care facilities. This report is based on literature findings and a single use case example of WBS in a Quebec long-term care home. WBS acts as an early warning system by detecting viral signals before clinical symptoms appear, allowing for earlier intervention. When used alongside clinical testing, WBS can reduce infections, hospitalizations, healthcare costs, and improve resident quality of life.
Publications
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Knowledge to Action Series Case Example Cost Utility Analysis: Wastewater-Based Surveillance of RSV
This case example discusses the cost-utility of the wastewater-based surveillance for Respiratory Syncytial Virus (RSV) in young children in Ontario before the RSV 2022-2023 season. WBS identified the start of RSV season 12-36 days earlier than the provincial start date, which was based on clinical testing. This early transmission was used to help inform resource allocation decisions across different healthcare settings. A CUA comparing the impact of RSV disease in immunized and non-immunized infants found WBS to be a cost-saving approach over clinical testing. WBS costs can be offset by savings from the reduced need for medical care. This RSV case study is an important demonstration of how harmonized sampling strategies, timely data reporting, and effective partnerships can enable public health action. By linking early, population-level detection with actionable clinical and policy responses, WBS yields measurable gains in health utility and health outcomes, while enhancing preparedness for future outbreaks.
Long-Acting Injectable Antiretroviral Medications (LAI-ARV) Fact Sheet
LAI-ARVs are a new form of combined extended-release antiretroviral therapy that avert the need for daily medications. They are given by injection for both HIV treatment and HIV pre-exposure prophylaxis (PrEP). This fact sheet overviews these medications’ safety profile, effectiveness and candidacy.
Measuring What Counts: Equity Prompts for Public Health Preparedness and Resilience
This guidance document encourages decision-making and action for pandemic preparedness and response that explicitly incorporate attention to structural and social determinants of health and address health inequities; and
Augments existing public health system resilience indicators to measure performance in addressing inequities and sustaining or enhancing equitable approaches now and in future outbreaks and pandemics.
Management of Community-Acquired Pneumonia in Adults Infographic
The Community Acquired Pneumonia (CAP) management tool provides guidelines for treating CAP among adult patients in Manitoba. The tool integrates antimicrobial stewardship principles for optimizing antibiotic use by incorporating current evidence concerning the choice of drug, dose, delivery method, and duration of therapy for CAP.
Public Health Surveillance 2030: Report on Regional Consultations
Surveillance is one of the six core functions of public health in Canada1. Public health surveillance has been defined as, “the continuous and systematic collection, orderly consolidation and evaluation of pertinent data with prompt dissemination of results to those who need to know, particularly those who are in a position to take action”2. Surveillance is…
Fact Sheet: What is Avian Influenza A (Bird Flu)
This fact sheet overviews H₅N₁ AI A – a rare, highly pathogenic avian influenza A virus that primarily affects birds but can also infect humans and other mammals, posing a significant public health risk.
Knowledge to Action Series Case Example Nunavik Board of Health and Social Services
As part of the NCCID and CWN Knowledge to Action Series, This case study shares the Nunavik Board of Health and Social Services (NBHSS) partnership with national and regional collaborators to pilot wastewater-based surveillance (WBS) as an innovative tool to enhance public health monitoring in remote Arctic communities.
Knowledge to Action Series Case Example Ottawa Public Health
As part of the NCCID and CWN Knowledge to Action Series, this case example overviews how OPH successfully integrated WBS data into its routine decision-making during the COVID-19 pandemic, providing the public and policymakers with clear, timely, and transparent information on community viral trends.
Knowledge to Action Series Case Example British Columbia Centre for Disease Control
As part of the NCCID and CWN Knowledge to Action Series, the BCCDC case example highlights how British Columbia integrated wastewater-based surveillance (WBS) into its public health system to support pandemic response and beyond.
Knowledge to Action Series Dashboards for Communication and Decision-Making
This segment of the Knowledge to Action series examines how public health dashboards can improve situational awareness, facilitate timely decision-making, and foster public trust.
Knowledge to Action Series Health Data Governance and Ethics
This feature in the Knowledge to Action series explores the ethical foundations and governance considerations of wastewater-based surveillance (WBS) in public health.