Publications
Knowledge to Action Series Cost Effectiveness Use Case: The Cost-Benefits of Wastewater Surveillance in Rural and Remote Communities
Rural and remote communities in Canada often face higher risks from infectious disease outbreaks due to limited access to timely testing and healthcare, multi-generational housing, and geographical isolation. Wastewater-based surveillance (WBS) offers a community-wide, non-invasive solution to detect respiratory viruses like SARS-CoV-2, influenza, and RSV early, helping local clinics act quickly and efficiently. This use case explains the usefulness of wastewater-based surveillance in the rural and remote Canadian context. This summarizes the findings reported in the literature and the case example from the WBS program of the Cree Board of Health and Social Services of James Bay. Since its inception during the COVID-19 pandemic, it has been monitoring viral spread in the region with minimal lab capacity. Community-led and grounded in OCAP principles, the program enables early warnings, supports clinical response, and conserves healthcare resources by reducing the need for widespread individual testing.
Knowledge to Action Series Cost Effectiveness Use Case: The Cost-Benefits of Wastewater Surveillance in Long-Term Care
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.
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.
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.
Knowledge to Action Series Wastewater-Based Surveillance for Public Health
This document overviews the Wastewater-Based Surveillance (WBS) for Public Health Knowledge-to-Action Series.
This series is intended for public health personnel working across all levels, disciplines and jurisdictions. Some of the resources may be appropriate for sharing with community partners to strengthen learning and collaboration for building a strong monitoring and assessment system in support of community health.