Wastewater-Based Surveillance Integration with Health Decision-Making: Protection Against Health Threats and Promotion of Health Equity

Wastewater-based surveillance (WBS) has shown to be an early warning system of health threats, an economic system that withstands high testing demands during pandemics and also an anonymous surveillance system that is adaptable for underrepresented and vulnerable communities. These capabilities have led to the installation of over 4600 WBS testing locations around the world, including 260 locations in Canada, since the start of the COVID-19 pandemic. Despite this rapid growth in WBS testing locations, limited integration between WBS knowledge and health decision-making currently exists due to the notable lack of standardized WBS data, ability to ensure data reliability and guidance on how to interpret WBS data for health actioning. The research outcomes will be built upon my team's experience in WBS and in particular our success in building a public health integrated WBS system with Ottawa Public Health in the city of Ottawa during the COVID-19 pandemic. The proposed Applied Public Health Chair research program will develop best practice guidelines, a data pipeline and implementation framework to ensure WBS data reliability and fully integrate WBS with health and policy decision-making to safeguard against future pandemics, promote health equity in Canada and around the world, and foster One Health concepts to minimize the impact of climate change-induced health threats. My research team will collaborate closely with 9 engaged health decision-maker partners, 5 community advisory committees comprised of individuals with lived experience from underrepresented and vulnerable populations and international collaborators, international WBS working groups and global WBS surveillance programs to produce research outcomes that are generalizable across Canada and the world.