Surveillance of Healthcare and Ambient Pathogens in our Environments and Spaces [SHAPES]

As an alternative to the time-consuming and resource-intensive process of testing individual humans, our team's previous work looked at how we can use environmental sampling to predict and potentially prevent COVID-19 outbreaks. The approach we developed uses swab samples taken from floors, which then undergo a lab processing technique that can detect the presence of the SARS-CoV-2, the virus that causes COVID-19. Through our work, we have discovered that the amount of SARS-CoV-2 we find on the floor correlates to the burden of infection in individual humans living and working in a given setting, and that the virus can be detected from floor samples days before an outbreak is recognized. This suggests a potential role for floor sampling in improving early outbreak identification and monitoring. We have further developed our approach to allow us to detect up to four different respiratory pathogens in one single test: SARS-CoV-2, influenza A, influenza B, and respiratory syncytial virus (RSV). Our proposed work aims to provide ongoing surveillance at 10 long-term care homes for one year. We will conduct floor swabbing for SARS-CoV-2, influenza A and B, and RSV, and will send reports to each home on a twice-weekly basis. These reports will indicate the number of swabs positive for SARS-CoV-2, the location where the swab was taken, and the trends in swab positivity over time. We will look at the number and duration of outbreaks in homes who received swabbing and reporting compared with other homes who were not swabbed. We will look at whether the RSV and flu virus we find on the floors correlates to infection in LTC residents. We will also look at how floor swabbing compares to the current process of twice-weekly rapid antigen testing for LTC staff. We hope to lay the groundwork for routine environmental surveillance of these common and potentially dangerous viruses, especially in settings where there are vulnerable people.