INNOVATION FUND The Future of Academic Medicine Innovative Approaches to Care Delivery, Public Health, and Equity, Diversity & Inclusion SHOWCASE 2023

Measurement of SARS-CoV-2 Protein and RNA in Wastewater; Real Time Measurement of Community Load (CHA-21-012)

Innovative Approaches to Care Delivery, Public Health, and Equity, Diversity & Inclusion

Alex MacKenzie
(613) 737-2772


Children’s Hospital of Eastern Ontario Research Institute

Faculty of Medicine University of Ottawa

Robert Delatolla and Tyson Graber


Supplies low cost real time daily measurement of population burden initially of SARS CoV 2 infections and currently, in Ottawa and elsewhere in Ontario: SARS CoV2, Flu A, Flu B, RSV, M-Pox and polio. Public Health Surveillance for Infectious Pathogens has been inalterably improved.


Methodology: Daily samples of influent wastewater (post screening and grit removal), primary clarified effluent, secondary clarified effluent, and post disinfection treatment samples were collected; Reverse Transcription Digital Droplet PCR (RT-ddPCR) of SARS-CoV-2 RNA extracted from the collected samples was conducted to amplify N, E and the non-structural protein 14 (nsp14) genes. The readout was presence of the targeted genes, along with the number of SARS-CoV-2 genome copies.

Results/Outcomes: The balance of the project was taken up establishing optimal assay configuration reproducibility and coordinating uptake at centers elsewhere in Ontario and beyond. This included rapidly configuring PCR primers for novel variants including Omicron. We proposed that the validated rapid determination of wastewater SARS-CoV-2 protein and/or RNA would readily implementable and represented a powerful comparatively low cost means of capturing viral load in communities across Ontario over time informing disease modelling and health policy. We believed this approach would be particularly important given real supply chain issues limiting population-based COVID 19 screening.

Conclusions/Next Steps: We found this to be the case, allowing effective early warning system anticipating clinical tests by as much as a week. Dr. Delatolla’s group has been successful in expanding the program geographically across the province and to other include clinically relative pathogens (e.g Flu A, Flu B, RSV, M-Pox and polio). Sustainable funding and incorporation into public health are the chief remaining challenges


D’Aoust, P. M., Graber, T. E., Mercier, E., Montpetit, D., Alexandrov, I., Neault, N., … & Delatolla, R. (2021). Catching a resurgence: Increase in SARS-CoV-2 viral RNA identified in wastewater 48 h before COVID-19 clinical tests and 96 h before hospitalizations. Science of The Total Environment, 770, 145319.

D’Aoust, P. M., Mercier, E., Montpetit, D., Jia, J. J., Alexandrov, I., Neault, N., … & Delatolla, R. (2021). Quantitative analysis of SARS-CoV-2 RNA from wastewater solids in communities with low COVID-19 incidence and prevalence. Water research, 188, 116560.

D’Aoust, P. M., Tian, X., Towhid, S. T., Xiao, A., Mercier, E., Hegazy, N., … & Delatolla, R. (2022). Wastewater to clinical case (WC) ratio of COVID-19 identifies insufficient clinical testing, onset of new variants of concern and population immunity in urban communities. Science of The Total Environment, 853, 158547.

Hegazy, N., Cowan, A., D’Aoust, P. M., Mercier, É., Towhid, S. T., Jia, J. J., … & Delatolla, R. (2022). Understanding the dynamic relation between wastewater SARS-CoV-2 signal and clinical metrics throughout the pandemic. Science of The Total Environment, 853, 158458.

D’Aoust, P. M., Towhid, S. T., Mercier, É., Hegazy, N., Tian, X., Bhatnagar, K., … & Delatolla, R. (2021). COVID-19 wastewater surveillance in rural communities: Comparison of lagoon and pumping station samples. Science of the Total Environment, 801, 149618.

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