Sewershed surveillance of COVID-19 in the City of Toronto

分子方法越来越多地被用于检测传染病的病原体。它们提供了灵敏、快速和定量的分析工具。关于当前新冠肺炎疫情的最新数据证实，冠状病毒可以在患者的粪便中传播，而且SARS-CoV2(新冠肺炎的病原体)阳性的粪便样本甚至可以在个人出现临床症状之前出现。下水道监测是一种新的替代战略，用于跟踪人类排放到下水道系统中的病原体和感兴趣的化学物质。在过去的几个月里，全球越来越有兴趣利用下水道监测来调查SARS-CoV-2遗传指标的循环。 我们与Pani Energy合作的目标是在多伦多市启动对SARS-CoV2的下水道监测。多伦多市污水处理厂监测项目的潜在成果包括及早发现新的新冠肺炎疫情，跟踪新冠肺炎感染趋势的变化(例如，社会和医疗干预的影响)，跟踪社区中新冠肺炎的流行情况(例如，确定感染的“热点”)，以及评估公用事业工人和暴露在未经处理污水中的工人的风险。该项目将在短期和长期内对公共卫生和经济效益产生重大影响。该项目将对多伦多市政府在不增加医疗系统负担的情况下大范围跟踪新冠肺炎的能力产生立竿见影的影响。在项目过程中和以后，产生的信息将支持公共卫生官员在医疗和社会干预方面做出战略决策，以阻止新冠肺炎的传播并安全地重启多伦多经济。

Molecular methods have increasingly been employed for detection of pathogens from infectious diseases. They offer the ability to be sensitive, rapid, and quantitative analytical tools. Recent data on the current COVID-19 pandemic confirms that the Coronavirus can be shed in the stools of patients and that SARS-CoV2 (the causative agent of COVID-19) positive stool samples can present days before individuals even show clinical symptoms. Sewershed surveillance is a novel and alternative strategy for tracking pathogens and chemicals of interest that have been shed into the sewer system by human populations. Over the past several months, there has been growing global interest in using sewershed surveillance to investigate the circulation of genetic indicators of SARS-CoV-2. The goal of our partnership with Pani Energy is to initiate sewershed surveillance of SARS-CoV2 in the City of Toronto. Potential outcomes of a sewershed surveillance program in the City of Toronto include early detection of new COVID-19 outbreaks, tracking changes in COVID-19 infection trends (e.g., impacts of social and medical interventions), tracking COVID-19 prevalence in communities (e.g., identifying 'hotspots' of infection), and assessing risk to utility workers and those exposed to raw sewage. This project will have significant short- and long-term public health and economic benefits. The project will have an immediate impact on the City of Toronto's ability to track COVID-19 at a broad scale without burdening the healthcare system. Over the course of the project and beyond, the information generated will support public health officials making strategic decisions on medical and social interventions to stop the spread of COVID-19 and safely reopen the Toronto economy.