Canadian researchers turn to wastewater tests at long-term care homes to detect COVID hot spots

Several Canadian universities are preparing to test wastewater from long-term care homes in Ottawa, Toronto and Edmonton to get early warnings of COVID-19 outbreaks.

Researchers in municipalities in six provinces are already testing wastewater for traces of SARS-CoV-2, the virus responsible for the disease. Many of those infected shed the virus through their feces, even if they don’t have symptoms, according to researchers. 

But that kind of testing uses samples from wastewater facilities and shows the results for an entire community. Researchers currently aren’t able to pinpoint the exact locations where outbreaks are flaring up.

If demand isn’t estimated correctly for a specific region, resources may not be deployed to keep the material cold all along the way. And at -70 C, you can’t just use the freezer your ice cream is in.

While Pfizer has used transportation containers — dubbed pizza boxes in some media reports — that could each transport nearly 200 vials of concentrated vaccines at the right temperature, and safely, governments designing a supply chain will still have to develop protocols.

“We don’t know that if a box is opened, how long can we keep it?” Mehrizi asked.

Pharmaceutical distributors and cold transport companies often use dry ice to keep materials cold in transport, and an additional concern would be disposing of that dry ice safely.

Remote or rural locations may not have the ability to dispose of dangerous goods such as dry ice safely after the vaccine has been used and no longer needs to be stored.

Two batches of the frozen stuff needed

An additional challenge that must be taken into account is unique to these vaccines — and unfortunately the ice cream man can’t help on this front.

“Both Pfizer and Moderna vaccines, people need to get two doses of those vaccines. Therefore we need to have a very good tracking system to make sure that people get the same vaccine twice within a limited time window,” Mehrizi pointed out.

Vaccine won’t put an end to the pandemic. Only vaccination will do the job.- Tinglong Dai, associate professor, Johns Hopkins University

The federal government, along with the provinces and health authorities, must develop the infrastructure to track who gets what vaccine, where they get it and when to make sure that no doses go to waste.

The absence of a national registry tracking who is vaccinated in Canada could be a hurdle, although many provinces have this data

With that information, it could be easier to predict when and where cold storage needs to be deployed.

The social science to encourage you to get ‘ice cream’

The final piece to the puzzle of the cold chain is making sure that supply and demand match each other. That’s where social science to predict how and what people will do comes into play.

“Social science is really important because we are talking about vaccination, not just a vaccine,” said Tinglong Dai, associate professor of operations management and business analytics at Johns Hopkins University’s Carey Business School in Baltimore.

“Vaccine won’t put an end to the pandemic. Only vaccination will do the job,” Dai said in an interview with The Cost of Living.

It’s not enough to have a vaccine distributed — people have to actually get vaccinated for it to have an effect.(University of Maryland School of Medicine/The Associated Press)

The widespread news coverage of multiple vaccine candidates may help encourage more people to get vaccinated — albeit inadvertently.

Dai compared it to the influenza shot, which doesn’t normally get publicity around who makes it or what type is available. Typically, Canadians do not think about which brand of flu vaccine they might get.

But knowledge of various options could encourage more people to actually select something.

“If we present people with more choices, but not too many choices, then people are more likely to buy something. So the upside from my perspective is that when people are actually thinking about which vaccine to get, maybe that will help them overcome the hurdle of whether or not to get a vaccine,” Dai said.

Patience is key, but the job is doable

As things stand right now, multiple experts say Canada isn’t ready to distribute vaccines — yet.

We have a handle on getting ice cream from coast to coast to coast, but keeping multiple doses of a vaccine at -70 C isn’t within reach at this point.

It’s partly why the federal government is turning to organizations such as the military — which has experience in transporting dangerous goods across large distances — for assistance in rapidly scaling up cold chain distribution.

“We are not super prepared [right now], but I think we are getting there,” said UBC professor Nagarajan.

“This is going to be one of the biggest logistical exercises in my lifetime at least…. People need to understand that it’s a very complex operation, one that we haven’t quite done before. I think we need to be quite patient.”

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