The future of public health could be in our wastewater
A made-in-Canada wastewater monitoring system is amongst the first in the world to anticipate disease outbreaks and provide reliable and accessible data to support public and individual health decisions.

Currently, there are approximately 5,000 wastewater monitoring research sites across 72 countries but, before 2020, few people imagined that wastewater could reveal much about our health.

Dr. Robert Delatolla was an exception. A professor of Civil Engineering at the University of Ottawa and CIHR Applied Public Health Chair in Environment, Climate Change and One Health, he understood early on that the pathogens we shed when flushing the toilet, taking a shower, or brushing our teeth could provide a snapshot of the health of entire communities.

Three times a week, the team at the Dr. Delatolla’s wastewater surveillance lab collects samples at the City of Ottawa Robert O. Pickard Environmental Centre Wastewater Treatment Facility, which are then tested for seasonal viruses such as influenza, SARS‑CoV‑2, and respiratory syncytial virus, as well as mpox and climate change-induced diseases like West Nile and Eastern equine encephalitis.

“By examining a picture of the health of approximately one million Ottawa residents in every sample, we can use this technology to bring the wellness of Ottawans into sharper focus and help protect those who need it most,” says Dr. Delatolla.

As an environmental engineer, Dr. Delatolla initially focused on how to remove harmful pollutants from wastewater. Equipped with microbiology instruments capable of analyzing pathogens like viruses, his team pivoted to respond to a new health emergency when COVID-19 was declared a pandemic.

They became the first in Canada, and among the first in the world, to monitor SARS‑CoV‑2 in wastewater and publish the results publicly. The team was also instrumental in building the Ontario Wastewater Surveillance Initiative that operated from 2020 to 2024. Supported by CIHR, NSERC and Genome Canada, Dr. Delatolla’s lab remains a leader in wastewater and environmental surveillance.

During the height of the pandemic, their data proved invaluable to Ottawa Public Health. “Ottawa Public Health directly integrated our wastewater data into their respiratory assessment toolkit and, based on this information, advised health care organizations on protective measures such when to implement masking in hospitals,” explains Dr. Delatolla.

Access to wastewater data was crucial for immunocompromised people like Michelle Burleigh, Co-Chair of the Canadian Immunocompromised Advocacy Network. She had just finished treatment for acute promyelocytic leukemia when the pandemic hit. “We hosted a party to celebrate, and my husband got me a cake that said, ‘Welcome to the first day of the rest of your life,’” she recalls. Only weeks later, she was back in social isolation.

As mandates lifted and public testing decreased, Michelle relied on wastewater data to navigate daily life and protect her health. “Having access to wastewater surveillance data would help us decide if it was safe to sit on a patio in the spring and have a coffee with a friend.”

Dr. Lana Silbernagel, an Ottawa psychiatrist, saw similar patterns among her patients. Many adjusted their behaviour when wastewater data indicated that COVID-19 cases were dangerously high. One patient who cared for an elderly family member told her, “Wastewater data helped us to communicate proactively with my grandmother’s care team about when additional measures, such as limiting visitors or using higher-grade masks, were necessary to reduce her exposure.”

Today, Dr. Delatolla’s wastewater research remains an important tool for immunocompromised communities who are disproportionally impacted by disease burden. “Even if the emergency phase of the pandemic is over, we are still experiencing severe illness, hospitalization, and death,” says Michelle. Dr. Silbernagel agrees: “Ongoing wastewater testing in Ottawa has been helping me guide my patients to make informed decisions during high-viral seasons.”

Dr. Delatolla continues to collaborate with organizations like Ottawa Public Health to ensure communities are empowered with accessible and actionable data. “My underlying goal is to promote health equity,” he says. For Dr. Silbernagel, this is already happening. “This tool is providing the most health equity for many of the vulnerable people I support in Ottawa.”

The impact of Dr. Delatolla’s work has reached far beyond Ottawa. The team has trained health professionals in six eastern African countries, helping them establish wastewater surveillance programs adapted to their health priorities.

In Canada, the team partners with Indigenous communities to co-develop wastewater monitoring tools that address community health priorities and ensure that communities retain ownership of their data. With new CIHR funding, Dr. Delatolla and the Sheshatshiu and Mushuau Innu First Nations are now co-developing new wastewater monitoring systems in the Labrador region.

Looking ahead, wastewater surveillance could become an increasingly vital public health tool in response to climate change. “As warming temperatures introduce increased risks of climate change-induced pathogens in Canada, wastewater monitoring could provide early warning signals for future outbreaks,” explains Dr. Delatolla.

For Michelle, the tool also supports long-term preparedness. “Wastewater monitoring data enables us to appropriately prepare for coming pandemics,” she says.

At a glance

Issue

Even if the emergency phase of the pandemic is over, immunocompromised people are disproportionally impacted by disease burden, especially during high-viral seasons.

Research

The Dr. Delatolla wastewater surveillance lab can anticipate disease outbreaks and provide reliable and accessible data to support public health decisions. The team’s ongoing wastewater testing in Ottawa and the North is also helping communities make informed decisions about their health.