Doug Manuel

Doug Manuel, MD

Deputy, CoVaRR-Net Public Health, Health Systems and Social Policy Impacts Pillar
Director, CoVaRR-Net Wastewater Surveillance Research Group
Senior Scientist, Ottawa Health Research Institute
Distinguished University Professor, University of Ottawa

Lucas Castellani, MD

Collaborator, CoVaRR-Net’s Coronavirus in the Built Environment (CUBE) project
Medical Director of Infection Prevention and Control, and Medical Director Medicine, Sault Area Hospital
Assistant Professor, Northern Ontario School of Medicine

Airports worldwide are fast emerging as sentinels to watch for the entry and spread of new and emerging SARS-CoV-2 variants: they are testing wastewater on planes and perhaps soon, swabbing floors and surfaces in airports and planes as well. CoVaRR-Net’s Wastewater Surveillance Research Group (WWSRG) is playing a major role in improving this type of surveillance in Canada and worldwide. Its “Public Health and Environmental Surveillance Open Data Model (PHES-ODM)” – standardizing the way wastewater data is collected, reported and stored – has been adopted by 27 countries and is being recommended by the European Union. Meantime, its surface testing research in airports and planes is a new concept that could become the way of curbing the spread of pathogens around the planet well into the future.

“Early identification of new variants is challenging. Sampling wastewater from planes and airport terminals is a novel method to help do that and fill important surveillance gaps,” says Dr. Doug Manuel, Director of CoVaRR-Net’s Wastewater Surveillance Research Group, Deputy of CoVaRR-Net Public Health, Health Systems and Social Policy Impacts Pillar, and Distinguished University Professor, University of Ottawa.

“Surface testing in airports and planes could complement wastewater testing by identifying where new SARS-CoV-2 variants or other pathogens are coming from in a more granular way. You could potentially swab floors on specific international flights and pinpoint precise areas in a plane to help identify and understand which groups of passengers from which countries are carrying a new or emerging variant, and track levels of specific variants,” explains Dr. Lucas Castellani, Collaborator, CoVaRR-Net’s Coronavirus in the Built Environment (CUBE) project, Medical Director of Infection Prevention and Control, and Medical Director Medicine at the Sault Area Hospital, and Assistant Professor, Northern Ontario School of Medicine.

Open Data Model facilitates global early warning system

“The pandemic showed the value of sharing data around the world. There would be an incredible value in anticipating new infectious disease threats and responding quickly if you had a network of airports around the world testing wastewater from planes and sharing the data in real time with governments and public health officials in many different countries,” explains Dr. Manuel. “If you pick up a consistent signal for a new SARS-CoV-2 variant or another dangerous pathogen in multiple countries and the signal becomes stronger, this could be a very helpful early warning system for the world.”

This is where CoVaRR-Net’s Public Health and Environmental Surveillance Open Data Model (PHES-ODM) comes in. Developed with open science collaborators worldwide, with funding from CoVaRR-Net and the Public Health Agency of Canada (PHAC), it supports and facilitates the establishment of a global wastewater surveillance network. It standardizes the way wastewater data is collected, organized, reported and stored globally. This tool can be used not only in airports and on planes, but in fact anywhere. It is not only helpful to track SARS-CoV-2 variants, but also for any emerging disease threat.

Just last month, the European Union recommended wide international use of PHES-ODM v2, which expands the original version to include surface and air testing in addition to wastewater. “The EU has been a valuable partner in contributing to and further developing the PHES-ODM, and recently published its templates to support and promote international reporting and sharing of wastewater sampling data from airplanes and airports,” says Dr. Manuel.

Real-time surveillance to help prevent the next pandemic

A major advantage of wastewater testing in planes – which is non-intrusive and more informative than testing random travelers – is that it can pick up signals and monitor levels of new or emerging pathogens days or weeks before people develop symptoms and cases are confirmed. 

“When you consider how fast contagion travels, having a few extra days or weeks to prepare can be critical in helping researchers and public health authorities at the international, national, provincial, and local levels. They can then quickly alert populations at risk and take precautionary measures to reduce the spread of a new or emerging pathogens, and potentially prevent the next pandemic,” says Dr. Manuel.

Future directions: surface testing in planes

Testing floors in airports and in planes for SARS-CoV-2 and other pathogens is a promising new surveillance method that could potentially complement wastewater sampling by providing more specific and detailed information about viral transmission patterns across borders.

“With surface testing in planes and airports, you can also capture information about passengers carrying the virus that’s not picked up in wastewater because not everyone goes to the bathroom in planes or in airports,” says Dr. Castellani. “Novel pathogens are usually present in fewer people, so swabbing floors in planes could increase your chances of detecting a new pathogen earlier.”

Dr. Castellani is leading a CUBE pilot project at the Sault Ste. Marie airport this month to demonstrate the feasibility of floor sampling for SARS-CoV-2 and identifying specific variants in airports. “We’ll be swabbing floors in the pre-departure, departure and arrivals areas for international flights. Once we have proof of concept, the next logical steps will be to test floor sampling in a larger airport and in planes,” he says.

The CUBE research team discovered and previously demonstrated that floor sampling in hospitals, long-term care homes and other buildings is an effective new tool to detect and track SARS-CoV-2 (and other respiratory viruses such as influenza and RSV), and to predict outbreaks. Floor sampling works because when a person infected with a respiratory virus breathes, speaks, coughs or sneezes, the virus eventually falls and settles on the floor, and swab samples taken from the floor can detect whether and how much of the virus is present in a room or building.

Getting ahead of the next infectious disease threat

The transmission of new SARS-CoV-2 variants and other new pathogens from one geographical location to another is most likely to happen through air travel. “The current way of detecting variants of concern is so delayed that unless you have a more real-time approach you will end up identifying new variants, such as XBB1.5, too late to prevent the global spread of variants of concern. By using both wastewater and floor sampling in airports and planes for surveillance, you will be able to pick up signals for new variants or other dangerous new pathogens much earlier, alert public health authorities and take precautions to prevent further spread,” says Dr. Castellani.

To arrange an interview with Doug Manuel, or Lucas Castellani, please contact: