COVID cases on the rise in Hamilton

As COVID cases rise, Hamilton is missing a key tool used by the province as an early warning system.

Wastewater surveillance has been called the canary in the coal mine" by Health Minister Christine Elliott and a closely monitored key indicator" by chief medical officer of health Dr. Kieran Moore.

Wastewater data updated daily by the Ontario COVID-19 Science Advisory Table shows the virus is increasing across the province, including in Central West, which is Hamilton, Brant, Haldimand, Norfolk, Niagara, Waterloo and Wellington-Dufferin-Guelph.

But Hamilton public health doesn't understand local wastewater surveillance data by it's own admission. The department pulled its associate medical officer of health off of the project when resources became overwhelmed during the Omicron wave.

The reliability of wastewater surveillance has repeatedly been called into question by medical officer of health Dr. Elizabeth Richardson.

Wastewater data continues to be under evaluation," she said in a statement last week after making similar remarks to the board of health and at a city briefing.

She also blamed a lack of guidance from the province for the city's reluctance to incorporate wastewater as a monitoring tool.

There is no provincial guidance on its use for surveillance or disease control," she said.

But Coun. John-Paul Danko questioned, What guidance are we looking for from the province?"

He pointed to Ontario's $22-million investment in surveillance at more than 170 locations covering all public health units.

The reliance on wastewater signal for COVID seems to be fairly substantial across the province," Danko said at a board of health meeting on March 21.

He raised the importance of wastewater as the general public has no access to PCR testing, making other metrics significantly underestimated.

I think there would be a concern then that we're not actually verifying the prevalence of COVID in the community," said Danko. The viral signal in the wastewater is one method of verifying."

In addition, he asked about public health's long insistence that wastewater surveillance hasn't worked in Hamilton. Data made public for the first time on March 11 appears to show wastewater has been providing early warning of cases, hospitalizations, intensive care unit (ICU) admissions and deaths.

I'm just looking at this as a layperson but it seems to me that for Omicron they are quite closely aligned to date," said Danko.

The surveillance has been called remarkable" by the lead researcher of the team at the University of Ottawa that has been analyzing the data from the Woodward Avenue and Dundas treatment plants since July 2020. Robert Delatolla claims wastewater has been an early predictor of Hamilton hospitalizations for over 18 months now.

Delatolla said in recent weeks there has been effort to come to an understanding between researchers and Hamilton public health since The Spectator started publishing stories on the divide March 5.

Richardson said public health is working with the university and the Ministry of the Environment, Conservation and Parks to understand the data overall" and how it functions as an early indicator.

In addition, she says public health has kept in contact with Moore's office, and our approach that we are taking here in Hamilton has been supported ... by the chief medical officer of health."

A statement from the Ministry of Health neither confirms nor denies support for Hamilton's stance on wastewater, but makes clear the province is using it as a key metric.

At this time, the Ministry of Health is using the wastewater surveillance data in conjunction with other public health and health system indicators ... to monitor the current epidemiology of the COVID-19 pandemic in Ontario," it said.

Dr. Bart Harvey was looking at how wastewater could be similarly used to monitor COVID in Hamilton, but the associate medical officer of health was pulled away during the fifth wave that started in December.

The unprecedented surge in infections and outbreaks in high-risk settings led Hamilton Public Health Services to prioritize resources to reduce the transmission of COVID-19 and its impact on the community," Richardson said. Dr. Harvey's time, as with all staff, was prioritized to support the most urgent areas of the response."

Richardson said there was still engagement with the project over the Omicron wave but at a lower level." Now, she's waiting for provincial guidance that isn't expected until the fall.

That time lag is significant considering COVID is on the rise. Hamilton's average daily cases and weekly rate per 100,000 population have been increasing since March 19.

Hospital staff self-isolating was up to 394 Monday compared to 292 just under one week ago. During that same time, COVID patients hospitalized increased to 82 from 49.

Outbreaks in high-risk settings are up to 15 after holding steady between five and 10 for more than one month.

The city reported two deaths since Wednesday to bring the toll to 528 - one was a senior age 80 or older and the other was in their 70s.

Joanna Frketich is a health reporter at The Spectator. jfrketich@thespec.com