NFRF-funded COVID-19 rapid-response research projects at a glance
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- Acute Respiratory Mortality Surveillance (ARMS) for Coronavirus Infection (COVID-19): A Globally Relevant Technology to Strengthen Mortality Surveillance for Acute Respiratory Deaths in Many Countries Lacking Complete Medical Certification of Death
- Assessing and Mitigating the Food Security Consequences of COVID-19 in China
- Canada's Response to Covid-19 in the Context of the IHR (2005) and its Opportunity to Lead in Global Health Security: A Policy Analysis
- Developing COVID-19 Risk Communication and Community Engagement Readiness Strategy Guidance for Travelers Visiting Friends and Relatives
- Development and Implementation of Rapid Metagenomic Sequencing Coupled with Isothermal Amplification Point of Care Testing for Viral Diagnostics
- Ethical Pathways for Therapeutics and Vaccine R&D in the Context of Public Health Emergencies of International Concern: An Analysis of the 2013-16 Ebola Outbreak to Rapidly Inform COVID-19 R&D
- Harnessing Human Mobility and Surveillance Data for Disease Forecasting to Drive Evidence-based public Health policy during the COVID-19 Epidemic
- Mobilizing the Chinese Immigrant Community and Battling the Potential COVID-19 Outbreak in the Greater Toronto Area: Gathering Essential Information, Creating a Mutual Support Quarantine Network and Assessing Psychological Impacts
- Point-of-care Diagnostics of COVID-19 Using Isothermal Amplification and CRISPR Technology
- PROTECH Pandemic Rapid response Optimization To Enhance Community-Resilience and Health
- Senior Public Health Leadership during the 2019 Novel Coronavirus Outbreak: Comparative Approaches to Mitigating the Spread of Infectious Disease and its Social Consequences in Canada and Abroad
- Socio-Cultural Implications of COVID-19: Educating, Engaging & Empowering the Public
- Understanding Compliance with the International Health Regulations (2005): Recommended Strategies to Inform and Strengthen Global Coordination of the COVID-19 Outbreak Response
- Understanding the Effects of Public Health Outbreak Control Policies and Implementation on Individuals and Communities: A Path to Improving COVID-19 Policy Effectiveness
- Understanding the Pathogenesis of COVID-19
Prabhat Jha, Unity Health Toronto, University of Toronto
Acute Respiratory Mortality Surveillance (ARMS) for Coronavirus Infection (COVID-19): A Globally Relevant Technology to Strengthen Mortality Surveillance for Acute Respiratory Deaths in Many Countries Lacking Complete Medical Certification of Death
Unusual spikes in infection-related deaths due to COVID-19 can register quickly in higher-income countries and in China, but may go unrecognized for weeks or months in low-income settings where even very ill people do not go to a hospital. Detecting a mortality signal is important and may be the first step in recognizing a serious outbreak. Drawing on extensive experience using verbal autopsy in the long-running Indian Million Death Study, and ongoing studies in China, Hong Kong, Ethiopia and Sierra Leone, Dr. Prabhat Jha and his research team are developing an enhanced verbal autopsy module to identify deaths from COVID-19. This module will serve as a model for use with the next novel pathogen, as near as possible to real-time, in settings without routine medical certification of death.
The team is testing whether their Acute Respiratory Mortality Surveillance (ARMS) module can be added quickly to the World Health Organization’s verbal autopsy instrument, and validated against hospitalized cases and deaths (paired with epidemiological information and machine learning) to distinguish COVID-19 from other causes of respiratory deaths. Early deployment of the ARMS module in China, Hong Kong, India, Sierra Leone, and Ethiopia will help establish baseline data to inform modelling. With effective knowledge translation of an open-source, widely available ARMS module, the team hopes to improve the global response to COVID-19, particularly in the lowest income countries, and to improve mortality assessments for any subsequent waves of COVID-19.
With the team already making good progress, they expect to launch the enhanced verbal autopsy tool to detect COVID/respiratory deaths in low and middle-income countries in spring 2020, and plan to make it available for use worldwide. They will be submitting the tool and open source code for journal publication and will have it released first in pre-print format. Full materials for the work
Jonathan Crush, Wilfrid Laurier University
Assessing and Mitigating the Food Security Consequences of COVID-19 in China
The global spread of COVID-19 has touched many aspects of life, including food supply and security. A research project led by Jonathan Crush at Wilfrid Laurier University is evaluating COVID-19 impacts on household food security in the Chinese cities of Wuhan and Nanjing. Crush and his research team at Laurier, the University of Waterloo and Nanjing University are investigating food security challenges resulting from China's quarantine measures, an unstable food supply, and the public’s fear of food shopping.
The team will also compare food security status in Nanjing before the COVID-19 outbreak (using 2015 baseline data) and after it, and assess policies established to address food security challenges and to promote effective countermeasures. In assessing the effectiveness of temporary policies, the research will shed light on ways to mitigate food security impacts when developing social and policy measures. The project will engage local stakeholders through an online household survey, follow-up telephone interviews and a complementary inventory of immediate policy measures. Policy and longitudinal analyses will evaluate changes in household food security resulting from the COVID-19 pandemic to help draw out lessons from the Chinese experience. The study’s conclusions will be relevant for academics, international organizations and policymakers globally on the COVID-19 pandemic.
Already, the team has made rapid progress and had an exceptional response to its household survey. They have launched a project website that features a blog series authored by prominent international researchers and a curated Observatory highlighting media reports and research reports on the food security implications of the pandemic globally, especially in low- and middle-income countries (LMICs). Discussions are being held with other partners on upscaling the research to LMICs where the team has worked: South Africa, Zimbabwe, Mexico, Ecuador, Kenya and Jamaica.
Kumanan Wilson, Bruyère Research Institute
Canada's Response to Covid-19 in the Context of the IHR (2005) and its Opportunity to Lead in Global Health Security: A Policy Analysis
Guided by global rules (the International Health Regulations), the World Health Organization has taken action to limit the harm caused by COVID-19, while at the same time protecting international travel and trade. Dr. Kumanan Wilson at the Bruyère Research Institute and his colleagues are studying how Canada has adhered to these global rules and what it can do to support them. They will review media stories, important policy documents and other relevant materials, and will interview key people in Canada and around the world involved in protecting the public from the threats of COVID-19. Through collection of this data, they will specifically examine if there is an opportunity for Canada to help lead efforts to protect the world from similar health threats in the future.
An Op-Ed by Dr. Wilson, related in part to the project, was published on CBC on March 18, 2020. An article co-authored with Barbara von Tigerstrom (University of Saskatchewan College of Law) entitled “COVID-19 travel restrictions and the International Health Regulations (2005)” will soon be published in BMJ Global Health.
Cynthia Jardine, University of the Fraser Valley
Developing COVID-19 Risk Communication and Community Engagement Readiness Strategy Guidance for Travelers Visiting Friends and Relatives
Containing COVID-19 depends on stopping its spread around the world. People who travel to their countries of origin to visit friends and relatives (VFR), including international students and the children of immigrants, are often at higher risk of contracting the disease and spreading it to others. Cynthia Jardine at the University of the Fraser Valley and a team of Canadian and international researchers are gathering and analyzing data to better understand VFR traveler knowledge, risk perceptions, information needs, barriers to pre-travel care and advice, and access to protective measures. They are also gathering information on COVID-19 awareness, and how the pandemic may change future travel advice and plans.
This data will help in developing strategies that can keep travellers healthy and prevent the spread of COVID-19 and other infectious diseases. Through focus groups, surveys and interviews, the researchers are gathering information from Chinese and Punjabi VFR travellers, students at the University of the Fraser Valley and the University of Manitoba, and family physicians. Collaborations with knowledge user partners such as provincial and regional health officers will ensure the information gained can help inform future policies and practices. The team includes researchers from Australia, New Zealand and other countries to assure that the study and recommendations can be part of a coordinated international response.
Dylan Pillai, University of Calgary
Development and Implementation of Rapid Metagenomic Sequencing Coupled with Isothermal Amplification Point of Care Testing for Viral Diagnostics
Infectious pandemics or plagues have altered human history for thousands of years. Today we face the threat of viral diseases like influenza, Ebola, and now SARS-CoV-2 spreading globally, fueled by the ease of international travel. We must create novel tools that enable us to rapidly identify the virus and stop it in its tracks.
The research team headed by Dr. Dylan Pillai at the University of Calgary is working to develop a reliable and portable test for the COVID-19 virus that can be used in the community and at ports of entry to reduce transmission in hospitals and public places. The project is developing this point-of-care testing for use in the current pandemic and for any future viral outbreaks.
Maxwell Smith, Western University
Ethical Pathways for Therapeutics and Vaccine R&D in the Context of Public Health Emergencies of International Concern: An Analysis of the 2013-16 Ebola Outbreak to Rapidly Inform COVID-19 R&D
A cross-cutting research priority identified by the World Health Organization is the establishment of appropriate ethical oversight and global collaboration to accelerate COVID-19 R&D in a way that promotes solidarity and equity. Yet the WHO is largely silent on the global ethical pathways required to oversee rapid therapeutics and vaccine R&D in this context.
To aid the global research community in navigating these pathways for COVID-19 R&D, Maxwell Smith at Western University is leading a research team that will analyze and describe the ethical pathways used for R&D during the 2013-16 Ebola virus disease (EVD) outbreak. An unprecedented R&D response to the EVD outbreak at the time provides some guidance on the current pandemic, as the atypical expediency of R&D efforts was, in part, the result of significant modifications to the usual ethical and regulatory pathways for health product development. The research will analyze and describe the ethical pathways established and navigated for COVID-19 R&D to rapidly support ongoing and future COVID-19 R&D. The project team will also conduct an ethical analysis of the ethical pathways developed for EVD and COVID-19 R&D to help inform future R&D during epidemics.
Read highlights of Maxwell Smith’s research, and some articles for which he was a co-author:
- “Emergency use authorization for COVID-19 vaccines: lessons from Ebola,” published in The Lancet;
- “Ethical conditions for accelerating COVID-19 vaccine research,” published in Wellcome Open Research;
- “Learning Lessons from COVID-19 Requires Recognizing Moral Failures,” published in the Journal of Bioethical Inquiry; and
- “Allocating Scarce Unproven Interventions During Public Health Emergencies: Insights from the WHO MEURI Framework,” published in the American Journal of Bioethics.
Isaac Bogoch, University Health Network, Toronto
Harnessing Human Mobility and Surveillance Data for Disease Forecasting to Drive Evidence-based public Health policy during the COVID-19 Epidemic
Led by Dr. Isaac Bogoch at the University Health Network in Toronto, a team is examining validated tools to predict where COVID-19 will spread in real time by using a novel, artificial intelligence-driven, web-based surveillance tool coupled with real-time human mobility data. The surveillance system identifies regions with real or suspected cases of COVID-19, and by harnessing global commercial air transportation data and geo-referenced mobile device data the team can evaluate regions where the virus may spread by tracking human mobility in real time. The team has validated these tools for COVID-19 forecasting during this epidemic and published their results in peer-reviewed literature.
After identifying regions with confirmed and suspected COVID-19 cases, they will model the spread of infection from these locations by using human mobility data to identify and forecast new regions for virus importation. Working closely with partners from the World Health Organization, the Association of South East Asian Nations and the International Air Transport Association, the team will use the data to help drive evidence-based public health policy in real time, with a focus on global projection strategies, as well as on strategies for low- and middle-income countries in Southeast Asia.
Peizhong Wang, Memorial University of Newfoundland
Mobilizing the Chinese Immigrant Community and Battling the Potential COVID-19 Outbreak in the Greater Toronto Area: Gathering Essential Information, Creating a Mutual Support Quarantine Network and Assessing Psychological Impacts
The COVID-19 pandemic that originated in China has spread globally including to Canada. One of the largest Chinese communities in the world is found in the Greater Toronto Area (GTA) and is bearing the brunt of fear, anxiety, and panic associated with this disease. The Toronto Chinese community may be the most vulnerable and yet least prepared population for the COVID-19 outbreak, creating an urgent need to mobilize it in fighting the outbreak. Dr. Peizhong Wang of Memorial University of Newfoundland is spearheading a research team to assess knowledge, develop effective epidemic control practices, and identify the psychological impacts of the disease through coordinated efforts across communities, professionals, and local residents.
Comprised of researchers from the related fields of public health (epidemiology), psychology, sociology and health policy, the team will assess GTA Chinese community knowledge, attitudes/beliefs, and protection practices toward COVID-19. This will help in developing, evaluating, and optimizing a mutual-support quarantine network to help contain COVID-19. They will also assess the psychological impacts and associated predictors of the COVID-19 outbreak on the community.
X. Chris Le, University of Alberta
Point-of-care Diagnostics of COVID-19 Using Isothermal Amplification and CRISPR Technology
X. Chris Le, at the University of Alberta, and a team of virologists, chemists, infectious disease specialists, front-line practitioners and public health researchers are focused on addressing the urgent need for rapid point-of-care diagnostics for COVID-19. Their immediate priority is the development of two complementary diagnostic techniques to be performed on-site and in resource-limited settings. Their work takes advantage of the most recent advances in chemistry, molecular biology, genome technology and nanotechnology. The diagnostic tests employ chemical reactions that take place in a single tube at a moderate temperature; the resulting reaction products register as colour changes visible to the naked eye, eliminating the need for elaborate equipment.
A longer-term priority of the team includes refining the new diagnostic tools to monitor mutational changes in the virus as it evolves. The project is progressing well with excellent research team collaboration, support from the University of Alberta, continued access to labs despite the partial closure of the university due to COVID-19, and encouraging results.
Josephine Wong, Ryerson University
PROTECH Pandemic Rapid response Optimization To Enhance Community-Resilience and Health
News about emerging pandemics often brings out fear and anxiety in the public domain. The 2003 SARS crisis in Toronto showed that this type of stigma can lead to crushing harm on the health, psychological, social, and economic well-being of affected communities. Recent public responses to the COVID-19 outbreak have again reflected blame, fear, and racism against Chinese Canadian communities. Building on the lessons learned during the SARS pandemic, Josephine Wong at Ryerson University and her team are working to promote collective community resilience using a cutting-edge, three-component model to mitigate harms in the face of the pandemic.
The Pandemic Rapid Response Optimization to Enhance Community Resilience and Health (PROTECH) uses an online resource hub to provide accurate and timely COVID-19 information, along with recommendations for coping with fear and anxiety. The hub also features online group training (PACER) with live video meetings and pre-meeting e-learning to help reduce stigma/stress and promote resilience among affected groups, e.g., those who have lost loved ones or tested positive, healthcare providers experiencing stress or burnout, and community leaders. The team of clinicians, researchers and leaders from the public, arts, and business sectors will seek out key opinion leaders and community influencers to mobilize the Chinese community and other affected communities. Through town halls, focus groups and surveys they will examine the effectiveness of PROTECH and how it can best support affected groups to stay well despite challenges.
The team has now curated information and resources through their community consultations, and has built the online technological infrastructure to deliver their Live-Chat and PACER online training. On May 4, 2020, PROTECH was launched through an online media conference, rolling out the resource hub ahead of schedule thanks to the commitment of the team, collaborators and volunteers, all while managing the challenges of COVID-19. The project was featured on CBC’s The Current, where Dr. Kenneth Fung discussed the impact of the pandemic on Chinese Canadian communities and how PROTECH is supporting those communities to manage the social and mental health challenges of COVID-19. The PROTECH Facebook page includes media coverage and interviews.
Patrick Fafard, University of Ottawa
Senior Public Health Leadership during the 2019 Novel Coronavirus Outbreak: Comparative Approaches to Mitigating the Spread of Infectious Disease and its Social Consequences in Canada and Abroad
The emergence of COVID-19 has demonstrated the need for clear, timely, and accessible information from trusted and authoritative public figures. Effective public health communication can help reduce the risk of transmission, translate scientific information to the public, and address the challenges associated with public health containment and mitigation efforts. At the University of Ottawa, Patrick Fafard and his research team are analyzing how public health leaders in Canada and four other countries with similar public health systems are communicating to the public about COVID-19 and how their messaging reflects ongoing debates regarding the science underlying pandemic response efforts.
Using text analysis of official communications across a range of platforms including social media, as well as interviews with public health leaders, the research team will compare how senior public health leaders communicate public health advice and how their roles have shifted in response to a crisis situation. The team will also use public opinion data to determine how and to what extent citizens in five similar countries (the United Kingdom, Ireland, Australia, Canada, and New Zealand) receive, understand, and trust government communications. The research will offer a fuller understanding of who speaks for the government during an outbreak, what kind of information they share, and how members of the public understand their messages.
Jeanna Parsons Leigh, Dalhousie University
Socio-Cultural Implications of COVID-19: Educating, Engaging & Empowering the Public
Infectious disease outbreaks pose a severe threat to the physical and mental health of individuals and populations worldwide. An evidence-informed understanding of the social and cultural factors contributing to public knowledge and perceptions of COVID-19 is needed to develop strategies that combat misinformation, stigma and fear. Jeanna Parsons Leigh of Dalhousie University and her research team are developing a national knowledge translation campaign to enhance public knowledge and understand public perceptions related to COVID-19.
They will achieve this through:
- a national public survey to find key gaps in public knowledge, perceptions and behaviours during the COVID-19 outbreak;
- focus groups to identify the major factors influencing these areas; and
- a national knowledge translation campaign to engage the public in becoming informed stewards of health knowledge related to the outbreak, and to foster positive public change in the context of the COVID-19 epidemic.
The team’s findings will strengthen public understanding about individual and community impacts and provide evidence-backed interventions to inform social and public health responses that could moderate threats to physical and mental health.
The project team has added a knowledge synthesis stream of work using several rapid reviews that examine pressing COVID-19 issues to inform the knowledge translation arm of the research. The knowledge translation stream has also been expanded to include a focus on health-care providers through local, national and international studies. Results from the national survey have been collected and the team has analyzed most of the survey data. The team has been successful in obtaining additional funding from Research Nova Scotia for the project. Read highlights of Jeanna Parsons Leigh’s research
Kelley Lee, Simon Fraser University
Understanding Compliance with the International Health Regulations (2005): Recommended Strategies to Inform and Strengthen Global Coordination of the COVID-19 Outbreak Response
Disease outbreaks such as COVID-19 can lead to countries adopting excessive and counterproductive measures that hinder a globally coordinated response, compound illness and loss of life through unnecessary social and economic disruption, and discourage countries from openly reporting outbreaks for fear of retaliation. The World Health Organization (WHO) has recommended evidence-based decisions for adopting cross-border measures in adherence to the principles of the International Health Regulationsadopted in 2005. Preliminary analysis, however, suggests that a higher number and range of cross-border measures are being adopted than during previous international public health emergencies. Working with key knowledge users, including the WHO, a research team led by Kelley Lee of Simon Fraser University is collecting and analyzing new data, and combining it with existing datasets, to conduct real-time quantitative cross-outbreak analyses. The team’s research will enhance understanding of the diverse cross-border measures adopted, their public health and wider societal impacts, and reasons for their adoption. Their findings will support better decisions on what, when and why measures should be adopted.
The research team recently published a comment in The Lancet entitled "Global coordination on cross-border travel and trade measures crucial to COVID-19 response," and has two other research papers in progress. Lee recently published the short article, “Canada’s COVID-19 response: navigating national and global solidarity” in The Round Table: The Commonwealth Journal of International Affairs and has also presented talks and given more than 50 international media interviews on COVID-19. The team is now working closely with a local technology start-up, looking to partner on harnessing project data to develop and pilot a technology-based platform of tools to help policy-makers decide when to adopt or lift cross-border measures, such as travel restrictions and border closures. The platform would also be used for training and strategic preparedness planning. Read more highlights of Kelly Lee’s research
Scott Halperin, Dalhousie University
Understanding the Effects of Public Health Outbreak Control Policies and Implementation on Individuals and Communities: A Path to Improving COVID-19 Policy Effectiveness
Scott Halperin of Dalhousie University leads a project team that is examining the cultural dimensions of the COVID-19 pandemic through the ways individuals and communities understand and react to the disease, how public health authorities respond, and how public health policy affects individuals and communities. While policies such as quarantine, limitations to public gatherings and other restrictive measures are required to control an infectious disease outbreak, they can adversely affect individuals and communities through social and economic burdens that may be experienced disproportionately.
This multi-province, multi-country study conducted in Canada, Bangladesh and China is using qualitative methodology (document review, key informant interviews, focus groups) and quantitative methods (surveys). The team is studying policy and implementation from the viewpoint of public health/public policy, media, communities, healthcare providers, patients, caregivers and the general public, gathering new data as a means to help understand and improve the processes by which public health policies are created and implemented.
The team is now in the process of collecting data for the document review phase, and standardizing their approach across jurisdictions. With a vast amount of information to review, the team’s sampling strategy is far more complex than originally anticipated. Halperin co-authored a related article discussing the role of children in the COVID-19 chain of transmission, which was published in The Lancet on March 25, 2020.
Louis Flamand, Université Laval
Understanding the Pathogenesis of COVID-19
Pulmonary infections from viruses such as the SARS coronavirus (SARS-CoV-1) and Middle East Respiratory Syndrome (MERS-CoV) are associated with significant morbidity and mortality. Clinically, these viral infections are associated with pronounced lung inflammation from immune activation, causing respiratory problems that frequently develop into secondary pneumonia. Two main inflammatory mediators exist: cytokines and lipid mediators of inflammation (LMIs). When immune activation is too pronounced or sustained, cytokines and LMIs can cause more harm than good.
A Université Laval team led by Louis Flamand, professor and director of the faculty of medicine’s department of microbiology, infectiology and immunology, is studying the inflammatory response of lungs and blood cells during infection/exposure to SARS-CoV-2. They then compare these with the reactions generated by SARS-CoV-1 and MERS-CoV. The data will help the team obtain correlates of pathogenicity between these three viruses. The mediators of inflammation will be measured using state-of-the-art methodology after the primary epithelial cells and leukocytes have been exposed to the three viruses. These results will support the design of therapeutic strategies to help combat COVID-19.
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