Studies also research the immune response to vaccines
Long-term care facilities have been disproportionately burdened by COVID-19, accounting for about 60% of COVID-19 deaths nationwide, 70% if retirement homes are included. Not only are residents of these facilities particularly vulnerable to COVID-19 given their advanced age, reduced immune system capacity and multiple underlying health conditions, but staff also face an increased risk of infection. The Government of Canada, through its COVID-19 Immunity Task Force (CITF), is providing a total of $8.5 million to support two studies investigating various aspects of immunity and people’s response to vaccines within long-term care facilities. These studies are recruiting participants in Ontario, Quebec and British Columbia.
Investigators from the Bruyère Research Institute and the University of Ottawa have been awarded $3.5 million in funding for their cross-provincial study.
“Over the course of one year, we will study the immune response of workers and residents in long-term care facilities across Ontario, Quebec and British Columbia,” explains Amy Hsu, PhD, Investigator at the Bruyère Research Institute. The team will recruit over 3,500 residents and 2,500 workers from long-term care facilities in all three provinces and ask them for blood samples over several months. Their goal is to gain insight into how various immunity factors, such as antibodies, react to COVID-19 and/or vaccines.
“We will compare the immune response in individuals who previously had COVID-19, those who got vaccinated, and those who have not been infected,” explains co-investigator Marc-André Langlois, Professor at the University of Ottawa. “By linking the information that we find from analyzing their blood to healthcare data, we will be able to follow individuals over time to look at their long-term outcomes following an infection and the duration of protection they get from vaccination. We will track the occurrence of adverse events and serious illness over time. More specifically, we will be closely analyzing the subgroup of antibodies, called virus neutralizing antibodies, that protect against new infections.”
“We will use an app called CANImmunize, which is a pan-Canadian digital immunization tracking application developed by study co-investigator, Dr. Kumanan Wilson. We’ve modified it a little for long-term care facilities to allow them to input the information for all participating residents and staff in a batch while allowing each participant to have a record of which vaccine they received, when, and how long it was between their first and second dose,” explains Dr. Hsu. “We currently don’t have a tracking system for vaccines in long-term care facilities in Canada. This platform will allow us to better track vaccinations in long-term care facilities in the future.” To find out more: www.c19immunitystudy.ca
The second study, in which the CITF is investing $5 million, led by Dr. Sharon Straus, from St. Michael’s Hospital of Unity Health Toronto, will include people in 72 long-term care facilities in the Greater Toronto Area and the Ottawa-Champlain region.
“We want to know how many people previously had COVID-19, whether they had symptoms or not,” explains Dr. Straus, Physician-in-Chief, St. Michael’s Hospital and Professor in the Department of Medicine, University of Toronto. “We will learn what factors at the home, which individual factors, and what immune-response levels are associated with previous COVID-19 infection or with the prevention of infection. We will also be able to track how the COVID-19 vaccines influence immune responses over time.”
The research team will be exploring these questions through studies using blood and saliva samples. They are engaging long-term care facility residents, their essential care partners, staff, and their household members.
“We are also exploring how wastewater surveillance of SARS-CoV-19 may identify outbreaks sooner in long-term care facilities and in the communities,” adds Dr. Straus. “This would allow earlier implementation of onsite testing and other strategies to manage the outbreak.” The wastewater testing will be led by Dr. Rob Delatolla from the University of Ottawa and Dr. Claire Oswald and Dr. Kimberly Gilbride from Ryerson University.
Dr. Straus and her team, which includes established researchers across the country such as Drs. Christine Fahim, Stefan Baral, Sharmistha Mishra, Allison McGeer, and Adrienne Chan, are working with 40 partners to develop, implement, and evaluate an intervention plan that could be implemented at long-term care facilities across Canada rapidly.
“This plan is aimed at enhancing staff wellness at long-term care facilities and encouraging the uptake of infection prevention best practices and vaccine implementation, including addressing vaccine hesitancy,” says Dr. Straus. Examples of recent components of this intervention include town halls, a vaccine infographic for personal support workers and a wraparound care plan which includes help with accessing groceries, medications, childcare for workers who need to be quarantined.
In addition to the CITF funding, a newly amalgamated organization that brings together Canadian Foundation for Healthcare Improvement (CFHI) and Canadian Patient Safety Institute (CPSI) is providing an additional $920,000 to contribute towards the implementation of these interventions in long-term care facilities and in shelters serving those who experience homelessness. This expansion is in partnership with the Canadian Centre on Substance Use and Addiction and the support includes infection prevention and control expertise.
“The LTC+ Acting on Pandemic Learning program is helping enable nearly 500 long-term care and retirement homes from across the country to rapidly learn from each other to strengthen their pandemic response,” states Jennifer Zelmer, President and CEO of CFHI and CPSI.
To find out more about Dr. Straus’ study: www.wellness-hub.ca.
“The CITF has created networks among several of our funded studies with the aim of sharing data collection methods, ideas, and processes, and the Long-Term Care Network is one of them,” says Dr. Catherine Hankins, CITF Co-Chair. “These two projects have gone a step beyond, working closely together after realizing there was overlap in their projects’ participant population. Their collaborative approach is what the Task Force aims to encourage, as it’s an opportunity to gather the most robust picture without duplication of efforts, while minimizing the burden and disruption to their resident populations.”
“These studies investigate the factors that have contributed to COVID-19’s disproportionate impact on those living and working in long-term care facilities across the country,” states Canada’s Chief Public Health Officer, Dr. Theresa Tam. “Their results will support strategies to better protect residents and staff in these facilities.”
ABOUT THE COVID-19 IMMUNITY TASK FORCE
In late April 2020, the Government of Canada established the COVID-19 Immunity Task Force with a two-year mandate. The Task Force is overseen by a Leadership Group of volunteers that includes leading Canadian scientists and experts from universities and healthcare facilities across Canada who are focused on understanding the nature of immunity arising from the novel coronavirus that causes COVID-19. To that end, the CITF is supporting numerous studies to determine the extent of SARS-CoV-2 infection in Canada (in the general population as well as in specific communities and priority populations), understand the nature of immunity following infection, develop improved antibody testing methods, and help monitor the effectiveness and safety of vaccines as they are rolled out across Canada. The Task Force and its Secretariat accordingly work closely with a range of partners, including governments, public health agencies, institutions, health organizations, research teams, other task forces, and engages communities and stakeholders from inception through to dissemination of findings. For more information visit: www.covid19immunitytaskforce.ca
Bruyère provides a wide range of health services within its hospitals and long-term care facilities in Ottawa. As an academic healthcare organization, Bruyère specializes in care of the elderly through rehabilitation, palliative care, brain health, and complex continuing care. The Bruyère Research Institute supports investigators who contribute to a better, more responsive healthcare system that delivers the best care to patients, residents and families. To learn more, visit www.bruyere.org.
ABOUT ST. MICHAEL’S HOSPITAL
St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.
ABOUT UNITY HEALTH TORONTO
Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit www.unityhealth.to.
ABOUT THE UNIVERSITY OF OTTAWA
The University of Ottawa is home to over 50,000 students, faculty and staff, who live, work and study in both French and English. Our campus is a crossroads of cultures and ideas, where bold minds come together to inspire game-changing ideas. We are one of Canada’s top 10 research universities—our professors and researchers explore new approaches to today’s challenges. One of a handful of Canadian universities ranked among the top 200 in the world, we attract exceptional thinkers and welcome diverse perspectives from across the globe. www.uottawa.ca
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