Time frame: 2020-2022

Overview:
Not long after the World Health Organization declared COVID-19 a pandemic, Dr Natalie Prystajecky and Dr Melissa Glier, who had already been studying viruses in wastewater since 2018, were able to quickly leverage an existing collaboration, methods, and equipment for testing enteric viruses in wastewater to be able to test for SARS-CoV-2, the virus that causes COVID-19. Recently adopting an alternative sampling method that allows to test wastewater from an entire community, their team is also working on a method to test wastewater as it exits a building, thus providing key information on how COVID-19 is being spread throughout and among BC communities.

Results:
Funding for their work allowed Drs Prystajecky and Glier’s team to optimize their methods and test for SARS-CoV-2 in five wastewater treatment plants in Metro Vancouver, covering nearly 50% of BC’s population, along two regional health authorities. Weekly reports are shared with medical health officers and epidemiologists within regional health authorities, BC Centre for Disease Control staff, and Metro Vancouver.

Their collaborations have extended to the development of a three-day rapid sequencing method to effectively track COVID-19 variants of concern within a region, and key findings from their studies have been published in the Journal of Environmental Sciences and the American Society for Microbiology, with more to come. With the Omicron variant, wastewater testing has become a critical and necessary component of SARS-CoV-2 monitoring and surveillance.

Rapid SARS-CoV-2 Vaccine Research Initiative in BC

Time frame: 2021-2022

Overview:
In a new and unique partnership with Genome BC and Michael Smith Health Research BC (formerly the Michael Smith Foundation for Health Research), we funded nine new rapid-response vaccine research projects addressing COVID-19 vaccine research priorities and knowledge gaps. This funding program was developed and implemented in real-time, enabling us to get funding to critical research projects rapidly in order to have high-impact on vaccination roll-out for BC. Collective funding of around $1.3M is allowing for vaccine research that ultimately focuses on public health response and ensuring access to, and confidence in, vaccination programs for everyone in BC.

More specifically, the projects funded address areas such as:

• vaccine breakthrough infections;
• vaccine effectiveness in the context of Variants of Concern and in immune response;
• viral transmission;
• equitable distribution;
• vaccine acceptance and attitudes towards vaccines; and
• vaccine literacy and hesitancy among people who are pregnant or breastfeeding, people who are incarcerated, people who work in long-term care homes and a variety of multicultural communities in the Lower Mainland.

For a summary of the projects, go here.

Results:
We’ll continue to share outcomes of this research as these projects progress. You can stay connected on project updates by visiting this page and subscribing to our newsletter.

The post COVID-19 Response: From Monitoring to Vaccination appeared first on Pacific Public Health Foundation.

Approximately 200,000 respondents completed the SPEAK 2 Survey, allowing public health experts to track and learn from local- and community-level data ensuring the cross-section of the population of BC is well-captured.

The purpose of this second-round survey was to better understand British Columbians’ experiences one year into the pandemic. This includes data on areas such as how behaviours and experiences have changed over the course of the pandemic, and the impacts of the pandemic on British Columbians. These data are helping our experts determine how to best respond to ongoing challenges, plan for adaptation and recovery, understand what barriers exist to accessing vaccines, and what supports are needed to help with recovery.

Examples of how the data have been used so far include:

• Inform re-opening plans for safe return to school for kindergarten to grade 12 and the return of in-person post-secondary education.
• Model the impact of the pandemic and informed restart plans.
• Target education and interventions to areas with high vaccine hesitancy levels and inform COVID-19 vaccine program decisions and equity considerations.
• Raise discussions with medical and health leaders around virtual health and healthcare access.
• Raise discussions with community stakeholders to target supports and initiatives to improve mental health.
• Inform recovery priorities in supporting the health and wellbeing of young adults aged 18-29 years and their communities across BC.

“The results from this round of the population health survey continue to show the severe impacts of the pandemic on the health and wellbeing of British Columbians, in particular, worsening mental health, disproportional impact on young adults, and increasing inequities.”

Jat Sandhu, Senior Executive Director, Innovation, Partnerships and Population Public Health Management

Results provide evidence across a variety of key indicators that will help British Columbia learn from the past and prepare for the future.

You can find more data and technical notes on the BCCDC website.

We’re as always very grateful to our donors and partners who have helped us to support such critical work that our public health leaders, decision-makers, and experts need to get us through the pandemic and better prepare us for recovery.

We continue to raise funds to support COVID-19 response and recovery efforts through our Emergency Response Fund and with your support we can help more people, faster.

The BCCDC Foundation continues to take on initiatives that leverage the government’s leadership role in healthcare delivery by supporting public health research, programs, and initiatives, and we are committed to seeing the province through recovery, ensuring that we bring a health equity focus to all population and public health programs.

If you would like to make a significant contribution to ensure BC is on the cutting-edge of COVID-19 response and research, please contact us at donate@bccdcfoundation.org.

The post Providing Evidence to Guide COVID-19 Response: BC COVID-19 SPEAK 2 Survey and Interactive Dashboard appeared first on Pacific Public Health Foundation.

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“Now, more than ever before, British Columbians recognize and value public health leadership, and the need for us all to share responsibility for protecting the health of our population. By partnering with MSFHR and Genome BC, we can share the responsibility of funding vaccine research and ensure we’re keeping our population safe and well.”

Kristy Kerr, Executive Director, BCCDC Foundation for Public Health

The main goal of this provincial initiative is to fund BC-based research solutions in priority areas that will have significant potential for fast impact on the COVID-19 pandemic in BC.

The objective is to address questions such as:

• What is the long-term effectiveness of vaccination in preventing illness and infection and reducing transmission?
• What can we learn about the immune response to vaccination using real world data?
• What concerns do people or communities in British Columbia have and how can we counter misinformation?
• How can we overcome barriers to equitable distribution?
• How could new considerations, such as Variants of Concern, affect implementation strategies?

To guarantee real and immediate impact, we also partnered with the Academic Science Health Network to ensure engagement with public and patient populations was embedded within the research, and Population Data BC to support key access to data needs in a timely fashion. These two key pieces will help researchers to ensure that their results can have the intended impact—real-time results to provide solutions to vaccine questions that will advance COVID-19 vaccination in BC.

The projects represent a range of studies, all with an emphasis on addressing urgent issues; at their core they all focus on our public health response and ensuring access to and confidence in vaccination programs for everyone in BC. It’s critical research such as this that has, and will continue, to address COVID-19, and help us get closer to putting an end to our pandemic in BC.

With a collective funding allocation of around $1.3M, this initiative is able to support 9 research projects that will address areas such as:

• vaccine breakthrough infections;
• vaccine effectiveness in the context of Variants of Concern and in immune response;
• viral transmission;
• equitable distribution;
• vaccine acceptance and attitudes towards vaccines; and
• vaccine literacy and hesitancy among people who are pregnant or breastfeeding, people who are incarcerated, people who work in long-term care homes and a variety of multicultural communities in the Lower Mainland.

This is collaboration at its best—when we authentically work together with a shared goal and vision the impact is clear—Genome BC and MSFHR are essential research funding organizations in BC, and by joining forces we will move the dial on vaccine research much faster.

We’d like to thank Genome BC and MSFHR for their commitment to supporting critical research in BC, and for their willingness to work together to help combat the COVID-19 pandemic.

Project summaries:

Daniel Ting, UBC
Vaccine Effectiveness of Variants in British Columbia
The Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN) has harmonized data collection for COVID-19 tested patients across 50 emergency departments in 8 provinces, including BC. This new project will leverage CCEDRRN’s existing and growing registry infrastructure to determine the real-world effectiveness of vaccines in BC in reducing severe COVID-19, as documented by emergency admission. Research efforts will specifically focus on vaccine effectiveness against the P.1 Variant of Concern circulating in BC, and on effectiveness of a single dose to assess outcomes of Canada’s dose delay. This study will provide critical real-world data about vaccine performance and support key study sites in the Lower Mainland.

Zabrina Brumme, Simon Fraser University (SFU)
COVID-19 vaccine immune response with HIV
This project will evaluate the magnitude and duration of COVID-19 vaccine immune response over time in persons with and without HIV (control). Laboratory analysis investigating both antibody and cellular immune responses will also consider recognition of emerging Variants of Concern. This study also includes looking at socio-demographic and other correlates of immunity differences to try to help direct public health response around handling vaccination for individuals living with HIV and, potentially, other immunocompromised individuals.

Agatha Jassem, UBC, BC Centre for Disease Control
COVID-19 SMILES – the study of vaccine escape mutants
Vaccine escape mutants have the potential to undermine the effectiveness of the global vaccination campaign against SARS-CoV-2. The team will develop a surveillance program to detect and sequence viral variants emerging from vaccine breakthrough infections. These mutants will be tested experimentally to understand their responsiveness to vaccine-induced immunity, and modeling will be incorporated to project the impacts of vaccine escape mutants on transmission and pandemic progression in BC.

Catherine Hogan, UBC, BC Centre for Disease Control
VITAL: Vaccine Investigation of Transmission Analysis Longitudinally and Effectiveness
This project will integrate data sources to investigate (1) the impact of SARS CoV-2 vaccination on viral load and subsequent infection transmission at a population level and (2) the characteristics of individuals who have post-vaccine breakthrough infections with and without Variants of Concern. The outcome of this work will be to understand the vaccination scenarios most likely to effectively halt transmission in BC, and to help plan and prioritize public health interventions.

Sofia Bartlett, UBC, BC Centre for Disease Control
Advancing COVID‐19 vaccines in BC Prisons
A previous COVID-19 study in BC Provincial Correctional Centres in January 2021 identified that COVID-19 vaccine acceptance among people who are incarcerated (PWAI) was low, with only 59% (181/308) of PWAI surveyed indicating they would accept a COVID-19 vaccine if offered. To increase COVID-19 vaccine confidence among PWAI, the team will undertake a community-based study including PWAI in the research design process and as peer educators. Quantitative surveys will be developed with PWAI, then deployed to determine current vaccine literacy levels and concerns about COVID-19 vaccines among PWAI. Using this data, educational resources will be co-developed with PWAI, and peer-educator training provided to PWAI.

Julie Bettinger, UBC, BC Children’s Hospital Institute
COVID-19 South Asian Community Response Study
Statistics Canada estimates South Asians are 50-60% less likely to get a COVID-19 vaccine due to misinformation and fear of adverse events. Our study will identify the information needs, values, beliefs, and experiences related to COVID-19 vaccination among ethnically South Asian communities in the lower mainland of British Columbia and develop culturally appropriate communication interventions to promote COVID-19 vaccination.   

Marie Tarrant, UBC Okanagan
COVID-19 vaccine hesitancy in pregnancy, breastfeeding, and parenthood
Limited data on COVID-19 vaccine developments for pregnant and breastfeeding persons as well as for children may increase vaccine hesitancy in Canada. To counter misinformation and promote vaccine uptake, this project will examine vaccine hesitancies and concerns among people who are (or planning to be) pregnant or breastfeeding and parents with young children in BC. Quantitative and qualitative data will be collected to examine COVID-19 vaccine knowledge, concerns, and vaccine hesitancy to assist in developing knowledge mobilization materials for these groups. A deeper understanding of these communities’ hesitancies will allow us to create tailored resources for these priority populations to promote vaccine acceptance.

Katelin Albert, University of Victoria
What British Columbians Know and Think about COVID-19 and Vaccinations
This research investigates Southern British Columbians’ concerns, opinions, and attitudes towards COVID-19 vaccinations and public health initiatives, and what contributes to these beliefs. In order to combat misinformation and vaccine hesitancy, this project will uncover what information people have, what they do with that information, and how it influences their attitudes towards vaccination. From those insights, these efforts will contribute to revealing the relationships between people’s views of personal and public safety, their attitudes towards vaccination, their behaviours during this pandemic, and the daily stressors and mental health needs that might lead them to draw on misinformation or adopt risky behaviours.

Valorie Crooks, SFU
The INFORM Study
The COVID-19 pandemic has created a crisis in long-term care. In Fraser Health, there have been 105 outbreaks and 426 deaths across its 85 long-term care facilities. Even with the arrival of vaccines, challenges still exist for this sector and this project will address the emerging challenge of concerningly low rates of vaccination among long-term care staff in Fraser Health. This team of researchers and integrated end-users will tackle this problem by developing and disseminating tailored informational tools through a two-pronged qualitative approach. The tools will also be more widely distributed throughout British Columbia using engaged end-user networks.

The post A New Partnership to Fund Priority Research on COVID-19 Vaccination in BC appeared first on Pacific Public Health Foundation.

Q. Your COVID-19 research that we’re able to support through our Emergency Response Fund includes the population health survey, serological testing, and sentinel surveillance: why is this three-pronged approach the best way to proceed?

We are experiencing a continuing global spread of SARS-COV2 (the virus that causes COVID-19) that will require heightened coordinated public health surveillance and response activities for the foreseeable future. As this core work continues, there remains a number of unanswered questions on the efficacy of interventions; adverse consequences from public health measures; whether having experienced the infection affords any protection from re-infection; and, whether there are opportunities to identify earlier signs of community transmission.

My work at the BC Centre for Disease Control is to lead this three-pronged investigation.  We will examine these issues and provide some of the key information necessary to guide policy and planning decisions over the short-to-medium term response activities. These policy and planning decisions are aimed at keeping British Columbians safe and healthy.

All British Columbians have been impacted by the pandemic and have been very engaged on the progression of the local epidemic. Our approach is intended to further engage the public in supporting the response by informing the pertinent issues under consideration.

Q. What was a standout learning or piece of data from the BCCDC’s “Your Story, Our Future” population health survey that’s really stuck with you?

The results from the population health survey indicate that overall British Columbians have been very compliant with the measures in place and have adopted good personal preventive practices to limit exposure and spread of COVID-19. However, the results also reveal that these measures are having adverse consequences for British Columbians, in particular young adults, households with school-aged children, and those from some visible minority backgrounds.

Q. What do you hope to achieve from serological testing? What do you want to learn and how will that help protect our population?

Serological (antibody) testing is conducted to help understand if someone has contracted COVID-19. When we’re exposed to a new virus our immune system produces antibodies which help fight off infections and can provide protection against getting that disease again—this is immunity. Serological, or antibody tests, tell us about a past infection and cannot be used to diagnose a current infection.

We use serological tests to understand the extent to which a population has been infected with COVID-19; it provides information on population susceptibility and the potential for the virus to continue to propagate in the absence of an effective vaccine.

Secondly, it may help us understand which population sub-groups have had more exposure to COVID-19. Understanding how specific sub-groups are impacted, like households with children, can guide prevention efforts which allows us to better target possible chains of transmission in the community.

Thirdly, we don’t currently know how much protection the antibodies for COVID-19 may provide to subsequent infections or how long this protection may last. In other words, we don’t know how long people who have had COVID-19 are immune for. It is very important we examine this over time with repeated testing in the short to medium term.

Q. “Surveillance” sounds scary. What does the third phase of this work, sentinel surveillance, actually mean and how will it help?

Surveillance is the monitoring, or information gathering, to help better characterize a particular health condition. Public health regularly uses surveillance to keep track of many different communicable diseases. However, most information is captured after an individual experiences an illness and has a diagnosis.

“Until an effective vaccine is developed and widely distributed, we have to rely on a public health response of keeping transmission low.”

Sentinel surveillance provides an opportunity to seek out COVID-19 illness at an earlier stage by monitoring self-reported symptoms within a defined setting (for example, households) across British Columbia’s population. With appropriate technology to distinguish relevant symptoms, it can provide an efficient and early warning system of potential increase in community transmission.

Q. Why do research? Why not just develop a vaccine?

COVID-19 is caused by a novel pathogen that has emerged with significant global consequences, and there is much around its transmission, adverse physical health impacts, and immune response we are still trying to understand.  Vaccine development typically requires years of safety and efficacy trials before it is approved for general use at scale.

Until that time, we need to maintain focus on the core public health response of testing and tracing, which are essential steps to suppressing community transmission. The more effectively and quickly this is done, the better we prevent the escalation of localized cases into broader community transmission that may result in greater burden on the health care system.

Until an effective vaccine is developed and widely distributed, we have to rely on a public health response of keeping transmission low, and our research will indicate the best ways of doing that for our population.

Q. How does your work, and the work of the BCCDC, fit into the larger response in BC and align with the Ministry, the health authorities, and what other experts and researchers are doing? What piece of the puzzle is the BCCDC bringing to this work?

Our provincial collaboration is critical to public health. Working together ensures we have the greatest collective impact. Public health leadership across BC includes the BCCDC, the Provincial Health Officer, and the Chief Medical Health Officers who have the responsibility for carrying out legislated requirements under the Public Health Act and to monitor, assess, and advise on health in BC. It is this leadership group who are actively providing critical tactical and strategic guidance for managing the public health emergency and part of this role is providing key direction that guides this project and associated work.

This leadership group also allows us to bring together information from all the relevant experts that support public health practice and applied research in BC. This ensures decisions are based on available data, such as the survey results, emerging research and the best evidence.

BCCDC is a critical hub in this larger response effort; from testing to research to providing guidance on public health direction for the PHO, BCCDC’s leadership and experts are an invaluable resource for not only this project but for so many of the public health efforts currently underway to keep British Columbians safe. 

Dr. Jat Sandhu is a Consultant in Epidemiology & Population Health Management at the BC Centre for Disease Control, and Clinical Associate Professor at UBC’s School of Population and Public Health. Dr. Sandhu has been seconded to the BCCDC part time from his primary role at Vancouver Coastal Health as Executive Director for Data Analytics and Decision Support.

View more of the population health survey results, and BCCDC modelling updates here.

You can support Dr. Sandhu’s research and the BCCDC’s public health response to COVID-19 by donating to our Emergency Response Fund. We’re more than 80% of the way to our goal of $500,000. Donations will support the serology and sentinel surveillance phases of this work.

The post Interview with Dr Jat Sandhu: BCCDC’s COVID-19 Pandemic Response Research appeared first on Pacific Public Health Foundation.