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.

BC COVID-19 SPEAK Survey and Dashboard

One of the first key projects we supported in May 2020 was the BC COVID-19 SPEAK Survey: Your Story, Our Future, the largest-ever population health survey at that time in Canada with nearly 400,000 respondents. The purpose of the survey was to learn about British Columbians’ experiences, knowledge, and actions during the early days of the COVID-19 pandemic. The results of this survey provided our public health leaders with vital knowledge that helped shaped BC’s COVID-19 response.

Some of the key results of the SPEAK Survey included:

• British Columbians were following public health advice.
• People of diverse racial and ethnic backgrounds were impacted differently by COVID-19.
• Those with lower income suffered more negative economic and health consequences due to COVID-19.
• Those ages 18-29 and families with children reported greater mental health and economic burden throughout COVID-19.

The data from the SPEAK Survey were made available for all British Columbians through an interactive dashboard. The data not only offers evidence of how COVID-19 is impacting people in all corners of BC, but it also provides the public with a tool to look at and understand the data themselves, in particular what is happening at their regional and community levels.

Drawing heavily on the BC SPEAK data, as well as quantitative and qualitative findings, including quotes from young adults in BC describing the impacts of the pandemic in their own voice, the BCCDC COVID-19 Young Adult Task Force Report “Impacts of the COVID-19 Pandemic on the Health and Well-Being of Young Adults in British Columbia” was released in July 2021. In total, the report contains 32 specific recommendations spread across nine key areas of action and priorities.

BC COVID-19 SPEAK 2 Survey and Dashboard

Thanks again to our donors, we funded the BC COVID-19 SPEAK 2 Survey in 2021, which invited British Columbians to share about their experience one year into the pandemic. This second iteration of the population-level survey focused on gathering evidence at a second time point in the pandemic, as well as for recovery efforts and vaccination programming. More specifically, the “SPEAK 2 Survey” addressed four key areas:

• Life during the pandemic: How British Columbians’ behaviours and experiences have changed over the course of the pandemic.
• Vaccines: What barriers exist to accessing vaccines.
• Innovation and adaptation: How things have changed and how these changes have impacted British Columbians.
• Recovery: What supports are needed to help British Columbians through recovery from the pandemic.

Some examples of how the data are being used include to:

• 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.

A second interactive dashboard to reflect the data from the SPEAK 2 Survey was also made available to the public, and more sub-analyses and reports are expected to come from SPEAK 2 Survey data.

It is imperative that we collaborate across sectors, and with diverse stakeholders, to support and undertake more research and to take action to address the unintended consequences and inequities perpetuated by the COVID-19 pandemic.

Thus, we continue to raise funds and undertake COVID-19 response and recovery work. If you’d like to make a donation, please go here or call 604-707-2415.

For updates on this work and other related projects, go here.

The post COVID-19 Response: Population Health Evidence to Action  appeared first on Pacific Public Health Foundation.

CIE peer groups supported:
The Association for the Collaborative End to Stigma
ANKORS Cranbrook
Canadian Association for Safe Supply (CASS)
The CLEAN Team
Coalition of Peers Dismantling the Drug War (CPDDW)
Coalition of Substance User of the North (CSUN)
Comox Valley Street Outreach
“Connections” (formerly the Sunshine Coast Drug User Collective)
Drinker’s Lounge
Indigenous Harm Reduction Team
Kandu-Kelowna Area Network of Drug Users
The Langley Community Action Team (CAT) Peer Group
Positive Living North (PLN)
The POUNDS Project
Raincity
SNOW
Unbroken Chain
Unnamed emerging peer group in Terrace
Vernon Entrenched People Against Discrimination (VEPAD)
Youth Peer Group (YPG)

For updates on this work and other related projects, go here.

The post Compassion, Inclusion, Engagement (CIE) appeared first on Pacific Public Health Foundation.

Buprenorphine/naloxone Standard Dosing and Microdosing in the Emergency Department: A feasibility study (2019)

Research Lead: Dr Jessica Moe

Many vulnerable populations, such as First Nations, construction workers, and people who use drugs alone, are at high risk for overdose, and may only seek out healthcare services in Emergency Departments (EDs). Yet, EDs don’t have a good way of identifying those at risk and offering treatments that could prevent future overdoses. By preventing cravings and withdrawal symptoms, Buprenorphine/naloxone (Suboxone) is the recommended treatment for patients with opioid addiction who wish to decrease their harmful opioid use, and studies show that starting people on buprenorphine/naloxone during ED visits helps to connect them with addictions services.

At the same time, many barriers exist that prevent people from accepting this treatment, like experiencing uncomfortable opioid withdrawal symptoms like agitation, nausea, vomiting, and sweats, before starting buprenorphine/naloxone at standard doses, plus, the medication can make patients’ withdrawal symptoms worse if started too early. As a result, microdosing is a new way of starting buprenorphine/naloxone where people take small doses that gradually increase over 6-7 days. People also do not need to be in withdrawal before a microdosing method is started, and the risk of causing worsening withdrawal symptoms during initiation is low. Still, the longer time to reach a target dose is a downside. This innovative study examined the feasibility of starting people on buprenorphine/naloxone from the ED using both standard dosing and microdosing methods, and was the first to address knowledge gaps on the acceptability of these methods, further contributing to the understanding of barriers to induction methods and of how to optimize buprenorphine/naloxone provision for vulnerable ED patients.

Opioid prescribing evaluation and research activities (2016-2018)

Research Lead: Dr Roy Purcell

Deaths due to illicit drug overdoses in BC is on the rise. This dramatic increase in deaths due to illicit drugs is partially due to patients transitioning from prescription opioid use to illicit drug use, which is very common. Many drugs sold illicitly contain fentanyl, an extremely dangerous opioid that is many times more potent than heroin. Patients who transition from taking prescription pain relievers containing opioids to injecting illicit drugs will be a much higher risk of overdose death.

Funding from the BCCDC Foundation allowed researchers to use data from the BC Hepatitis Testers Cohort (BC-HTC), a comprehensive population-based longitudinal cohort consisting of all BC residents who have been tested for HCV or HIV at the BCCDC Public Health Laboratory, to investigate the association between prescribed opioid therapy and objective measures of intravenous drug use (IDU) in a population-based cohort of almost 1.4 million people in Canada. Importantly, this grant was a key component of further funding to complete this research.

CDPC National Knowledge Exchange and Consultation on Supervised Consumption Services (2016)

Research Lead: Dr Naveed Janjua

People who inject drugs face serious potential health risks, including vulnerability to HIV and HCV. As Canada is in the grips of an overdose crisis, many groups are working to establish Supervised Consumption Services (SCSs) as part of a comprehensive response to the overdose situation. Funding from the BCCDC Foundation brought the Canadian Drug Policy Coalition (CDPC) and the Canadian HIV/AIDS Legal Network (Legal Network) together for a two-day facilitated “National Knowledge Exchange and Consultation on Supervised Consumption Services (SCS)” in Vancouver, BC, hosting 100 guests from 20+ localities in Canada considering and/or implementing SCSs.

The event successfully enabled the development of a comprehensive analysis of barriers created by the Respect for Communities Act, and a greater understanding of challenges encountered when operating a supervised consumption site. Additionally, an important network of stakeholders such as community groups, health authorities, harm reduction workers, and people who use drugs, was established to further future knowledge exchange efforts and coordination. The CDPC continues to work at a national level and focuses on including a broader range of participants in its network and activities related to SCSs. With the newly refreshed network of SCS advocates, the CDPC will look at implementing new digital engagement strategies, and may create some task sub-groups to focus on issues of SCS applications, operations, and community advisory processes.

Peer engagement and evaluation project (2015-2016)

Research Lead: Dr Jane Buxton

Harm reduction programs are internationally accepted as effective for reducing health disparities associated with drug use. However, there are large variations in the availability, accessibility, and utilization of these programs across BC. Partnering with people who use drugs, or ‘peers,’ reduces inequities by making services relevant and responsive. The Peer Engagement and Evaluation Project (PEEP) aimed to develop, implement, and evaluate best practice guidelines for peer engagement for harm reduction initiatives using an approach that includes capacity building, empowerment, and engagement of peers, providers, and decision makers.

BCCDC Foundation funding was granted for the purpose of a team meeting, for which one of the main findings was understanding the amount of stigma and discrimination among health providers across the province. As a result, the development of knowledge translation tools, including anti-stigma training with a photo series, were used at presentations across the province, as well as the development of best practice guidelines, which have been directly informed by the validation of their focus group findings at the team meeting.

You can stay connected on all project updates by visiting this page and subscribing to our newsletter.

The post Reducing Harms: Seed and Pilot Funding for BCCDC Researchers appeared first on Pacific Public Health Foundation.

• Share professional and lived experiences about SOGIECE in a supportive, affirming, and collaborative environment
• Identify key health and social service needs of SOGIECE survivors
• Exchange ideas about pan-North American interventions, including policy and advocacy work, public awareness & education, and improved supports for SOGIECE survivors
• Determine how research could be undertaken to fulsomely characterize the prevalence and nature of SOGIECE in Canada, as well as to inform interventions to prevent new harms and ameliorate ongoing negative health and social impacts of SOGIECE

By funding this work through the Community-Based Research Centre (CBRC), this event was a catalyst for broader research priorities around supporting the health and wellness needs of SOGIECE survivors. Through conducting in-depth interviews with survivors across Canada, researchers aim to shed light on the specific needs of this population to better support their long-term positive health outcomes.

Results:
Because the health of LGBTQ2S communities is an essential part of public health, the stories and collective expertise from the Vancouver Dialogue was used to form important research questions, with the aims of empowering survivors, identifying how to best support the health and wellness of LGBTQ2S youth and adult survivors, how to create institutional change, and what advocacy can be done to end SOGIECE practices in Canada.

The following are some of the outcomes and ongoing work being done:

• Researchers published a detailed report entitled Ending Conversion Therapy in Canada
• Advocacy around the conversion therapy conversation led to Prime Minister Trudeau issuing a mandate letter to Attorney General Lametti to “… amend the ‘Criminal Code’ to ban the practice of conversion therapy and take other steps required with the provinces and territories to end conversion therapy in Canada.”
• Ongoing interviews are being conducted across Canada to continue the research
• A second Dialogue event is being planned for Fall 2020

For more information, visit our website for a guest blog post from Dr Travis Salway Beyond the Ban: A Public Health Strategy to Eradicate Anti-2S/LGBTQ Practices and SOGIECE through the Centre for Gender & Sexual Health Equity.

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Researchers: Drs James Johnston, Jennifer Gardy, and Patrick Tang

Tuberculosis (TB) is an infection caused by a slow-growing germ most often in the lungs spread through the air from one infected person to another through coughing, sneezing, laughing, or singing. TB isn’t a disease of the past–decades after the first antibiotics to treat TB were developed, Canada still sees five people diagnosed with TB every day. Federally and provincially, Canada is committed to eliminating TB, and in British Columbia (BC), innovative genomics techniques are being used to accelerate our progress towards elimination.

The BCCDC Foundation is proud to have funded a five-year project—one of the largest TB genomics projects at the time (nearly 1500 TB genomes)—that used DNA sequencing of the TB bacterium to understand how it is entering BC, how it is moving from person to person across the province, and, most importantly, how this transmission can be stopped, resulting in fewer cases of this serious illness.

Drs Gardy and Johnston felt that the impact of this project was profound, a world first, and it generated actionable insights into TB transmission, changing how BC approaches TB prevention.

This project has been the best experience of our scientific lives so far!

Dr Jennifer Gardy, researcher, in 2018

As of 2018, this work had generated 16 publications and been presented internationally, with over 50 invited talks and poster presentations. Begun with funds through the BCCDC Foundation in 2014, additional funds were secured through Genome BC, allowing the Foundation to successfully leverage our initial investment and extend the project and expand the outcomes well beyond the initially-proposed aims. Though this project wrapped up in 2019, we’re very proud to have made such an impact to TB research for BC and know that we helped set this research team on a path to further success.  

You can stay connected on all project updates by visiting this page and subscribing to our newsletter.

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