Dr. Andrew Pinto, Dr. Benita Hosseini and Norm Umali. (Photo: Eduardo Lima)

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Unity Health Toronto has received $18.9 million in federal funding to create a national pandemic preparedness system that will improve Canada’s capacity to identify and track new pathogens, monitor disease spread and speed up research and development of diagnostic tests, vaccines and therapeutics.

The PREPARED network will enlist up to 50 primary care clinics and emergency departments across Canada, plus research institutions and industry partners to build a coordinated ecosystem that can swiftly respond to new viruses or pathogens. The PREPARED grant is one of the largest operating grants Unity Health Toronto has received.

The goal is to prepare Canada for the next pandemic — which is only a matter of time, says Dr. Andrew Pinto, project lead and scientist and family physician at St. Michael’s Hospital, a site of Unity Health Toronto.

“I was in medical school during SARS and joined meetings that tried to tackle the rapid spread of a novel virus. Even with learnings from other flu pandemics, Canada still faced the same challenges when COVID arrived,” said Pinto, who is also the director of the Upstream Lab. “We didn’t have an early warning system. We didn’t have a coordinated system to rapidly enroll patients in critical research studies.”

The funding from the Canada Biomedical Research Fund (CBRF) was announced on May 6 in Montreal. PREPARED is one of four research programs endorsed by the Canadian Hub for Health Intelligence and Innovation in Infectious Diseases (HI3) that was funded by CBRF in 2023 with a mandate to bolster Canada’s biomanufacturing capacity and readiness to respond to emerging health threats.

A new ecosystem built on primary care

The goal of the PREPARED network is to build an ecosystem that can be activated from the moment there is news of a novel pathogen emerging, says Norman Umali, Upstream Lab, St. Michael’s Hospital research pharmacist and project team member. 

In the new ecosystem, primary care clinics and emergency departments across Canada would be on alert for any signs of the new pathogen. When a patient goes to their family physician or local emergency department showing symptoms, the patient would be assessed and given a diagnostic test that would confirm within minutes whether the patient has the virus. Swabs from the positive patient would be taken to help identify and sequence the exact pathogens circulating in the community. These samples could also be used to help build the next diagnostic test or vaccine.

Data from patients’ electronic records could be rapidly and securely accessed to support clinicians in decision making, while also contributing to national disease surveillance efforts. As well, patients who test positive would be invited to participate in research studies and trials to gain access to the latest therapies and to help determine which therapies are beneficial.

The ecosystem builds on a Canadian network of primary care clinics and emergency departments. The project team includes leaders of 16 primary care research networks that collectively serve more than 2.5 million Canadians, from British Columbia, Alberta, Manitoba, Ontario, Quebec and Newfoundland and Labrador.

The team has also consulted and will collaborate with 11 industry partners with expertise in specimen collection, diagnostics, genomics, surveillance and data management, therapeutics, gene therapies and vaccine development.

Building a resilient, adaptable system

Beyond tracking acute respiratory infections, the team sees other future applications for this model, says Dr. Benita Hosseini, Upstream Lab research scientist and project co-lead.

“We would like to adapt the ecosystem to track other infectious diseases, such as mpox, or other chronic conditions. It could also be adapted to perform surveillance during other public health emergencies, such as those driven by climate change,” she said. The goal is to build an adaptable, patient-centered healthcare system, to improve our readiness for current and future health challenges and for transforming healthcare efficiency and effectiveness.

Part of the project is to train the next generation of researchers through the PREPARED Talent Development Program, Hosseini adds. In this program, trainees can choose a learning stream to focus on surveillance, data science, Implementation Science or Community-Based Participatory Research.

Pinto notes that in the United Kingdom, clinicians were able to quickly enroll patients into clinical trials within weeks of the first COVID cases being detected. As a result, the U.K. led the world in understanding what therapies worked in treating COVID, he said. One of the goals of PREPARED is to facilitate linkages to research trials by integrating recruitment efforts within primary care clinics and emergency departments, he said.

“We are excited about the opportunity to create a coast-to-coast shield that will help protect Canada and Canadians in the future,” said Pinto.

By: Marlene Leung