New initiative to shield Canada against future pandemics

Western’s DELPHI Network one of the 16 primary care electronic medical record networks across the country to enhance early detection and response time.
(Image design by Megan Morris)

By Upstream Lab with files from Schulich Medicine & Dentistry

Downtown cores stood silent, streets were almost empty and people stayed six feet apart - that was the "new normal" four years ago when, after 180,000 cases worldwide and more than 4,000 deaths, the World Health Organization declared COVID-19 a pandemic. But the question remains: is Canada ready for the next public health emergency? 

The Upstream Lab in collaboration with Western University and other institutions across the country, has received $18.9 million from the Canada Biomedical Research Fund to create a new approach to pandemic preparedness that will improve the monitoring and early detection of pathogens while accelerating the development of vaccines, treatments and diagnostics.  

The  Pandemic P reparedness Engaging  Primary C are and  Emergency  Departments, or  PREPARED , is a new initiative to improve the national response to pandemics. PREPARED will create a system to alert government agencies and researchers of new pathogens and provide real-time samples for faster vaccine, treatment and diagnostic development. 

"Our work is about preparing Canada for future pandemics. We will create a system of surveillance integrated with research. This means connecting people to trials and accelerating the development of new diagnostics, vaccines and treatments," said Dr. Andrew Pinto,  Upstream Lab  director and project lead. PREPARED builds on the lab's existing research on the social factors that influenced COVID-19 , automating surveillance and evaluating treatments through CanTreatCOVID , an ongoing national trial. "Upstream prevention means thinking about the interplay between infectious threats and social threats." 

Primary care electronic medical record networks as a solution 

The PREPARED initiative will ultimately partner with 50 sites across Canada to routinely collect samples from patients with respiratory symptoms and continuously scan electronic medical records. The data from both sources will help identify new viruses and monitor the evolution of known diseases. 

“We are pleased to be one of the 16 primary care electronic medical record networks across Canada contributing to this ground-breaking work to enhance surveillance and response to acute respiratory illness,” said Bridget Ryan, PhD, project co-investigator and associate professor in the Departments of Family Medicine and Epidemiology and Biostatistics at Schulich Medicine & Dentistry. 

Ryan, and Schulich Medicine & Dentistry professor and project co-investigator Amanda Terry, PhD, are co-leads of the Deliver Primary Healthcare Information (DELPHI) network, based at Western’s Centre for Studies in Family Medicine. DELPHI created a primary care electronic medical records-derived database to conduct research on patients’ symptoms and health conditions, as well as to conduct health services utilization studies.

“This project will strengthen Canada’s pandemic preparedness, and the overall resilience and responsiveness of our health care system,” said Terry, associate professor in the Departments of Family Medicine and Epidemiology and Biostatistics. 

The initiative will implement new, rapid testing systems for multiple viruses such as COVID-19, RSV, adenovirus and influenza. With this standardized approach in health-care settings, patients receive care faster and can avoid unnecessary antibiotics. It also helps build healthier communities by safely and securely providing real-time samples to industry partners that develop vaccines, treatments and diagnostic tests. 

PREPARED has emerged as a collaboration with 30 institutions and 16 primary care research networks that serve more than 2.5 million patients in Canada, including those from Ontario, Alberta, British Columbia, Manitoba, Newfoundland and Labrador and Québec. Experts in primary care, infectious diseases and pandemic preparedness co-lead the initiative. 

Looking beyond COVID-19 

In addition to enhancing pandemic preparedness, the initiative will go beyond monitoring respiratory illnesses. "We would like to adapt this approach to track other emerging infectious diseases, such as mpox. It could be adapted to perform surveillance during other public health emergencies, such as those driven by climate change," said Dr. Benita Hosseini, Upstream Lab research scientist and a project co-lead. 

Part of the project is to train the next generation of researchers through the PREPARED Talent Development Program, Dr. Hosseini added. Trainees can choose a learning stream to focus on surveillance, data science, implementation science or community-based participatory research.