Briefing on the Canadian Response to the Outbreak of the Coronavirus
Dr. Mona Nemer
Chief Science Advisor of Canada
Briefing on the Canadian Response to the Outbreak of the Coronavirus
Standing Committee on Health (HESA)
Tuesday, May 19, 2020
Thank you Mr. Chair,
Good afternoon! Thank you Mr. Chair and committee members for the opportunity to exchange with you today. I’d also like to thank my co-witnesses for their statements and for all their efforts during this pandemic.
Part I - CSA role/mandate
I was appointed as Canada’s Chief Science Advisor on September 26, 2017 to provide science advice to the Prime Minister and Cabinet.
My office works to ensure scientific analyses are considered in government decisions and coordinates expert advice to Cabinet. I also provide recommendations on how government can better support quality scientific research. Furthermore, my office helps ensure that government science is fully available to the public. Lastly, I have a mandate to promote collaboration between federal scientists and academia, both in Canada and abroad, and to raise public awareness of scientific issues.
Since the beginning of the COVID-19 pandemic I have had the opportunity to make contributions in all these areas, which I will summarize for you.
Part II - CSA involvement in COVID-19
Starting in February 2020, I set up a number of expert groups and task forces. These experts are keeping us abreast of ongoing clinical and scientific challenges and best practices for pandemic response in Canada.
I have also been involved in science coordination efforts within the federal government with respect to medical countermeasures and testing. I have worked with the broader science and research community to enhance coordination efforts.
Among others, I helped setup CanCOVID, a pan-Canadian research platform to optimize collaboration during the COVID-19 crisis. More than 2000 researchers are registered on the CanCOVID platform, which testifies to the extraordinary engagement of the Canadian scientific community in the response to the pandemic.
Additionally, I am engaged in the international science advice response to COVID-19. Chief science advisors or equivalents from a dozen countries have been meeting weekly for the past two months. We discuss the dynamic developments and challenges of the pandemic and its evolving characteristics in different countries, at different times.
We also share data and information on social and medical measures. These interactions also provide important opportunities for coordinating research and science advice.
A tangible example of this international effort was the group’s call to publishers to make COVID-19 scientific publications openly accessible to all, which the publishers quickly agreed to. This has meant that research results are now quickly disseminated and used to help manage the pandemic everywhere. This is an unprecedented development that is supporting scientific data sharing at a rate never witnessed before.
Part III – State of COVID-19 science and policy impacts
Over the past few months, our knowledge of the new SARS-CoV2 virus that causes COVID-19 has rapidly progressed but there are still many unknowns that affect disease prevention and management. I’ll highlight a few of those:
Disease susceptibility: Not everyone in the population appears to have similar risk of infection; how exposure to different levels of viral loads leads to different individual response is unclear. This has impact on prevention measures in different settings.
Infectivity: Infected individuals seem to be contagious two or three days prior to symptoms onset until around 7 days thereafter, possibly longer. This implies that significant transmission comes from asymptomatic individuals and this creates an added challenge for early detection and the control of disease spread.
Disease outcome: Older age and chronic pre-conditions such as cardiovascular disease, diabetes or obesity, have been associated with higher risk of poor Covid-19 outcome for reasons that remain unexplained.
Our experts have pointed out the need for harmonized quality data collection and sharing; this is important to sort out confounding variables and more precisely guide disease management in the Canadian context.
Prevention and treatment: In the absence of acquired immunity or an effective vaccine, avoiding or minimizing exposure to the virus is the best prevention. Vaccine development is underway including in Canada using a wide range of classical and novel approaches.
With respect to treatments, several clinical trials to test the efficacy of existing drugs are ongoing but so far, the results are disappointing. It should be noted that there are presently very few broad-acting antiviral medicines, which is why the development of new antiviral drugs are being pursued in parallel to vaccine production efforts. Successful management of Hepatitis C and HIV with anti-viral therapies is a case in point.
Diagnostics: Laboratory-based molecular (qPCR) test to detect infected individuals is gold standard. This multi-step test requires specialized equipment and personnel and highly sought after reagents.
In spite of its high sensitivity, this lab-based test is not ideal for remote areas or for situations requiring faster or repeated screening (for example: at borders or in primary care). Development of complementary detection methods is ongoing.
The qPCR test provides a snapshot of the infected population at a specific time. The prevalence of the disease (percentage of the population that has already been infected) can be determined by measuring the presence of antibodies in the blood.
The Immunity Task Force was set up to coordinate pan-Canadian serology efforts, which will help to better understand the epidemiology of the disease including infection and fatality rates. However, whether previous exposure protects against future infection is to be determined through rigorous research.
Part IV – Prospective
As countries reopen their economies in the weeks and months ahead, the scientific community will continue to gather more data to better understand both the virus and the disease it causes.
These efforts are instrumental for our ongoing preparedness to live with and overcome the virus.
Around the globe, countries are stepping up their efforts in key areas that include:
- Deploying a robust and agile system for virus testing and contact tracing as well as understanding the level of the population that has been exposed to the virus.
- Standardizing data collection in the context of COVID-19 testing and health management, and developing protocols for sharing and mining the data (including using AI-supported tools) to better understand the disease epidemiology and in turn prepare for possible future waves.
- Stocking up on medical equipment and therapeutics, and putting in place national strategies for local manufacturing of personal protective equipment as well as COVID-19 diagnostics and medical countermeasures.
- Expanding research and development efforts and considering approaches to national health security across the entire medical supply chain.
- Strengthening health emergency preparedness including at the level of multidisciplinary science advisory function.
Part V – Conclusion – Looking into the future
In conclusion, let me say that this pandemic is highlighting the critical value of research and the importance of science coordination across disciplines and sectors. It is also underscoring the need for national production capacity for health security.
We are playing catch-up right now, but it is hoped that current investments and efforts will result in a sustainable ecosystem for infectious disease research and development.
The war against COVID-19 will be won through science.
Let us ensure that Canada’s excellence in science continues to be mobilized for the benefit of all Canadians.
Thank you for your attention.
I look forward to our exchange.
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