New initiative to shield Canada against future pandemics

May 6, 2024

The Upstream Lab, with 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.

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 Pandemic Preparedness Engaging Primary Care 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.”

New solutions to old problems

Canada’s health system’s challenges during COVID-19 were similar to those of previous pandemics. At the height of the SARS outbreak, hospitals grappled with the rapid spread of a novel virus, recalled Dr. Pinto, a first-year medical student at the time. As with COVID-19, “We didn’t have an early warning system, and we didn’t have a coordinated system to enroll patients in critical research studies,” he added.

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.

One problem at the beginning of the pandemic was the absence of coordination and ways to control the flow of the virus into Canada, which resulted in lockdowns, said Norman Umali, Upstream Lab research pharmacist and project team member. “PREPARED will aim to fill gaps we saw in Canada during COVID-19, and support the important work of public health organizations locally and nationally.”

The initiative will implement new, rapid testing systems for multiple viruses such as COVID-19, RSV, adenovirus, and influenza. With this standardized approach in healthcare 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 29 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.

The initiative is one of four research programs endorsed by the Canadian Hub for Health Intelligence and Innovation in Infectious Diseases (HI3) at the University of Toronto that was funded by the Canada Biomedical Research Fund with a mandate to bolster Canada’s readiness to respond to emerging health threats.

PREPARED will help Canada be ready for the next pandemic. “We are excited about working with many partners to create a shield that will help protect Canada, now and in the future,” said Dr. Pinto.


About the Upstream Lab: The Upstream Lab is a non-profit research lab based at MAP Centre for Urban Health Solutions, St. Michael’s Hospital, a site of Unity Health Toronto. The Lab is committed to improving the health and well-being of the population by tackling social determinants of health, using artificial intelligence, and conducting clinical trials.


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