Researchers at the University of Toronto are playing a leading role in a national effort to study the efficacy of using blood plasma from recovered COVID-19 patients to treat those who are sick with the disease.
The joint effort with researchers at more than 40 Canadian hospitals, the Université de Montréal, University of Ottawa, McMaster University and the University of British Columbia seeks to test whether it helps to transfuse plasma – the pale yellow liquid from whole blood that is rich in antibodies – from people who have recovered from COVID-19 to patients suffering from the illness.
Antibodies in what’s known as “convalescent plasma” could give a boost to the immune system of COVID-19-infected patients to help them fight the disease, says Dr. Jeannie Callum, a professor in the department of laboratory medicine and pathobiology in the Faculty of Medicine and an associate scientist at Sunnybrook Health Sciences Centre.
“Antibodies are kind of like little forks that stick into the virus and assist your immune system,” Callum says, adding that the body’s immune system sees the virus attached to the end of the fork and tells macrophages and other immune cells to attack it. “It’s like your immune system is at war and you provided more tanks to fight the enemy.”
Doctors in China and other countries have experimented with antibody-rich convalescent plasma to treat COVID-19 patients, Callum notes. One Chinese study published last month focused on 10 “severe adult cases” and suggested that a dose of plasma from recovered patients was “well tolerated and could significantly increase or maintain the neutralizing antibodies at a high level.”
The Canadian researchers plan to recruit 1,200 adults and 100 children to participate in separate trials to get a much better idea of whether the technique works and, possibly, answer lingering questions about the novel coronavirus, including why it affects adults differently than children.
Dr. Donald Arnold, a hematologist at McMaster University, Dr. Philippe Bégin, an immuno-allergist at the Université de Montréal, and Dr. Julia Upton, an assistant professor of pediatrics at U of T and staff physician at the Hospital for Sick Children, are leading the trials.
Canada’s blood suppliers, Canadian Blood Services and Héma-Québec, will be managing donations of plasma from those who have recovered from COVID-19.
“This is the most promising thing I’ve seen in a while,” tweeted David Fisman, a professor of epidemiology in U of T’s Dalla Lana School of Public Health who is cross-appointed to the Faculty of Medicine. Rather than use convalescent serum in intensive care units, Fisman, who isn’t involved in the trial, said he could see it being used “upstream” to treat patients before their condition worsens.
Doctors have experimented with convalescent plasma as a potential treatment for other illnesses, including SARS and MERS, which belong to the same coronavirus family. The history of the approach dates back even longer – to the 1918 Spanish flu pandemic.
“We know from the use of the [plasma] product in the 1918 pandemic – it suggested that the earlier you use the product the more likely it is to change the patient’s outcome,” Callum says.
The researchers have chosen to do the trial in an “intermediate” group of patients, meaning those who have been hospitalized but aren’t so sick that they require intensive care and ventilation.
“We’re hoping to turn it around so that the person doesn’t need to go on a ventilator or go to the ICU, stays a shorter time in hospital and gets back home,” Callum says.
Dr. Rulan Parekh, a professor of pediatrics and medicine at U of T and associate chief of clinical research at the Hospital for Sick Children, is part of the SickKids group leading the pediatrics component of the trial. Although children tend to have better outcomes from COVID-19, they may have underlying conditions that put them at greater risk and that differ from those often seen in older adults, like diabetes, Parekh says.
“Even though there are few deaths [among children with COVID-19] that have been reported, it’s more likely that they will have a worsening of their clinical symptoms,” she says. “We want to see if the convalescent plasma will improve their respiratory findings.”
Because they expect to have fewer study participants in the pediatric trial, researchers will be able to follow patients over a longer period, Upton says.
Parekh – who is also a staff physician in nephrology at the University Health Network – is also leading a study, with Dr. Dana Devine of UBC and Canadian Blood Services, to follow the donors of convalescent plasma to understand factors that impact immunity.
“We want to study systematically if the virus-neutralizing antibody [concentration] is associated with outcomes in both children and adults,” Parekh says.
Even if the clinical trials support the use of blood plasma as a treatment for COVID-19, it wouldn’t make the development of a vaccine any less important. The plasma treatment may help COVID-19 patients get better, but a vaccine would help prevent infection in the first place. “The vaccine is the holy grail,” Callum says, adding that the plasma treatment could help buy time until one is developed – a process that experts say may take 12 to 18 months.
For the clinical trial to go forward, Callum says Canadians who have fully recovered from COVID-19 have to be “ready to step up to the plate” and donate plasma – more than once if possible. “We’re going to be wholly dependent on their goodwill,” she says, adding that the procedure is less taxing than donating whole blood.
Richard Carl, a former COVID-19 patient who recovered at Sunnybrook, told the Globe and Mail that he already plans to donate. “The thought of asking someone to help fix this thing – I couldn’t say yes fast enough,” he said.
VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.
Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.
In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.
The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.
Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”
Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”
This report by The Canadian Press was first published Sept. 16, 2024
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
