Dr. Braden O'Neill, Family Physician in the Family and Community Medicine Program at North York General Hospital, talks about leading COVID-19 related studies at the hospital.
Could you tell us a bit about the COVID-19 studies you are performing?
I’m currently leading three COVID-19 related studies at North York General Hospital (NYGH). Two of these studies are ‘randomized controlled trials’ (RCTs) testing the effectiveness of medications, currently used to treat other conditions, to treat or prevent COVID-19.
The first study is called ILIAD (Interferon Lambda for Immediate Antiviral therapy at Diagnosis). For this study we’re collaborating with a team led by Dr. Jordan Feld at University Health Network in Toronto. The aim is to evaluate the effectiveness of a single dose of a medicine called ‘interferon’, which has been previously used for the treatment of other conditions like hepatitis.
The other RCT, entitled ‘CORIPREV-LR’ (COVID-19 Ring-based Prevention Trial with Lopinavir/Ritonavir), involves collaborating with a team led by Dr. Darrell Tan at St. Michael’s Hospital in Toronto, and other colleagues across the country. We are evaluating whether a medication called ‘lopinavir/ritonavir’, normally used for the treatment of HIV, is effective in reducing the risk of developing COVID-19 for people who are “close contacts” of someone who tests positive for the virus, for example, people who live together.
The third study is about symptoms of COVID-19. This study design is called ‘retrospective’ because we are analyzing data that has been collected for another purpose. Since COVID-19 is such a new disease, the full spectrum of symptoms is still unknown to us. Some studies have found that people who get COVID-19 are more likely to lose their sense of smell. This is a symptom we’ve been asking people about at the NYGH COVID-19 assessment centres, since they opened at the onset of the pandemic. We’re now looking at these data to see how frequently people with COVID-19 lose their sense of smell than those without the condition.
What is the importance of your COVID-19 studies within our community/hospital setting?
NYGH is at the forefront of an integrated-community response to COVID-19. We were one of the first hospitals to test people who live in group settings such as shelters and long-term care homes, and we remain one of the highest volume testing centres in the province. And I think that this is in large part because of the leadership from Dr. Rebecca Stoller and Carla Moran-Venegas, who have been instrumental in continuing to ensure we can efficiently test and support patients throughout the pandemic and have been huge supporters of research. The studies I’m involved with – known as ‘outpatient’ studies because the people involved are not admitted overnight to the hospital – were only made possible because of our amazing community. It’s important to acknowledge our more than 300 family medicine colleagues, led by Dr. David Eisen, NYGH Chief of Family and Community Medicine and Program Medical Director. They have been working tirelessly to ensure we are able to deliver high-quality care. We’re ideally placed to support our local community while providing national and international leadership in research. The breadth and quality of COVID-19 research at NYGH is yet another example of its excellence and why we collaborate with some of the top research teams in the country. We know that part of our job in fighting COVID-19 is to help generate the evidence that we need to prevent and treat it.
How do you see the future of COVID-19?
Unfortunately, I think COVID-19 is going to be with us for a long time. We need to make sure we support each other as colleagues, and to support our friends and family. We’ll need to continue to follow public health guidance, such as avoiding close-contact settings whenever possible, while we come up with innovative ways to re-open so people can come together. I’m particularly concerned about the potential detrimental effects of ‘lockdown’ decreasing the opportunity for children to have social interaction and education, which we know plays a critical role in their development. Ultimately, everything in life involves risk and we’re going to have to take some risks in re-opening – calculated, thoughtful ones, guided by the best available evidence – in order to support each other through this. I’m hopeful, and I know that the team at NYGH will lead the way to help our local community.