2023 Catalyst and Research Development Grant Recipients

Denis Walsh, Faculty of Arts & Science; Brian Baigrie, Faculty of Arts & Science There is growing recognition that public trust is at a low ebb across a range of issues of public health concern, from the contribution to climate change of human activity, the safety of vaccines, and the effectiveness of public health measures during the Covid-19 pandemic. This erosion of public trust is deeply troubling. Given that public support has a significant impact on the effectiveness of public health measures, an important (but much neglected) way of furthering the goal of developing resilient health systems that are able to weather future public health emergencies is research that focuses attention on the salient issues of trust, facilitates the validity of its measurement, and contributes to the identification of steps that are needed to build/re-build trust in public health.

The dearth of studies in the medical literature that include the concept of trust in the primary research question is remarkable, testifying that a thorough understanding of trust as it relates to public health is under-researched. To fill this gap, the objective of this project is to carry out a literature review that targets two questions: (1) how extant studies conceptualize the components of public trust as they influence the public’s response to public health measures; (2) how studies measure the concept of trust as a prominent factor in the public's acceptance of public health programs.

Zahra Shakeri, Dalla Lana School of Public Health; Ishtiaque Ahmed, Faculty of Arts & Science; Shohini Bhattasali, University of Toronto Scarborough

Hospitals serve as the cornerstone of healthcare systems, providing critical support during emergencies like the COVID-19 pandemic. Ensuring their operational, secure, and resilient nature is essential for both extended response and ongoing recovery. Hospital resilience requires a multifaceted approach, with patient care experiences playing a significant role in healthcare outcomes. Prioritizing enhanced patient experiences leads to improved treatment adherence, better clinical outcomes, increased safety, quality, equity, and efficient healthcare utilization. In fragile health systems, hospitals must maintain resilience by adapting to daily challenges and quickly recovering during public health emergencies, ensuring safe, uninterrupted critical services.

This research seeks to create an intelligent AI-based hospital system that bolsters hospitals' resilience, recovery, and preparedness amid public health crises. Leveraging AI-driven analysis of a large-scale dataset (over 111,000 open-text comments) from patients' self-reported experiences in Ontario hospitals (2017-2021), we can examine the COVID-19 pandemic's impact on patient care experiences. Our analysis will compare pre-pandemic and pandemic data to identify improvement areas, address care continuity gaps, and enhance care quality, while considering the evolving needs and challenges of different service components. Acknowledging hospitals' vital role in recovery through health education and preventive measure awareness, this research seeks to develop a nationwide intelligent system in future phases. This system aims to rebuild public trust by fostering health education, providing reliable information, and addressing misinformation, enabling informed decisions and preventive actions for improved health outcomes. This research supports enhancing healthcare services for all Canadians, fostering an accessible, efficient, and equitable system across diverse application domains.

Esteban Parra, University of Toronto Mississauga; Shaza Fadel, Dalla Lana School of Public Health; France Gagnon, Dalla Lana School of Public Health; Frank Wendt, University of Toronto Mississauga

Post-COVID Condition (PCC), or Long COVID, has a wide-ranging impact, and the ultimate causes of this syndrome remain to be elucidated. We propose pilot studies, aligned to the IFP’s “Pandemic recovery” theme, to explore broader health and societal impacts of the COVID-19 pandemic by investigating long-term COVID cognitive dysfunction in young individuals from Canada and Brazil (ages 18 to 40). Using well-characterized cohorts from two different countries, this project will set the basis for future studies focused on identifying factors associated with long-term cognitive dysfunction using a multi-omics approach. For this catalyst grant, our primary objectives are:

1. To  describe willingness to participate and demographic characteristics of populations from two, Canadian and Brazilian, cohorts.

2. To pilot and align ascertainment tools, including psychometric and immunological analyses that will best characterize young adults with cognitive dysfunction as part of a post-COVID-19 condition.

Results from this project will serve as preliminary data for future studies that will apply a broad range of analytical approaches, including genomics, metabolomics, and characterization of immunological markers to better measure morbidity after SARS-CoV2- infection for young adults. This project has the potential to offer new insights into factors playing a role in the development of long COVID cognitive dysfunction as well as identifying potential predictive tools in two diverse community settings.  

Alex Hoagland, Dalla Lana School of Public Health; Sara Allin, Dalla Lana School of Public Health; Alan Walks, University of Toronto Mississauga; David Rudoler, Dalla Lana School of Public Health

During the COVID-19 pandemic, the extent to which a person could effectively follow public health guidelines was contingent upon suitable housing.¹ Large periods of the pandemic necessitated increased time at home and, as such, any harmful pre-existing physical or social conditions of the house exacerbated poor mental health outcomes of its inhabitants.²𝄒³ In response to the economic and social instability during the pandemic, states implemented new social protections, including those targeting housing. Housing-specific interventions such as eviction moratoria in the US were able to curb severe mental distress associated with eviction,⁴𝄒⁵ while also reducing COVID-19 incidence and mortality that would be exacerbated by more evictions and doubling-up.⁶𝄒⁷𝄒⁸ However, it is unclear the extent to which housing policies in Canada considered mental health or what their impact was. As such, this project seeks to address the question: what can we learn from the variations in housing decisions made across Canada’s provinces during the COVID-19 pandemic to mitigate mental health crises of future pandemics? To answer this, a three-pronged approach including an initial exploration of pandemic-era housing policies in two provinces, formation of stakeholders in the housing sector to guide our research and reporting of results, and construction of a dataset to assess impacts of housing policy decisions on mental health and financial security. In this way, the project will allow for the intersection of housing, health, and resilience to be documented and used to suggest policy directions to improve readiness for future pandemics. 

Hilary Brown, University of Toronto Scarborough; Amol Verma, Temerty Faculty of Medicine; Fahad Razak, Temerty Faculty of Medicine; Yona Lunsky, Temerty Faculty of Medicine; Rahim Moineddin, Dalla Lana School of Public Health

The World Health Organization (WHO) estimates there are 1 billion people with a physical, sensory, or developmental disability globally. In North America, the prevalence of disability is 20%, with one-third of individuals over 65 years having a disability. While evidence suggests people with disabilities are at elevated risk for acquiring and suffering severe outcomes associated with COVID-19, the impact of the pandemic on hospital care and outcomes for patients with disabilities more generally has received little attention. Research in the general population shows communication failures contribute to patient harm, and pandemic conditions may have disproportionately hindered communication for patients with disabilities via restricted visitor policies and facemasks and face shields that impede communication. People with disabilities have also experienced disruptions to outpatient clinical, personal care, meal, and medication services that have had a profound impact on their well-being. These issues may contribute to elevated risk of adverse clinical outcomes in patients with disabilities on a medical service.

Our objective is to examine the impact of the COVID-19 pandemic on clinical outcomes (in-hospital mortality, intensive care unit [ICU] admission, hospital length of stay [LOS], unplanned 30-day readmission) of patients with and without a disability admitted to a medical service for non-COVID-related illnesses.

Our study has implications for pandemic resilience by providing data to support disability-related considerations in current (and future) pandemic responses, including training for health care providers on accessibility-related needs of hospitalized patients on a medical service, and development of supports for patients discharged from hospital who need additional assistance.

Benita Hosseini, Temerty Faculty of Medicine; Andrew Pinto, Temerty Faculty of Medicine; Aaron Orkin, Temerty Faculty of Medicine

The COVID-19 pandemic emphasized the importance of global preparedness and effective surveillance systems for infectious diseases. Early Warning Systems (EWSs) can mitigate the impact of such diseases through information exchange, monitoring, and early detection. This study aims to evaluate the effectiveness of EWSs and co-design an early threat detection system for respiratory infections in collaboration with Canadian primary care providers and ED physicians. The study involves a systematic literature review on EWS strategies and efficacy, as well as the co-design of a surveillance system tailored for outpatient settings across Canada's five zones. A comprehensive search will be performed, and two independent reviewers will assess articles describing and evaluating EWSs. Following data extraction, the quality of the studies will be assessed, and the findings will be synthesized to provide a comprehensive summary. The co-design process involves stakeholder identification, needs assessment through semi-structured interviews (5 per zone) and focus groups (1 per zone) and co-design workshops (1 per zone) to actively engage stakeholders from each zone in the co-design process. The workshops will focus on understanding the specific needs of the participants and identifying feasible implementation strategies tailored to each zone's unique regional characteristics. A thematic analysis approach will be employed to identify key themes and recommendations for the co-designed system. The findings from this study serve as a basis for obtaining further funding and refining the surveillance system for nationwide implementation. Moreover, we will leverage existing funds from other similar studies to provide additional financial support for this project if needed.

Laura Rosella, Dalla Lana School of Public Health; Dionne Aleman, Faculty of Applied Science & Engineering

SARS-CoV-2 (COVID-19) was officially declared a pandemic in March 2020 and infections spread rapidly around the world. Researchers, healthcare practitioners, and government officials recognized the need for effective mitigation strategies to reduce the incidence of infection. The Medical Operations Research Lab's Pandemic Outbreak Planner (morPOP) is an agent-based simulation (ABS) model utilized to illustrate the potential outcomes of COVID-19 mitigation strategies at various compliance rates. Despite numerous applications of ABSs in the peer-reviewed literature, important gaps remain, with the high dimensional nature of these models resulting in high computational complexity and prohibitively long run times. Applications of surrogate machine learning (ML) have been implemented to overcome these challenges and demonstrated the ability to accurately predict ABS outputs while reducing overall run time.

This study aims to develop an interpretable ML surrogate model for the morPOP agent-based simulation model. Four model architectures are proposed – logistic regression, eXtreme Gradient Boosted trees, Support Vector Machines, and Artificial Neural Networks. Model performance will be evaluated using F1 Score and sensitivity and specificity metrics. The goal of the ML model is to accurately predict the number of cases resulting from implementing a specific mitigation strategy at a range of compliance rates. This information can be used by decision-makers about the potential efficacy of these strategies and therefore inform the selection of the optimal mitigation methods. Due to its intended use in public health decision-making, the focus is on maintaining interpretability and efficiency in the ML model while achieving high accuracy.

Andrea Gershon, Temerty Faculty of Medicine; Peter Austin, Dalla Lana School of Public Health; Candace McNaughton; Temerty Faculty of Medicine; Clare Atzema, Temerty Faculty of Medicine

Background: Many individuals diagnosed with COVID-19 experience symptoms that last for an extended period of time. These extended symptoms are frequently referred to as Long-COVID, officially known as Post COVID-19 Condition (PCC). PCC is a complex disease that requires the involvement of multiple medical specialties to be properly managed and is placing a substantial burden on provincial healthcare systems. Ontario has developed a new healthcare billing code to specifically identify PCC.

Objectives: The objectives of this study are to understand 1) which doctors are using the PCC billing code 2) how many individuals are being diagnosed with PCC in Ontario and if these people belong to disadvantaged groups 3) how much and what types of healthcare people with PCC are using.

Methods and Outcomes: Ontario health administrative data includes information on almost all health care services that are used by virtually all people living in the province of Ontario. This information will be used to identify the number of people in Ontario who have been diagnosed with PCC and to investigate the types of healthcare that individuals with PCC use before and after they have been diagnosed with PCC. For example, types of specialists visited, emergency room visits, and hospital admissions.

Relevance to Pandemic Recovery: PCC is a serious and ongoing problem that places a substantial burden on the healthcare system. This project will help us understand which communities are being most affected by PCC and how we can allocate resources to help more Canadians with PCC.

Mark Wade, Ontario Institute for Studies in Education; Julia Knight, Temerty Faculty of Medicine; Stephen G Matthews, Temery Faculty of Medicine; Cindy-Lee Dennis, Lawrence S. Bloomberg Faculty of Nursing; Prakeshkumar Shah, Temerty Faculty of Medicine; Jennifer Jenkins, Ontario Institute for Studies in Education; Robert Levitan, Centre for Addiction and Mental Health; Rayjean Hung, Dalla Lana School of Public Health

The COVID-19 pandemic has been unprecedented in the scope of its impact across multiple sectors. However, even as many Canadian families return to something that resembles normal day-to-day life, there are many unanswered questions about just how impactful the pandemic has been on young children. Many small, geographically limited studies have suggested a negative impact on children’s cognitive and emotional health, yet each of these generally suffers from multiple shortcomings. The Ontario Birth Study (OBS) is the largest epidemiological study in Canada spanning the prenatal and postnatal period with data collected during the pre-pandemic and pandemic period. In the OBS, many children were born and completed assessments before the pandemic began, while others were either born before or during the pandemic and completed assessments during the pandemic. All mothers completed multiple questionnaires related to their own depression, anxiety, and perceived distress prenatally and postnatally. This unique design will be leveraged to determine whether (i) the combination of pre- and postnatal pandemic exposure is more harmful to children than postnatal exposure alone; and (ii) whether increased levels of mothers’ depression, anxiety, and perceived distress (prenatally and/or postnatally) explain differences in children’s cognitive and emotional well-being at 24 and 54 months as a function of pandemic exposure using a combination of parent-report and objective assessments. The findings can be used by parents, educators, clinicians, and policymakers in determining how best to respond to the needs of children and families impacted by the pandemic and in planning for future ecological crises.

Teresa Kramarz, Faculty of Arts & Science; Sara Allin, Dalla Lana School of Public Health; Brian Baigrie, Faculty of Arts & Science; Marlys Christianson, Rotman School of Management

This project seeks to understand how policymakers, practitioners, and academics can improve the planning, delivery and resilience of the health system through outcomes-based contracts.  Outcomes-based contracts are a term used to describe formal partnerships between the government and private, non-profit, or charitable sector organizations to deliver health services to patients, such as public health interventions that improve Type 2 Diabetes management or improve cardiovascular health. We will host a workshop with academic and policy leaders to talk about the benefits and drawbacks of working with private, non-profit or charitable organisations to deliver health services.  This process will identify tools that governments and planners can use to improve collaborations with non-governmental actors to improve the health system. This seed funding will help form a new network of interdisciplinary scholars in Canada and internationally interested in conducting innovative research to inform policy design and implementation for Canada with the aim of strengthening health system resilience.

András Tilcsik, Rotman School of Management; Angelina Grigoryeva, University of Toronto Scarborough

"The COVID-19 pandemic exposed and intensified workplace inequalities, disproportionately affecting women and racialized workers. Pandemic impact statements have been widely adopted by organizations to contextualize employee performance, aiming to foster fairer evaluations and a more equitable pandemic recovery. However, the effectiveness of these statements in addressing inequities remains uncertain. One concern is that these statements might draw attention to caregiving roles and thus reinforce stereotypes that harm women and racialized workers in caregiver roles. Additionally, employees from marginalized groups may be less likely to use these statements, potentially amplifying—rather than ameliorating—existing inequities.

 Our collaboration—involving a management scholar, a sociologist, an organic chemist, and trainees at three levels—will assess the effect of pandemic impact statements on workplace inequities and provide evidence-based best practices for organizations considering their use. We seek to understand if these statements contribute to an equitable recovery or exacerbate disparities and how decision-makers can implement more equitable employee performance evaluations during future pandemics.

In the project’s first year, we will assemble archival datasets, create participant databases, run pilots, and conduct a multidisciplinary literature review. These steps will strengthen our applications for SSHRC Insight and Connection Grants. Ultimately, this project will generate knowledge about workplace interventions for equitable pandemic recovery. These outcomes will benefit researchers studying pandemic recovery and workplace inequalities, managers seeking to improve performance reviews, and university administrators formulating tenure and promotion policies. The project will also significantly enhance the research and collaboration skills of our postdoctoral, doctoral, and undergraduate trainees."

Swetaprovo Chaudhuri, Faculty of Applied Science & Engineering; Sharmistha Mishra, Temerty Faculty of Medicine; Vijaya Kumar Murty, Faculty of Arts & Science; Stephen Hwang, Temerty Faculty of Medicine

Shelters face the perfect storm during epidemics like COVID. This is in part due to the density of shared living quarters in shelters and high turnover within shelters. One barrier to rapidly mobilizing and activating a response in shelters was that front-line teams were not sure how big a shelter-outbreak could get. We propose to develop an analytic and computer model that shelter and public health teams could use to predict (1) the chance of an outbreak occurring; (2) how many people may get infected in the shelter after one case is found; and (3) what it would take to shrink the size of an outbreak once started or prevent an outbreak from ever starting. Our model uses dynamics of airflow to capture key factors that shape airborne virus transmission related to physical space, crowding, ventilation – alongside the biological properties of the virus itself. We will build and test the model with real-world SARS-CoV-2 data in Toronto from surveillance, shelters, and persons experiencing homelessness as part of a cohort study. The model can then be used to test the impact of intervention measures that could be activated after the detection of the first case in a shelter, or what structural measures need to be put into place to prevent outbreaks before they occur. The model would support public health and front-line teams at shelters in their readiness during the current and evolving SARS-CoV-2 pandemic - to predict, react, but also to prepare.

Matthew Adams, University of Toronto Mississauga; Laura Rosella, Dalla Lana School of Public Health.

Computerized mapping played an essential role in managing the COVID-19 pandemic, with a far greater influence than ever due to the increased accessibility of tools and data. Many approaches were borrowed from other fields of science as they showed promise to support public health needs. In this project, we will review the existing peer-reviewed and grey literature to identify how mapping tools were applied to identify pandemic hotspots. In addition, we will evaluate the potential statistical techniques to determine if they can be used to identify emerging pandemic hotspots throughout each wave of the first four waves of COVID-19 in Ontario. Finally, the hotspots will be evaluated against sociodemographic data to mine for features that could be used to understand a hotspot’s long-term stability better. The project includes three trainees: one undergraduate, one MSc student and a Ph.D. student.

Research outputs will include a scoping review of geospatial hotspot analysis tools applied during the COVID-19 pandemic. A scientific paper including the statistical analysis of each potential tool and its application to COVID-19 case data in Ontario for the identification of emerging hotspots.

Future research will include developing geographic information systems tools that public health teams can apply during future pandemics based on the findings and further evaluation as to how the geopolitical boundaries applied for the aggregation of case data may skew hotspot identification during the pandemic.

Sarah Kaplan, Rotman School of Management; Beverley Essue, Dalla Lana School of Public Health

Before COVID-19, violence against cis and trans women, Two-Spirit and gender-diverse people was already a crisis. Globally, the pandemic intensified this crisis through job loss, financial insecurity, and quarantining measures. The United Nations deemed this pandemic-fueled rise in violence as a “shadow pandemic,” with marginalized communities, including low-income, Indigenous, racialized, and LGBT+ people, facing increased risks and worse outcomes from gender-based violence (GBV).

This project will address the IfP theme of pandemic recovery through the development of research collaborations themed on GBV and pandemic recovery to define and address the effects of this “shadow pandemic.” The project objectives are: 1) define the economic and social impacts of the pandemic-fueled rise in GBV on communities facing marginalization, 2) identify the types of policy interventions that will help society recover from increased GBV and prevent rising GBV in future pandemics and more generally.

To meet these objectives, we will 1) convene researchers, community workers, and policymakers in a workshop to share their GBV research and insights across sectors, facilitate connections and develop a research agenda, 2) translate insights from the workshop to policymakers and the public, and 3) form the basis for new multi-disciplinary projects on GBV and pandemic recovery. 

The outcomes will be 1) groundwork for a research network themed on GBV and pandemic recovery, including a future research agenda and the potential for new multi-disciplinary projects, and 2) resources for policymakers, the public, and other stakeholders based on workshop insights, including a research overview and multimedia outputs.

Paul Grootendorst, Leslie Dan Faculty of Pharmacy; Ashleigh Tuite, Dalla Lana School of Public Health

With pandemics occurring with increasing frequency, governments now appear to appreciate the need for a reliable and timely supply of pandemic vaccines.  To reduce pandemic-related mortality without vaccines, governments typically restrict the degree to which individuals can be in close contact.  In practice, this means, inter alia, school closures, restrictions on travel, and public or private social gatherings.  These measures, while necessary, impose costs of their own on educational outcomes, mental health and incomes.

To avoid these costs, ideally, governments would rapidly deploy pandemic vaccines, but securing sufficient vaccine supplies quickly is itself costly.  How much should governments allocate to ensuring rapid vaccine access? To answer this, we propose to estimate how increases in the fraction of the population vaccinated against COVID-19 reduced the stringency of pandemic related lockdowns.  These estimates, combined with estimates of the cost of lockdowns produced by other researchers, can quantify the value of rapid pandemic vaccination initiatives. 

We will estimate models of lockdown stringency using both country level data and province level data for Canada.  Estimating models using both data sets allows us to check whether results are consistent.

We will also construct and estimate statistical and hybrid statistical-epidemiological models of mortality rates and how these rates vary with the fraction of the population that is vaccinated against COVID-19.  This hybrid approach applies restrictions from epidemiological models onto regression and other types of models.  Moreover, we can model how vaccine uptake affects mortality among individuals by sex and in specific age groups.

Mina Tadrous, Leslie Dan Faculty of Pharmacy; Nelson Lee, Dalla Lana School of Public Health; Jeff Kwong, Dalla Lana School of Public Health; Jillian Kohler, Leslie Dan Faculty of Pharmacy

The COVID-19 pandemic had a significant adverse impact on the drug supply chain and the access to medicines on a global scale. Restrictions on travel and shipments resulted in disruptions in the supply of raw materials and finished products, causing delays and shortages in the global drug supply. Specific drugs, such as those used in the treatment for COVID-19, or those that were inappropriate but cited in social media as treatment drugs, or medications for symptomatic relief, surged in demand, increasing pressure on an already strained supply chain. Additionally, access to available treatments and vaccines was not equitable across populations. There is evidence that suggests these changes in drug utilization patterns may act as an early detection tool for outbreaks of COVID-19 which include increased spending on certain medications such as ‘cold and flu’ medicine. The objective of this research proposal is to study COVID-related drugs of interest on a global scale to address pandemic readiness, resilience, and recovery. To achieve this objective, our research will focus on understanding the impact of the COVID-19 pandemic on drug and vaccine utilization (including medical devices) and on COVID-19 drugs of interest. Additionally, we will determine if assessing drug utilization patterns can be leveraged to predict future outbreaks for the next pandemic. This pandemic has highlighted the need for a resilient and equitable drug supply chain and has also revealed the potential to complement existing surveillance systems for early detection of a pandemic.

Andrew D. Pinto, Temerty Faculty of Medicine; Sharon Straus, Temerty Faculty of Medicine; Notisha Massaquoi, University of Toronto Scarborough; Fahad Razak, Temerty Faculty of Medicine; Benita Hosseini, Temerty Faculty of Medicine

Reports quickly emerged in spring 2020 that COVID-19 was disproportionately impacting communities made vulnerable by social and economic policies. In the early phase of the pandemic, we conducted a rapid review of the international literature on the social determinants of COVID-19 infection, published between December 1, 2019 – June 25, 2020. We found strong associations between race or ethnicity, socioeconomic deprivation, occupation and other social determinants and COVID-19 incidence and hospitalizations. In response to this and other evidence, members of our study team also developed robust guidelines for Canadian policymakers on how to mitigate the impact of the pandemic on these communities. Since the review and guidelines were published, a large number of additional reports and studies have been published on how the pandemic impacted racialized, low-income and non-healthcare workers who could not shelter at home. However, no study has yet created a detailed picture of the impact of the COVID-19 pandemic on these communities in Canada. And no research has yet been conducted on whether Canadian jurisdictions implemented policies to support equitable recover. The products of this research will help create a foundation for future research on interventions to improve pandemic preparedness in a way that engages communities made vulnerable by social and economic policies.

Kuan Liu, Dalla Lana School of Public Health; Jennifer Jenkins, Ontario Institute for Studies in Education; Geoffrey Anderson, Dalla Lana School of Public Health; Beverley Essue, Dalla Lana School of Public Health

Public health mitigation policies have led to widespread education disruption. Social interactions, intellectual simulation, and the surrounding environment during school hours play a key role in the development of school-aged children and youth. Social isolation for extended periods of time may trigger and exacerbate anxiety, depression and substance abuse and disproportionately impact families from more material and social deprived neighbourhoods. The effects of education disruption on mental health may be long lasting. Although evidence exists on short-term impact, the temporal and spatial intersectionality between school closure and socioeconomic status (SES) on mental health outcomes among children and youth remains unexplored.

Our study aims to evaluate the complex effects of pandemic mitigation measures and the dynamic role of neighborhood social vulnerability and resilience on mental health of children and youth. The objectives are to leverage an interdisciplinary collaboration and readily available administrative data to: i) identify neighbourhood clusters with different trajectories clusters of longitudinal mental health outcomes by SES and identify factors associated with these clusters, and ii) to estimate time-varying causal effects of school closures on repeatedly measured mental health outcomes stratified by community-level SES and by neighbourhood clusters.

Our study will generate new knowledge on the differential impact of school closure at community-level and provide crucial evidence to inform and develop targeted and equitable pandemic recovery interventions and policy. As we recover from pandemics, it is pivotal to understand the population-based impact of education disruption across time and geographical regions, diverse socioeconomics groups and made-vulnerable populations.

Kathleen Wilson, University of Toronto Mississauga; Tracey Galloway, University of Toronto Mississauga; Matthew Adams, University of Toronto Mississauga; Madeleine Mant, University of Toronto Mississauga; Ghazal Fazli, University of Toronto Scarborough

This project addresses two urgent, yet underexamined issues in Canada – structural racism and long COVID (i.e., Post Covid Condition (PCC)). The overarching goal of the research is to identify solutions to PCC management that address the intersecting social, structural, and health needs of immigrant and racialized populations in Peel Region, Ontario.

Research Objectives:

1. Examine how everyday forms of structural racism shape differential experiences of short and long Covid among (im)migrant and racialized residents in Peel Region.
2. Assess how PCC is embodied in the everyday realities of (im)migrant and racialized residents.
3. Build capacity and expertise in research methods, research implementation and data synthesis within (im)migrant and racialized populations in Peel Region.

This will generate research outcomes that:

1. Enhance understanding of intersecting systems of inequities and their differential health and wellbeing impacts among (im)migrant and racialized men and women in and outside population centers.
2. Bring attention to neglected forms of structural racism borne out of chronicity, vulnerability, and intersectionality as individuals learn to live with COVID-19 and make use of health services.

This project directly relates to equitable pandemic recovery because it supports knowledge generation that addresses broader health and societal impacts of COVID-19 that disproportionately affect equity deserving communities. Knowledge gleaned can assist in the development of effective policies, strategies, and interventions to drive equitable recovery and reduce the broader health and societal impacts of the pandemic. "

Manal Tadros, Temerty Faculty of Medicine; Aaron Campigotto, Temerty Faculty of Medicine

Universally accessible testing forms are the cornerstone of pandemic preparedness. The SARS COV-2 pandemic has specifically highlighted the inequities in testing and care. Nasopharyngeal (NP) swabs can often be traumatic to kids and rely on health care workers (HCW) for collection. Saliva, oral/nasal specimens, can be self-collected even in children, thus having potential for broader deployment, and allows testing in inaccessible areas, among underserved communities and even in schools. While providing a useful alternative to NP testing, these non-invasive specimens, remove the need for a HCW for testing. They also decrease the risk of exposure of HCW to respiratory pathogens and save resources. For all the above reasons, saliva, oral/nasal specimens were widely adopted for SARS-CoV-2 virus testing. However, data about their utility  for testing for other respiratory viruses is lacking. The purpose of this study is to evaluate the clinical utility of saliva and oral/anterior nasal specimens for the detection of respiratory viruses other than SARS-CoV-2 in children by molecular methods compared to nasopharyngeal specimens. The use of these non-invasive specimen types would be extremely helpful as part of our pandemic readiness. This aligns with the objectives of the Institution of Pandemics especially the “Pandemic readiness” which looks at scientific tools to allow a timely response to a new pathogen. We believe that if saliva, oral/nasal specimens are comparable to NP specimens for detecting viral respiratory pathogens, this would remove a huge roadblock in testing accessibility, a crucial step in our readiness for another respiratory viral outbreak or pandemic.

Tanya Titchkosky, Ontario Institute for Studies in Education; Aparna Menon, Dalla Lana School of Public Health

"Pandemic readiness initiatives are being launched world-wide and yet they continue to be done on inaccessible platforms, with no regard for diverse forms of communication, and no alternatives provided for disabled people. Unless pandemic readiness includes protocols that recognize the diversity of disability communication, future pandemics will inevitably result in the same catastrophic levels of death for disabled people (6 in 10 deaths [The Health Foundation, UK, 2021]), as well as extreme levels of disregard and isolation (Landes et al., 2021; Lunsky et al., 2022; Martin et al., 2022; Read et al., 2022).

This research project addresses systemic failures in health communication by examining past pandemic communication protocols regarding persons with disabilities [PWDs]. We do so by uncovering communication processes within the medical archives of two global public health influencers; the publicly funded University of Toronto, Canada and the Wellcome Trust Collection, London, UK. We focus on the largely post-colonial, post mass vaccination, pre-internet era of the 1960s to the 1990s. 

Public health archival research in the area of communication protocols can reveal how disability is addressed such that current pandemic mitigation initiatives deliver hazardous consequences for disabled people*. The research proposed in this project will reveal the conceptions of disability at play in pandemic communication protocols as they frame disability as a variability of vulnerability but not as a communicative co-participant. Through mapping such inclusions and exclusions, this research will ultimately impact the lives of disabled people by demonstrating the essential need for diverse communication in pandemic readiness plans.