McMaster research team to lead cross-country COVID-19 network

Research about COVID-19 is expanding almost as fast as the virus itself and that can make things confusing for researchers and policy-makers trying to keep up with the best available evidence.

A team of McMaster University researchers has been tapped to lead a national coalition that will help co-ordinate COVID-19 research across the country. The goal of the COVID-19 Evidence Network is to provide the most up-to-date scientific findings to help guide public policy while also trying to reduce the duplication of effort for researchers.

Led by John Lavis, director of the McMaster Health Forum and a health research methods professor, the COVID-19 Evidence Network has just been awarded a $1 million grant from the Canadian Institutes of Health Research.

Here are five questions and answers with Lavis about the network, which have been edited slightly for length and clarity.

What types of research are going to be co-ordinated through this initiative?

What's known about the science that can be directly used by decision makers, especially by government? What do all of the available studies tell us about public health measures, like masks. What do all of the available studies tell us about whether this new particular drug treatment is effective? What do all the studies tell us on the health systems side of making sure the vaccine gets rolled out in ways that gets as many Canadians vaccinated as quickly as possible? We're not doing the upstream basic science - it's the more applied public health, clinical health systems, and economic and social research that we're focused on."

Why is an initiative such as this needed in Canada?

The biggest challenge is the amount of duplication and lack of coordination in this evidence synthesis response. (Evidence synthesis is another term for systematic review of data and studies.) For some questions - like prognosis questions, such as what factors predict what people are more likely to have severe disease - we gave up counting after 200 evidence syntheses had been published. So there are a lot of people out there whose hearts are in the right place but we don't need 200 reviews. In contrast, there are many other domains where we don't have an evidence synthesis. So part of it is reducing duplication and also identifying the areas where we need new evidence syntheses.

The other thing we'll do with this grant is better co-ordinate the Canadian response with Canada-specific syntheses. Right now on any given day, there are probably 10 or 15 groups out there synthesizing evidence to inform vaccine rollout but they're all asking and answering the same question. We can probably get farther faster by building one really good team that updated that review every couple of weeks."

Are there any particular areas that you see as being a priority?

The No. 1 right now is vaccine rollout. Everybody is really trying to figure out vaccine rollout. From our perspective, there are five buckets where there are a whole set of unanswered questions. The first is securing and distributing a reliable supply of vaccines - lots of really tough questions around managing inventory, distributing within the country given the ultracold chain that is required. The second is allocating vaccines equitably. The list of who should be given priority keeps being adjusted. The third is communicating vaccine allocation plans and the safety and effectiveness of vaccines. The fourth is administering vaccines in ways that optimize timely uptake. Ontario is doing a lot of the early rollout through hospitals but if we want to vaccinate a big proportion of the 12 million-plus Ontarians, we're going to need to use many different ways of getting people vaccinated. And the fifth bucket of questions have to do with surveillance, monitoring and evaluation. How do we track adverse effects and how do we act on them quickly?"

How will you and your team organize and communicate with researchers across the country?

The biggest group we're trying to engage is actually the decision makers not the researchers. If we can get the big-picture questions they're grappling with, then we can produce more timely, relevant syntheses to meet their needs as they emerge. The biggest challenge we are dealing with right now is how do we organize an appropriate way of taking in questions so we're focused on the questions that really matter to the decision makers and we're getting them the evidence they need in a timely way. The second thing we're doing is keeping track of the evidence syntheses being produced by all the groups in the world, and through the inventory we're identifying the best ones. The third thing we're doing is horizon scanning. Every month, we review all the horizon scanning initiatives around the world for COVID-19 and say What are the emerging issues?' The final piece is working with researchers trying to unite all of the evidence synthesis shops in this country and trying to keep on track of the questions they're working on."

Time must be a significant pressure here because at some point, the pandemic will conclude. Can this initiative move quickly?

There are two types of products we have been producing. One we call rapid evidence profiles and we can turn those around in as short as four hours up to three days, depending on the complexity of the issue. The other type of syntheses that we have (come from) teams across the country that can produce in the five- to 10-day timeline. This might be a case where there is no existing evidence syntheses and we need a team who can quickly pull together all of the primary studies based on the best available science.

Before COVID, we used to think we were doing a good job if we could do rapid syntheses in three, 10 or 30 business days. But with COVID, we've sometimes had to cut it down to only four hours because of how quickly decisions are being made."

Steve Buist is a Hamilton-based investigative reporter at The Spectator. Reach him via email: sbuist@thespec.com