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St. Joseph’s Health Care London and Lawson Health Research Institute have announced plans to move forward with clinical trials testing a drug that could potentially be used to prevent and treat COVID-19. St. Joseph’s Health Care Foundation will accelerate the creation of the studies by providing seed funding to get the research started through donor support. Based on the immediate need, The St. Joseph’s Health Crisis Fund has been created by St. Joseph’s Health Care Foundation to enable these and other research studies currently in development through Lawson, the research arm of St. Joseph’s. 

While supporting urgent COVID-19 clinical trials will be an immediate focus, The St. Joseph’s Health Crisis Fund will also support critical patient care equipment and care and comfort items for healthcare staff and volunteers working on the frontlines of the pandemic across St. Joseph’s.

Led locally by Dr. Michael Silverman, Medical Director of St. Joseph’s Infectious Diseases Care Program, one trial will assess the safety and efficacy of using hydroxychloroquine (HCQ) to prevent COVID-19 in health care workers recently exposed to the virus. This trial will also assess the drug as a treatment for non-hospitalized patients with mild cases of the illness. St. Joseph’s will be one of many participating sites in the trial, which is being led by the Research Institute of the McGill University Health Centre.

“There is much debate surrounding the drug hydroxychloroquine. We do not yet know whether it’s safe or effective, and it should not be routinely recommended until we do,” says Dr. Silverman, also a Lawson Associate Scientist and city-wide Chair/Chief of Infectious Diseases. “We plan to carefully study the drug through a randomized controlled trial and assess whether it can help combat COVID-19.”

Dr. Silverman is also partnering with Dr. Michael Borrie, Geriatrician at St. Joseph’s and Lawson Scientist, on a prevention trial to test the safety and efficacy of the drug for patients and residents at Parkwood Institute who have been exposed to COVID-19. They are at a higher risk of infection, as well as serious complications and potential admission to acute care.

“There are two critical goals with this prophylactic trial,” explains Dr. Borrie. “First, we want to see if the drug, taken for five days, is safe for the participants in the study. We will then look to see whether it is effective to prevent illness or lessen symptoms and complications.” 

They are testing whether HCQ may inhibit the coronavirus similar to how the antiviral drug Tamiflu is used to prevent influenza after exposure. The research team will recruit patients and residents who have been accidentally exposed to the virus by a confirmed or presumed case of COVID-19, but who aren’t yet experiencing symptoms. In addition to cardiograms and blood tests for safety, they are collaborating with Dr. Saman Maleki, Lawson Scientist and Immunologist, to analyze the blood for a variety of indicators including the presence of antibodies and immune response. They will collect clinical data and information on common health conditions to gain insights into why some vulnerable individuals get the disease and others don’t.

“We are aware of two small studies that were published rapidly last week, one in France and the other in China, testing the use of chloroquine for potentially treating COVID-19. Further studies are greatly needed,” adds Dr. Borrie. “This study at Parkwood Institute is a good start and we hope to have other Canadian sites join us in recruiting participants so that we can offer statistically significant results as soon as possible.”  

Those interested in donating to St. Joseph’s Health Crisis Fund are asked to visit St. Joseph’s Health Care Foundation’s website to learn more at sjhcfoundation.org. Donations can be made online, through direct mail submissions or by calling the Foundation directly at 519-646-6085. 

“The Sisters of St. Joseph, who founded our organization, faced contagious diseases and other pandemics at different times in our 150+ year history,” says Michelle Campbell. “Today, it’s a different time, and a new disease. Now, more than ever, we ask our community to help us address the crisis facing us all.” 

In the news:

• Global News - London, Ont., researchers to study hydroxychloroquine’s potential to prevent, treat coronavirus
• CTV - London researchers testing drug to prevent COVID-19 spread in long-term care homes
• The London Free Press - New fund set up to help bankroll London research into COVID-19 drug

During a virtual event for Londoners hosted by Lawson Health Research Institute and the City of London, a multi-sectoral research team announced two projects representing a collaborative approach to preventing homelessness from within hospital walls. 

Built on the unique and successful No Fixed Address (NFA) strategy, these projects are being tested as a potential best practice for preventing hospital discharge to homelessness. 

Led by Dr. Cheryl Forchuk, Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation and Recovery, and Assistant Scientific Director at Lawson, NFA seeks to stop the cycle between hospital admissions and homelessness by providing timely and accessible supports to patients who would otherwise be discharged into homelessness. It brings housing and financial supports into the health-care system, starting as soon as upon admission, to assist in finding appropriate housing and supports or avoiding a potential eviction. 

Several departments at London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London collaborate with staff from the City of London, Canadian Mental Health Association (CMHA) Elgin-Middlesex, Youth Opportunities Unlimited (YOU), Salvation Army’s Housing Stability Bank and Ontario Works in the City of London to provide direct, on-site (or virtual) support for patients at risk of homelessness.

Patients discharged from hospital to homelessness in Canada face many challenges that make recovery more difficult. They often experience higher readmission rates and emergency department visits. This is particularly concerning for youth, who have been found to be the fastest growing segment of the homeless population.

NFA was initially tested with strong success for mental health patients across the city and the second version of the project was extended to medical units at LHSC’s University and Victoria Hospitals.

PROJECT 1: Collaboration to Address Homelessness - Health, Housing and Income (H2I) 

This research study will evaluate the City of London’s Coordinated Access Outreach program at hospital sites. A Coordinated Access Outreach worker will support individuals at risk of homelessness to maintain or obtain housing. Ontario Works will assist with the provision of income and employment supports and the Salvation Army Housing Stability Bank may be accessed for needed financial resources to secure or maintain housing.  

Over two years, 106 participants will be interviewed in hospital and again six months post-discharge. Focus groups with participants, health care providers and community partners will provide further insight into the effectiveness of NFA. This project is funded by the Canada Mortgage and Housing Corporation (CMHC)’s National Housing Strategy. 

PROJECT 2: Preventing discharge to No Fixed Address – Youth (NFA-Y) 

This research study will customize, implement and evaluate the NFA strategy for vulnerable youth agSwitch to plain text editores 16-24. The unique health and housing needs of youth at-risk will be explored by streamlining housing and financial support into a coordinated system of care, with additional support provided by Youth Opportunities Unlimited and Children’s Aid Society London and Middlesex. 

Over 3-4 years, data to be collected from 93 youth at three time points. Focus groups with youth participants, health care providers, and community agency partners will help enhance the NFA strategy to meet the unique needs of youth. This project is funded by the National Centres of Excellence (NCE) Making the Shift (MtS) Youth Social Innovation Lab. 

Media Coverage 

• Could this project keep discharged hospital patients from homelessness? - London Free Press 
• London, Ont., expands work to prevent homelessness after hospital stays - Global News
• London expands strategy to curb homelessness after hospital stays - Blackburn News 
• What happens to people who are discharged from hospital if they have nowhere to go? - CBC London

Learn more about No Fixed Address 

• Expanded No Fixed Address strategy houses half of those in danger of homelessness   
• Funding for unique strategy to prevent homelessness after hospital discharge

Lawson Health Research Institute is ranked eighth in the country according to the 2019 edition of “Canada’s Top 40 Research Hospitals List” by Re$earch Infosource. This strong national position has been maintained by Lawson for the past six years and also keeps the institute within the top five in Ontario.  

The results 

The research institute of London Health Sciences Centre and St. Joseph’s Health Care London (St. Joseph’s), Lawson has also maintained the top ranking for research intensity among the large tier institutions with $612,800 of research spending per researcher. 

“As a hospital-based research institute, our innovation happens where care is delivered,” says Dr. David Hill, Lawson Scientific Director. “Every day, teams of researchers are working directly with clinicians and patients to improve treatments or create entirely new ones. They also find innovative methods of delivering services that drive efficiency and reduce costs.” 

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The top 40 list analyzes hospital-based research institutes from across the country on several metrics, including total research income from the previous fiscal year. The ranking looks at funds received from all sources, including both internal and external, to support research at the organization. According to the report, Lawson received $123,790 million in research income in 2018, which represents 0.4 per cent in growth from the previous fiscal year.

“We are known across the country and around the world for our high level of research activity and success, despite our size. London punches well above our weight when it comes to health research,” adds Dr. Hill.

“Our position as a leading research institute is the foundation for brilliant research and worldwide partnerships tackling the most pressing challenges in health care.” 

What does this mean for London, Ontario? 

There are millions of dollars every year coming in London from elsewhere in Canada and in the world. Approximately 60 per cent of that is spent on jobs. Lawson employs over 2,000 people in hospital-based research. This is a major source of quality employment for Londoners and people in the surrounding region. Dr. Hill notes that this is one of the real benefits of having a strong biomedical industry associated with the city. 

“Another real benefit of having research directly in the hospitals is that our researchers focus on gaining knowledge that advances our ability to treat patients and find solutions to wicked problems that have been around for a long time.” 

For example, Lawson researchers have been tackling the issue of homelessness from within hospital walls. The No Fixed Address (NFA) strategy reaches and supports patients during the crucial transitional period when they are being discharged from the hospital and re-integrated into the community. Learn more about this successful research initiative. 

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How are we adapting to the current funding environment? 

While federal funding for research in Canada is slowly starting to increase, this sector experienced over a decade of decreasing funding that placed the country far behind other nations in terms of investing in health research. 

“We have become better at what we do in competing for grants and other funding sources, in particular from the government,” explains Dr. Hill. 

Also, “Lawson has been diversifying our sources of funding. We’ve have engaged in more partnerships with industry and joint research and development projects with companies. Not only does that have the advantage of providing additional resources, but also is often a more practical way of directly delivering our knowledge into salable products”

Strong partnerships 

This year, Re$earch Infosource is showcasing “Building Bridges: Pathways to Building Research Capacity and Discovery through Collaboration.” Health researchers in London have collaborations across many sectors that result in big impacts for the people in this region and beyond. 

As just one example, a group of scientists from Lawson, Brescia University College and Schulich School of Medicine & Dentistry at Western University provide academic support to London’s Fermented Foods Project that brings together industry partners, the agricultural sector, academic and health institutions, the City of London and the London Economic Development Corporation. 

The goals of this group, funded by the Weston Family Microbiome Initiative, are to support new product development and batch production, enhance customer confidence, quantify health benefits and establish a competitive advantage. 

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The COVID-19 pandemic is proving to be one of the most pressing health challenges of our time. With a rising number of cases and deaths worldwide, there’s a global urgency to finding a solution.

As the research institute of London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London, Lawson Health Research Institute excels in rapid response research and is uniquely positioned to tackle this problem from within hospital walls.

Our researchers belong to a health system at the forefront of the pandemic. With close proximity to patients and access to samples, they are mobilizing to address COVID-19.

“Lawson researchers include clinicians directly involved in the treatment of COVID-19 patients, as well as laboratory-based scientists and those with other expertise related to the pandemic response,” says Dr. David Hill, Scientific Director at Lawson and Integrated Vice President at LHSC and St. Joseph’s. “They are eager to contribute a solution and are combining their knowledge to address this issue from all angles.”

Already, Lawson research teams are initiating projects ranging from pre-clinical studies to clinical trials. They are planning to explore diagnosis, prevention and treatment of the disease, as well as long-term and mental health impacts. An immediate goal is to partner with other research hospitals to improve outcomes for COVID-19 patients around the world.

There are numerous COVID-19 studies underway at Lawson and many more going through the necessary approval processes. Recognizing the importance of a rapid response to this pandemic, Lawson’s Administration team is working to fast-track approval of the studies.

Lawson also offered a special internal COVID-19 funding competition to assist our researchers in their efforts. Lawson’s COVID-19 Pandemic Response Internal Research Fund supports projects that are identified as having the potential to impact the management of this pandemic and those that enhance our understanding of the pathophysiology of COVID-19. See the results of this competition and the 14 funded projects, for a total of more than $202,000 invested. 

While there is much to learn about COVID-19 and its impact on human health and our health care system, Lawson researchers are tackling the disease head-on.

How can you support COVID-19 research and clinical care?

Research at Lawson can be supported through three hospital foundations. With an outpouring of support from our community, the foundations are collecting donations to support our hospitals through this challenging time. Learn more about donating:

• St. Joseph’s Health Care Foundation – St. Joseph’s Health Crisis Fund
• London Health Sciences Foundation - COVID-19 Response Fund 
• Children’s Health Foundation - COVID-19 Response Fund

Learn more about COVID-19 research at Lawson:

• London researchers join global initiative to study loss of smell in COVID-19 patients
• Study to examine inflammatory response in patients with COVID-19
• Local COVID-19 research supported by St. Joseph's Health Crisis Fund