High-quality data and evidence, speed, and the agility to pivot in the face of ever-changing health system needs are essential during the COVID-19 pandemic. ICES and the McMaster Health Forum, two OSSU research centres, have become mainstays of Ontario’s COVID-19 response by providing up-to-date data analytics and evidence syntheses respectively, as part of their rapid support for government, the health system, and researchers.
With often daily government briefings on COVID-19, the ability to access up-to-date data on everything from testing to case numbers and vaccination rates, as well as evidence syntheses about topics like supporting vaccine roll-out, is critical for delivering health care, and for policy-makers and health-system leaders.
It has been a Herculean task to anticipate needs and gather and analyze data and evidence rapidly for the Ontario government, Ontario Health, Public Health Ontario and other groups involved in the COVID-19 response. ICES and the McMaster Health Forum quickly adapted to the challenge, starting in March 2020.
ICES initially provided daily reports on COVID-19 testing results linked to other health and demographic data for all Ontarians, as well as residents in long-term care and retirement homes, to the Ministry of Health command table and other stakeholders. As part of its data governance agreements with Indigenous organizations, ICES produced analyses and reports requested and approved by the Chiefs of Ontario and the Métis Nation of Ontario for those partners and First Nation communities.
“I would definitely say there has been an organization-wide response to support researchers and analytics,” says Dr. Michael Schull, CEO, ICES. “We had some staff working seven days a week to do this; across the organization, many scientists stepped up to sit on working groups and provide analytics upon request. Other staff rapidly negotiated the integration of new data sets and cleaned and linked the data very rapidly. It’s complicated to do and do quickly, but we had the entire leadership very engaged. At the same time, we were heavily involved with the Ministry’s efforts to build the Ontario Health Data Platform almost overnight.”
Over 140 research COVID-19 related studies and analytic projects have been launched.
Now with vaccines rolling out, ICES is analyzing and sharing COVaxOn vaccine administration data weekly with the government to understand vaccination trends and gaps, and posting public versions of the report on its website every two weeks. Research using vaccination data is already underway, led by both ICES and non-ICES researchers.
“I’ve always believed the strength of an organization is its people. The greatest asset is our staff and scientists. They have completely stepped up to respond in so many ways. It’s incredible when you see it in action,” says Michael.
Like a chef assembling raw ingredients into a meal, the McMaster Health Forum takes evidence to the next stage to incorporate into health and research decisions. Dr. John Lavis, Director of the McMaster Health Forum, in partnership with Dr. Jeremy Grimshaw at the Ottawa Hospital Research Institute, created the COVID-19 Evidence Network to support Decision-making (COVID-END) to, among other activities, maintain a regularly updated inventory of ‘best evidence syntheses’ on the full range of COVID-19 responses. COVID-END is a network of 57 of the world’s leading evidence-synthesis, technology-assessment and guideline-development groups that aims to reduce duplication and enhance coordination in the COVID-19 evidence response. Thanks to funding from CIHR, the team also launched COVID-END in Canada earlier this year, with 40+ of Canada’s leading evidence synthesis groups. COVID-END in Canada responds to requests from decision-makers across the country as quickly as 4 hours to 3 days (for rapid evidence profiles) and 5 to 10 days (for rapid syntheses).
“For any given COVID-19 decision, whether it’s public-health measures and clinical management or a health system arrangement and economic or social response, we summarize the best evidence that’s out there,” says Dr. John Lavis. “Researchers can use COVID-END’s resources, including the results of our monthly horizon-scanning panel’s deliberations, to identify gaps in both primary research and in evidence syntheses.”
Canadian decision-makers and researchers can keep up-to-date on the best global evidence syntheses, newly prepared Canadian evidence syntheses, and horizon-scanning outputs by signing up for twice-a-month Canadian spotlights.
Citizen partnership has been an important element in the McMaster Health Forum’s response to COVID-19, with a number of citizen partners involved in COVID-END’s global activities and about 20 Canadians engaged in its domestic work. Many of these citizens have experience with the economic and social responses to COVID-19 and don’t always identify as patients, which is why COVID-END refers to them as “citizen partners” rather than patient partners
“We have had a very ambitious citizen partnership strategy with COVID-END thanks to Maureen Smith, the incoming chair of OSSU’s Patient Partner Working Group. She has done an incredible job of recruiting citizen partners to provide input on all aspects of our work, and who are at every table with our partners,” says John.
Maureen has been particularly attentive to ensuring diversity, with different geographies covered – all WHO regions for the global work and all parts of Canada for the domestic work – as well as different ethnocultural, socioeconomic and other perspectives.
“Maureen is providing exceptional leadership working with citizen partners around the world and in Canada,” says John. “She identified a gap that citizen partners were being left out and that they need to be there every step of the way.”
At ICES, its Public Advisory Council was consulted and provided important recommendations on how best to present public-facing analyses on COVID-19 cases in Ontario and the vaccine roll-out on its COVID-19 web dashboard.
Patient engagement and supporting a learning health system are key directions for OSSU 2.0. While data analytics and evidence syntheses are important, patients are at the centre.
“I think the push around public and patient engagement is a major reflection of OSSU and SPOR in Ontario,” says Michael. “We have passed the Rubicon in that engaging the public in research is now the norm, and it’s a real success of OSSU. There have been many learnings through COVID and for OSSU’s Phase 2, it will be key to see how we can apply lessons to support a learning health system in a post-COVID world. We need to make sure we are answering meaningful questions and making positive change.” As these OSSU centres demonstrate, collaboration, rapid-responses to health system needs and up-to-date data analytics and evidence syntheses are critical for OSSU’s next phase.