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A COVID-19 surveillance study has been instrumental in curbing potential outbreaks of the virus among vulnerable populations in Hamilton. The study offers weekly on-site testing for residents in a number of congregate living centres and shelters across the city.

“It’s a highly provident approach to limiting the spread of COVID-19 in these high-risk settings,” said Dr. Tim O’Shea, an infectious diseases specialist and internist at the Hamilton Social Medicine Response Team (HAMSMaRT) and Shelter Health Network. “We’re fortunate to have access to testing resources outside of clinical labs as well as professional networks that have helped this important project continue.”

Clinicians from the Shelter Health Network and HAMSMaRT, including Drs. Kerry Beal and Tim O’Shea, teamed up with scientists at The Research Institute of St. Joe’s Hamilton to launch the study as Ontario experienced its first wave of the pandemic. Since April 2020, the team has conducted over 9,000 COVID-19 tests as part of the surveillance study.

PCR testing for the study, which is considered the gold standard in detecting the virus, is being provided by The Research Institute of St. Joe’s Hamilton. There, Drs. David Bulir and Marek Smieja lead a team of researchers who have built lab infrastructure to enable high-throughput testing. St. Joe’s COVID-19 test, developed by Dr. Bulir, is also capable of detecting and differentiating between eight other respiratory viruses, including influenza A/B and SARS-CoV-1 (the virus that caused the SARS outbreak of 2003). Dr. Bulir’s test remains effective in detecting the currently known variants of COVID-19.

The virology research lab at St. Joe’s was recently granted a provisional license to provide a diagnostic result on its COVID-19 tests – meaning their results can be directly reported into the medical record and to public health. This also means that positive samples no longer need to be sent for repeat testing in a clinical laboratory and are included in Ontario’s daily epidemiological update.

In this study, samples are taken weekly and sent for testing at St. Joe’s, with results usually available within 24 hours. This allows site administrators to quickly identify any individuals who test positive and safely move them to designated isolation areas.

Currently, a total of 40 sites across the city are actively participating. The YMCA Men’s Residence in downtown Hamilton is the latest site to join the study.

“We value working collaboratively with partner agencies to provide wrap around support to the men in residence,” said Genevieve Hladysh, a senior regional manager at the YMCA. “Regular surveillance testing allows us to be proactive to help reduce transmission, especially when cases are asymptomatic.”

Not only are researchers investigating the feasibility of conducting weekly surveillance testing at dozens of locations across Hamilton, but they’re also examining the effectiveness of using oral-nasal swabs for specimen collection instead of the more invasive nasopharyngeal swabs.

“We’ve found that patient self-collection using oral-nasal swabs led to an increased number of people volunteering to participate in weekly testing,” said Jodi Gilchrist, research coordinator of the COVID-19 surveillance study. “Since participants experience little to no discomfort with oral-nasal swabs compared to nasopharyngeal swabs used elsewhere, many have opted to continue with routine testing to help ensure their safety and that of their community.”

Gilchrist, along with research assistants Nicole Smieja and Valentina Vera, have been visiting congregate living centres and shelters to obtain consent from residents – who become research participants in the study – and to teach them how to self-collect samples using oral-nasal swabs. Any participants experiencing symptoms of COVID-19, as well as primary contacts of positive cases, are assessed and swabbed through a parallel program run separately by Dr. Kerry Beal and her dedicated Shelter Health Network team.

“Some of the centres we’ve enlisted in the study also have site leads who have been trained with the process, helping us to continue testing greater numbers,” added Gilchrist.

Funding for the COVID-19 surveillance study is provided by The Research Institute of St. Joe’s Hamilton, the Juravinski Research Institute, and the Hamilton Academic Health Sciences Organization (HAHSO).

St. Joe’s researchers previously made global headlines for bringing mass testing to Pearson Airport as part of a feasibility study to test incoming international travellers. They have developed novel COVID-19 testing solutions, including a robust PCR test and the use of liquid-handling robotics. To ensure province-wide mass testing can continue, they also managed to secure and innovate alternative suppliers of lab consumables that became scare as demand skyrocketed.

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