Data from multiple countries including the United States, United Kingdom and Canada indicate a disproportionate number of individuals of African ancestry are contracting SARS-CoV-2 and afflicted with more severe COVID-19 than people of other races. The Government of Canada, through its COVID-19 Immunity Task Force (CITF), is supporting a study investigating how many people in Black Canadian communities have had SARS-CoV-2, the virus causing COVID-19, and the risk factors associated with both contracting the infection and having poor outcomes, including hospitalization and death. Approximately $1.2 million in funding has been provided for this study.
“We have already seen evidence suggesting that Black Canadians are disproportionately represented among COVID-19 cases, and may suffer severe outcomes, including death. This is an indication that inequities can contribute to disease severity and outcomes. We must take great care to protect and promote the health of these communities specifically,” says Dr. Upton Allen, lead investigator of the study, Division Head of Infectious Diseases, and Senior Associate Scientist in the Child Health Evaluative Sciences Program at The Hospital for Sick Children (SickKids). “Our hope is that this study will inform targeted policies as well as health and safety measures that can effectively reduce the disease risk for Black Canadians.”
The study has partnered with various Black community groups, including the Jamaican Canadian Association, Black Health Alliance, WellFort Community Health Services, Black Creek and Taibu Community Health Centres, and Alliance for Healthier Communities, among others. “We carried out a pilot project in the Greater Toronto Area that opened doors within the community for this study and provided opportunities for us to build on that initial connection,” says Dr. Allen. “Community engagement is key to the study’s success.” The research team for the pilot project included investigators from the Universities of Toronto, York, Ryerson and Western.
To ensure the lines of communication remain open throughout the project, the study created a special Community Advisory Group, chaired by retired Citizenship Judge Pamela Appelt, which works and meets with the research team regularly. “It is significant that this is a Black-led project. Generating trust―and therefore greater community participation―is of the utmost importance,” Pamela Appelt, Chair of the study’s Community Advisory Group, adds.
The study will enroll 2,000 Black Canadians and 1,000 non-Black Canadians within specific Ontario postal codes for comparative purposes. “Participants will be asked to provide a blood sample which we will test for antibodies to SARS-CoV-2, to determine if there was a past infection,” explains Dr. Allen. “If antibodies are present, we will also delve further into the antibody response to the virus.” In particular, participants who test positive for antibodies will be asked to provide additional samples in order to determine how long antibodies remain. Participants who are initially negative will be offered the option to return for repeat testing after 4-6 months.
In addition to antibody testing, the researchers will look at socioeconomic, occupational, and housing factors as well as pre-existing medical conditions, as these have been implicated in higher rates of infection.
“Studies are limited, but preliminary reports have suggested a relationship between a vitamin D deficiency and an increased risk and severity of COVID-19,” explains Dr. Allen. “Blacks are potentially at risk of these adverse outcomes, in part because of the increased risk of vitamin D deficiency among darker-skinned individuals. For that reason, we also plan to look at vitamin D levels among our participants who test positive to SARS-CoV-2 compared with those who test negative.”
“This study is precisely aligned with a stated goal of the COVID-19 Immunity Task Force, which is to track the spread of the virus in the general population and priority groups, while aiming to shed light on immune responses to SARS-CoV-2 in diverse communities across Canada,” says Dr. David Naylor, CITF Co-chair. “As Canada prepares for the possibility of a third wave of infection, understanding the level of immunity and unique risk factors for the Black Canadian population will help those communities as they work with public health staff to developing more robust protective measures.”
“This collaborative effort among researchers and community groups will provide valuable information about COVID-19 amongst Black Canadians,” says Canada’s Chief Public Health Officer, Dr. Theresa Tam. “The results from this study will help inform strategies to prevent spread and respond to the needs of Black Canadian communities across the country.”
ABOUT THE COVID-19 IMMUNITY TASK FORCE
In late April 2020, the Government of Canada established the COVID-19 Immunity Task Force with a two-year mandate. The Task Force is overseen by a Leadership Group of volunteers that includes leading Canadian scientists and experts from universities and healthcare facilities across Canada who are focused on understanding the nature of immunity arising from the novel coronavirus that causes COVID-19. To that end, the CITF is supporting a range of studies to determine the extent of SARS-CoV-2 infection in Canada (in the general population as well as in specific communities and priority populations), understand the nature of immunity following infection, develop improved antibody testing methods, and help monitor the effectiveness and safety of vaccines as they are rolled out across Canada. The Task Force and its Secretariat accordingly work closely with a range of partners, including governments, public health agencies, institutions, health organizations, research teams, other task forces, communities, and stakeholders. Most recently, the Task Force has been asked to support vaccine surveillance, effectiveness and safety as part of its overall objective to generate data and ideas that inform interventions aimed at slowing – and ultimately stopping – the spread of SARS-CoV-2 in Canada. For more information visit: www.covid19immunitytaskforce.ca.
ABOUT THE HOSPITAL FOR SICK CHILDREN (SickKids)
The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric health-care institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally. Its mission is to provide the best in complex and specialized family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system. SickKids is a founding member of Kids Health Alliance, a network of partners working to create a high quality, consistent and coordinated approach to paediatric health care that is centred around children, youth and their families. SickKids is proud of its vision for “Healthier Children. A Better World.”