Category Archives: COVID-19

Posts and information on COVID-19 for Meakins-Christie, RECRU, and RESP members.

Montreal-area hospitals have almost reached capacity

COVID-19 situation in the ICU is critical

As the number of hospitalizations with COVID-19 patients increases into January 2021, Dr. Peter Goldberg discusses how the MUHC is planning to operationalize a potential increase in patients. These are some of the logistical and emotional choices Montreal area hospitals may have to face in the coming weeks.

Interviews with Dr. Goldberg on the status of Montreal hospitals, and what happens next:

Who will be most affected by COVID-19?

A related post from November 2020:

We are months into the second wave of COVID-19 yet healthcare workers remain unable to predict who will get sick from the virus and who will not. Neither the severity of a patient’s symptoms, nor their age, forecast the ultimate outcome. Nor does the existence of a pre-existing medical condition dictate how things will end. The truth is, healthcare teams do not know who will be most affected by COVID-19. In a recent interview, Dr. Peter Goldberg, associate member of the Meakins-Christie Laboratories and researcher in the RESP Program of the RI-MUHC, expresses his frustration at his inability to save someone who is too young, too alive, to die:

“it was like a forest fire, and all I had was a garden hose.”

Dr. Goldberg

Even patients seemingly on the mend can take a sudden turn for the worse and experience a rapid decline. Suddenly their life is in jeopardy. Physicians must be ready to respond quickly when this happens, but when not successful they are left to watch their patients pass on without the support of their family or friends.

“If there is anything more distressing than seeing someone die, it is seeing them die alone, or a nurse holding up a phone on Zoom or Skype so that family members can watch this,”

Dr. Goldberg

Canada’s case fatality rate is high amongst peer countries, but it is suggested that the trend could be due to testing: in Canada, testing has focused on individuals with symptoms and at-risk individuals, rather than the entire population. Regardless of testing, as the number of people with severe symptoms require hospitalization increases, hospitals become overloaded and physicians are faced with difficult decisions. Reflecting back on the spring and how the hospitals quickly filled up, Dr. Goldberg recalls having “very disturbing” conversations with hospital ethicists, and he sincerely hopes not to find himself in a similar position this time around:

“I don’t think the community knows that these conversations are going on. We’re talking about them — we’re not talking about something esoteric about ourselves. We’re talking about how ICUs, if we reach the limitation of our capacity to treat COVID patients, then we’re going to have to make decisions about who gets the bed.”

Dr. Peter Goldberg

Dr. Goldberg speaks of fighting this virus from a physician’s perspective, and the difficulty to predict who will be most affected by COVID-19, in his interview with Sharon Kirkley of the National Post.

The interview with Dr. Goldberg can be read here:

COVID-19 testing: Saliva vs Nasopharyngeal Swabs

Saliva Swabs are Just as Effective

A study co-authored by Dr. Dick Menzies, Senior Scientist in the RESP Program at the RI-MUHC and Associate Member of the Meakins-Christie Laboratories, reveals that saliva swabs are just as effective at detecting the COVID-19 virus as are nasopharyngeal swabs, but at a fraction of the cost and none of the discomfort.

Saliva swabs are just as effective and they can be self-collected. Thus, the expense of setting up and operating testing sites would be eliminated along with the cost of healthcare and other workers at those sites and the protective equipment required by those workers. Exposure of these workers to the virus would be eliminated and health professionals would be available to assist in other areas of healthcare.

“With over 75,000 tests being done per day in Canada, replacing nasopharyngeal swabs with saliva-based sampling methods would save half a million dollars every day,” 

Dr. Dick Menzies

Dr. Menzies and his team of researchers have discovered a win-win alternative to nasopharyngeal swabs. How soon can this new practice be implemented?

Read more about the study and the interview with Dr. Menzies:

Marc Tewfik and olfactory training if you lose your sense of smell or taste after COVID-19

Olfactory training after COVID-19

Dr. Marc Tewfik explains how olfactory training can be done at home if COVID-19 has stolen your sense of smell. Dr. Tewfik is an Associate Professor of Otolaryngology – Head and Neck Surgery at McGill University and an Investigator with the RI-MUHC RESP Program.

In a recent interview with CBC News, he discusses that up to 20% of people who lost their sense of smell after testing positive for COVID-19 don’t seem to recover their sense of smell or taste. He explains the importance of our sense of smell, and how olfactory training might work for some.

Olfactory training is easy and can be done at home. It involves smelling natural ingredients in jars twice a day for several months to help stimulate the nerve cells in the nose to regenerate.

Read the full article and interview here:

Has COVID-19 stolen your sense of smell? MUHC doctor suggests method to coax it back. CBC News Montreal. January 8, 2021

Nicole Ezer and the CONTAIN COVID-19 trial at the RI-MUHC with ciclesonide

COVID-19 contained with a nasal spray

Dr. Nicole Ezer is helping lead a trial with ciclesonide that promises to reduce symptoms of COVID-19. Read our initial posts about the trial here: Ciclesonide Clinical Trial for COVID-19 and ‘Contain COVID-19’ – in its earliest phases.

The Journal de Montreal reports the pursuits of our Quebec researchers and physicians in leading this trial. Ciclesonide has both anti-viral and anti-inflammatory properties. Of the few trials testing ciclesonide, the one led here at the MUHC is the only one that is studying the administration of the drug by nasal spray and inhaler. Inhalers and sprays have the advantage of acting directly in the nose, the airways, and the lungs, right were the SARS-CoV-2 virus is actually replicating. The goal of the trial is to determine whether ciclesonide reduces respiratory symptoms and in turn reduces hospitalizations.

Dr. Ezer is an Assistant Professor in the Department of Medicine at McGill University and a Junior Scientist with the RI-MUHC RESP Program.

To learn more about the trial or participate and the entire research team: www.contain-covid19.com/contenez-la-covid-19/  

Read the article:

COVID-19: un vaporisateur nasal en renfort. par Stéphanie Martin, Journal de Montréal. December 31, 2020.

Preliminary findings of Dr. Benjamin Smith's study suggest a shorter COVID-19 quarantine period may be possible for the future.

A shorter COVID-19 quarantine period

A RI-MUHC study led by Dr. Benjamin Smith suggests appropriate testing could bring the COVID-19 quarantine period down from 14 to 7 days. Healthcare workers who developed COVID-19 after they were advised to self-isolate following a high-risk SARS-CoV-2 exposure, were all detected by day 7. This means that a simple testing strategy may allow for the early detection of healthcare workers who will develop COVID-19 after a high-risk exposure.

Read More:

COVID-19 testing: Timing may be everything

The original post appeared November 2020:

It seems that a shorter COVID-19 quarantine period may be possible, thanks to the work of Dr. Benjamin Smith, MI4 scientist and member of the Meakins-Christie Laboratories. Dr. Smith was primarily looking to ease the burden of this virus on the healthcare system. Healthcare workers are at the greatest risk of exposure while at work and yet their presence at work is crucial to handle an ever-increasing influx of COVID-19 patients.

Dr. Smith began by questioning the duration of the isolation period after exposure, 14 days, and looked to reduce that window. He developed a study, and is using healthcare workers exposed to the virus as his test subjects. Testing them using a variety of methods at varying time intervals throughout their isolation has given positive results.

“Our study suggests that a simple infection control strategy consisting of symptom-triggered testing from day 0 to 7, followed by a standard home-based test on day 7, detects all or nearly all healthcare workers who develop COVID-19 after high-risk exposure. It’s a promising result. If these findings are confirmed as we test a larger number of people, this testing strategy could significantly shorten the self-isolation duration required for healthcare workers,”

Dr. Benjamin Smith

The initial findings of his study indicate that the results of a nasopharyngeal swab and saliva test on the 7th day of quarantine will predict fairly accurately the likelihood of developing the virus in day 8-14. Continued positive results in this ongoing study will bring a great sense of relief to many. A shorter COVID-19 quarantine period will benefit more than just the intended healthcare workers. Other patients looking to access the healthcare system, travellers, society as a whole will feel a burden lifting in light of this news.

Read More:

  • The full article about Dr. Benjamin Smith’s study and the encouraging results can be read in the article COVID-19 testing: Timing may be everything, appearing in the November 18, 2020 edition of Health e-News. Photo credit: Owen Egan / Joni Dufour.
Dr. Simon Rousseau and Dr. Jean Bourbeau of the RESP Program at the Research Institute of the MUHC are recipients of QRHN 2020-2021 Project Grants

RESP researchers receive QRHN funding

Congratulations to the following RESP researchers for receiving 2020-2021 grants from the Quebec Respiratory Health Research Network.

  • Dr. Simon Rousseau – awarded a Team Projects grant for his project: “Impact of prior coticosteroids therapy for airway diseases on COVID-19 clinical trajectory”.
  • Dr. Jean Bourbeau – awarded a Priority Projects grant for his project: “Impact of the environment on the development and aggravation of obstructive and remodelling lung diseases”.

More about the Quebec Respiratory Health Research Network (QRHN).

Larry Lands and Laurent Pharmaceuticles to begin a clinical trial on COVID-19 treatment with LAU-7b, a pro-resolving drug with potential antiviral properties against coronavirus

LAU-7b clinical trial on COVID-19 treatment

The RI-MUHC is currently enrolling patients in RESOLUTION, a clinical trial of LAU-7b for the treatment of hospitalized COVID-19 patients. The drug acts on lung inflammation and showed potent antiviral effects in-vitro against SARS-CoV-2. Results from previous studies in adult CF patients showed an important reduction of key pro-inflammatory biomarkers at the onset of a pulmonary exacerbation episodes, suggestive of a protective effect of the drug on the lungs.

Read more here:

Phase 2 clinical study with LAU-7b

An original post from April 2020 described the start of the clinical trial:

Laurent Pharmaceuticals, a McGill spinoff, will run a Phase 2 clinical study with LAU-7b, a pro-resolving drug with potential antiviral properties against coronavirus.

Larry Lands is the Chief Medical Advisor for Laurent Pharmaceuticals. Laurent Pharmaceuticals Inc. is planning to test its lead drug LAU-7b in patients with COVID-19 disease. LAU-7b was recently identified as a potential anti-viral therapeutic option for COVID-19 during a drug-library screening effort.

The Research Institute of the MUHC is presently enrolling participants in the study, called RESOLUTION. LAU-7b is a novel oral form of a drug called fenretinide, which inhibits the inflammatory reaction of the body to the virus. This study could lead to improved treatments for hospitalized COVID-19 patients who are at higher risk of developing complications.

“Thanks to its inflammation-controlling properties, low-dose fenretinide triggers a natural mechanism – the body’s own resolution of the inflammation process – which keeps the inflammatory response under control without suppressing its protective immune role.”

Dr. Larry Lands

Read more here:

McGill spinoff Laurent Pharmaceuticals to begin clinical trial on COVID-19 treatment. Company to run a Phase 2 clinical study with LAU-7b, a pro-resolving drug with potential antiviral properties against coronavirus. By Junji Nishihata. McGill Reporter. April 11, 2020.

Dr. Bruce Mazer, Associate Scientific Director of the COVID-19 Immunity Taskforce, on understanding COVID-19 immunity.

Decoding Immunity to COVID-19

This week on Health Matters, Centre universitaire de santé McGill – McGill University Health Centre physician and researcher, Dr. Bruce Mazer discusses findings and unanswered questions about decoding immunity to COVID-19 and his role in the COVID-19 Immunity Task Force.

Dr. Mazer, Associate Scientific Director of the Taskforce, sums up the goal of their work as: to understand the prevalence of the virus in the community at large, and to learn about how the body responds to the virus. Completed studies in this area have revealed the following:

“We know that the prevalence of the antibodies in the population of healthy blood donors is between 0.7% and 1.0% of the population, as high as 2.9% in certain areas of Quebec and Ontario.”

Dr. Bruce Mazer

Although these numbers indicate a lack of herd immunity, he feels it is more important to understand how to treat individuals who are most at risk, to develop a vaccine, and to find answers to some of their yet-to-be-answered questions. Finding answers to questions such as why some people are more affected by this virus than others, why some people are more affected by previous viruses but not this one, and how long the antibodies created by vaccination will last in the body, would go a long way in decoding immunity to COVID-19.

Listen to Dr. Mazer’s interview by Julie Quenneville on:

Dr. Nicole Ezer of the RI-MUHC's RESP Program on what doctors have learned about treating patients with COVID-19.

Treatments for COVID-19

Since the spring physicians have been discovering optimal treatments for COVID-19 symptoms. Dr. Nicole Ezer, a researcher with the RI-MUHC’s RESP Program, was interviewed on this subject on CJAD. Dr. Ezer explained:

Initially it was very challenging to know how to treat patients appropriately, in particular patients who presented in the emergency room and required lots of oxygen.

Dr. Nicole Ezer

Since the spring the medical community has learned a lot about this virus, thanks in part to the many publications that have come out.

The names of medications which have been found best to help hospitalized patients include the steroid dexamethasone and the antiviral remdesivir. These two medications have been very helpful in not only reducing the amount of time patients spend in hospital, but also the number of deaths caused by this virus. These were important discoveries for the medical community.

The focus remains on finding treatments to help patients with less severe symptoms. To this end, all residents of Quebec experiencing milder COVID-19 symptoms are encouraged to take part in an ongoing study at the MUHC called contain-covid19.com. No in-person visits are required. After acceptance into the trial participants will receive their medication by mail. All communications are done remotely. This is one way we can all be involved in the hunt for treatments for COVID-19.

Listen to Dr. Ezer’s interview

What have doctors learned about treating COVID-19 patients? on the Aaron Rand Show, CJAD.

Innate disease tolerance and the SARS CoV-2 virus

Innate Disease Tolerance and COVID-19

Dr. Maziar Divangahi, Associate Director of RI-MUHC’s Meakins-Christie Laboratories, is an expert on tuberculosis and well known in the field of innate disease tolerance. In a recent interview with Markham Heid of Elemental.Medium.com, Dr. Divangahi confirms that tuberculosis is one of the world’s deadliest infectious diseases. Nevertheless, a great number of people who are infected with the bacteria do not exhibit any symptoms. They have developed an innate disease tolerance for the virus. Could we teach our bodies innate disease tolerance towards the SARS CoV-2 virus?

Dr. Divangahi explains how the body of some people reacts when the tuberculosis virus reaches their lower airways:

“Either the bacteria will be eliminated during the early phase of the infection, or the host will wall off (the virus) by forming granulomas.”

“We’ve developed very successful mechanisms that allow us to live with (this virus).”

“Rather than trying to eliminate the bug, we basically keep it in check.”

The elimination of the SARS CoV-2 virus would be ideal, however, the interview with Dr. Divangahi suggests that there may be acceptable alternatives.

Read the full interview:

Some People’s Bodies Learn to Live With Covid-19. Elemental.Medium.com. By. Markham Heid. Sept 30, 2020.