鈥淜now your enemy,鈥� is perhaps one of the most well-known proverbs, often quoted by military buffs and corporate leaders alike. And yet in the face of the COVID-19 pandemic this ancient saying by the strategist and philosopher Sun Tzu, takes on a vital and important meaning. The virus that causes COVID-19 present many mysteries, and new reports of its effects and transmission seem to surface daily. There is so much yet to learn about this virulent pathogen.
In this context, the formation of the 鈥淏iobanque Qu茅b茅coise de la COVID-19鈥� (BQC19) / COVID-19 Qu茅bec Biobank, a provincial biobank initiative, on April 1 was an essential and strategic move. A task force made of clinicians, scientists, ethicists and operation experts created a medical, ethical and physical framework to collect samples of the patients it has infected, to enable researchers across the country 鈥� and indeed, around the world 鈥� to better understand the specific properties of the disease, how it spreads, and why it seems some people are more susceptible to it than others.
Since its inception, the BQC19 has been running at full speed, according to Dr. Vincent Mooser, Director of its Executive Committee, and a Canada Research Excellence Chair in Genomic Medicine of the Faculty of Medicine at 不良研究所. 鈥淩ecruitment of participants has been growing steadily since we began,鈥� he explained, referring to the over 350 samples gathered from patients who have agreed to take part. Although almost 25,000 cases have been reported in Quebec, only a small portion of those are being treated in one of the nine hospitals that are members of the BQC19 program. The hospitals taking part in the biobank are:
- Centre hospitalier de l'Universit茅 de Montr茅al
- 不良研究所 Hospital Centre
- Douglas Mental Health University Institute
- Centre hospitalier universitaire Sainte-Justine
- Centre int茅gr茅 universitaire de sant茅 et services sociaux CIUSSS du Saguenay鈥擫ac-Saint-Jean
- Centre hospitalier universitaire de Quebec 鈥� Universit茅 Laval
- Centre hospitalier de l鈥橴niversit茅 de Sherbrooke
- Institut universitaire de cardiologie et de pneumologie de Qu茅bec
- The Jewish General Hospital
One of the key protocols that BQC19 has enacted is the collection of samples on a set schedule. Patient tissues are gathered when they enter the hospital (termed Day Zero) and on Day Two and Day Seven. 鈥淭his is important for us to understand the dynamics of the virus,鈥� explains Dr. Mooser. 鈥淚t is these dynamics that will make the disease predictable. It will also help us ask questions about the serology, for example, and why some people may produce antibodies for the virus while others do not.鈥�
The gathering of samples, however, has posed another issue: how to ensure that all researchers have fair and transparent access to its data and samples. In response, the BQC19 is working with FRQS on establishing an independent data and samples Access Committee, a panel that has no direct connection to any members of the biobank鈥檚 Executive Committee. It is an essential step to preserve the academic integrity of the unit and to avoid any conflict of interest that might position more research in one field than another. The need for this independent committee is a sign of BQC19鈥檚 success thus far: the number of requests for samples is increasing dramatically, and Dr. Mooser underlines the need to handle this efficiently, equitably and ethically.
Dr. Mooser admits it has been a particular challenge to harmonize the systems of nine different hospitals around the new protocols required to set up this biobank initiative. 鈥淓ach hospital has its own agenda, its own set of priorities,鈥� he concedes. 鈥淏ut the cooperation has been proceeding well.鈥�
Discussions are underway to develop a larger, decentralized and federated biobank system at the national level, which fits with the Canadian government鈥檚 announcement last week of the formation of the COVID-19 Immunity Task Force. According to Dr. Mooser, such initiatives are in progress in countries around the world, notably in the United Kingdom, France, Germany and Japan. The BQC19 is having talks with these efforts as well: 鈥淏y working together with these groups, we increase our power and the chances that we make important discoveries.鈥�
The decision of BQC19 to also focus on long-term follow up is a competitive question as well, as it distinguishes the initiative from other international peers that do not focus on this long-range aspect of the disease. Looking ahead, Dr. Mooser stresses the biobank is by no means a one-time exercise that will be dismantled once a vaccine for SARS-CoV-2 鈥� the virus that causes COVID-19 鈥� is found.
鈥淭his is a long-term investment. We want to also have the capacity in the future to follow-up with survivors,鈥� says Dr. Mooser. 鈥淒oes this disease have long-term impact on cardiac health, for example, are survivors still infectious and what is their serology response? These are the kinds of questions we need to be able to answer.鈥�
鈥淐OVID is not the last pandemic,鈥� he concludes. 鈥淗aving built up this network, we need to continue to leverage it to fight future infections, whatever they may be.鈥�