TORONTO — The last flu pandemic has largely faded from the public consciousness, but it’s top of mind for more than 100 experts gathered from around the world in Toronto this week.
Their mission: to prepare for the next one.
The get-together was organized by the International Forum for Acute Care Trialists, or InFACT, an international organization of critical care researchers. It brings together scientists, doctors and representatives of government and funding agencies.
The chair of InFACT, Dr. John Marshall of St. Michael’s Hospital, describes the invitation-only meeting as an “exciting convergence of groups of people who don’t normally spend a lot of time together.”
The idea is to do as much as they can in the way of research and readiness between pandemics, he explained.
“When a pandemic occurs, there’s a sudden need for knowledge in an area where there hasn’t been any knowledge,” Marshall said Monday in an interview from the conference.
“You don’t know what the disease is like, you don’t know how serious it is, you don’t know who’s going to be at risk for it, you don’t know how best to treat it — but it is virtually impossible to generate that information during the pandemic simply because it presupposes you’ve set things up in advance to do the studies.”
Current discussions involve looking at pandemic research that can be done on an ongoing basis, and establishing research structures.
Then when the next pandemic occurs, it’s possible to ramp up activity rapidly so that information is available for governments and policymakers to make appropriate decisions and doctors know what they’re facing, Marshall said.
A study published last year in the Canadian Medical Association Journal found that there were 8,678 hospital admissions related to the H1N1 pandemic that hit Canada in 2009, including 1,473 admissions to intensive care units. There were 428 deaths.
Marshall said researchers have been able to launch registries that include some of the sickest H1N1 patients who were admitted to ICUs.
Now, there are more than 5,000 patients in five different registries around the world.
But during the pandemic, it was a challenge to get clinicians to collect data so it could be analyzed quickly and provide information to groups like the World Health Organization, he said.
“We tried to launch some clinical trials of inexpensive readily available treatments, but the challenges there were enormous because you have to develop protocols, you have to get a research ethics board to review it and approve it,” he said.
“Our biggest challenge was in negotiating contracts between countries, and getting indemnification for conducting research that’s not being held within Canada.”
“So a lot of those issues really meant that our randomized trial, by the time we had actually been able to launch it, the second wave of the H1N1 pandemic had essentially passed, and we were too late.”
The goal now is to be ready so that when another pandemic strikes, the pieces are in place and the scientific community doesn’t have to start from a blank slate, he indicated.
The attendees hoped to move beyond discussion, and develop and propose to funding groups some specific research projects, he said.