1 00:00:00,000 --> 00:00:13,320 Thanks for joining us at the Canadian Breakpoint, a Canadian infectious diseases podcast by 2 00:00:13,320 --> 00:00:16,520 Canadian infectious diseases physicians. 3 00:00:16,520 --> 00:00:21,860 I'm Summer Stewart, here with Dr. Rupina Pirwal, pediatric infectious diseases physician 4 00:00:21,860 --> 00:00:22,860 in Saskatoon. 5 00:00:22,860 --> 00:00:28,420 For this episode, we celebrate all things spooky for Halloween, and what's scarier 6 00:00:28,420 --> 00:00:30,360 than another pandemic. 7 00:00:30,360 --> 00:00:34,800 Today we welcome back Dr. Kinderchuck to discuss emerging viral diseases. 8 00:00:34,800 --> 00:00:37,160 Are we prepared for the next pandemic? 9 00:00:37,160 --> 00:00:38,160 Dr. Pirwal. 10 00:00:38,160 --> 00:00:43,040 All right, welcome everyone to another episode of our podcast, the Canadian Breakpoint. 11 00:00:43,040 --> 00:00:48,400 Today we have a very special guest with us, Dr. Kinderchuck, who is an associate professor 12 00:00:48,400 --> 00:00:52,900 and Canada research chair in emerging virus pathogenesis in the Department of Medical 13 00:00:52,900 --> 00:00:58,120 Microbiology and Infectious Diseases and cross appointed in the Department of Internal Medicine 14 00:00:58,120 --> 00:01:04,120 and Manitoba Centre for Proteomics and Systems Biology, the University of Manitoba. 15 00:01:04,120 --> 00:01:08,800 His work focuses on viruses that pose the greatest threat to global health, including 16 00:01:08,800 --> 00:01:14,400 Ebola virus, orthophox viruses, coronaviruses and influenza viruses. 17 00:01:14,400 --> 00:01:19,480 His research program centres on the circulation, transmission and pathogenesis of emerging 18 00:01:19,480 --> 00:01:20,480 viruses. 19 00:01:20,480 --> 00:01:25,240 Past and present findings from these investigations will help inform emerging virus therapeutic 20 00:01:25,240 --> 00:01:30,360 treatment strategies, outbreak prediction and preparedness efforts with impacts on both 21 00:01:30,360 --> 00:01:32,040 human and animal health. 22 00:01:32,040 --> 00:01:37,760 Dr. Kinderchuck leads multiple nationally funded emerging infectious disease research 23 00:01:37,760 --> 00:01:43,440 investigations, including One Health emerging zoonotic virus surveillance activities in 24 00:01:43,440 --> 00:01:44,440 Canada and Africa. 25 00:01:44,440 --> 00:01:50,560 These include as a director for the International EMPOC's Response Consortium, co-lead for 26 00:01:50,560 --> 00:01:55,660 pillar two of the Coronavirus Variance Rapid Response Network and ongoing investigations 27 00:01:55,660 --> 00:02:01,880 on the long-term impacts of Ebola virus infection in disease survivors in West Africa. 28 00:02:01,880 --> 00:02:07,760 Today we'll be talking about more just a broader topic, what he's been doing in terms of his 29 00:02:07,760 --> 00:02:12,840 work out in Africa in terms of emerging viral diseases. 30 00:02:12,840 --> 00:02:17,000 And really that one question that many of us probably have or multiple questions that 31 00:02:17,000 --> 00:02:20,840 we have about what are the actions that we're going to take to kind of prevent a pandemic 32 00:02:20,840 --> 00:02:28,560 or what's the future like, what's the preparedness level at this time in terms of, in the realm 33 00:02:28,560 --> 00:02:33,720 of being surrounded by emerging viral diseases. 34 00:02:33,720 --> 00:02:37,920 So thanks Dr. Kinderchuck for coming back on today and it's always a pleasure to have 35 00:02:37,920 --> 00:02:38,920 you. 36 00:02:38,920 --> 00:02:39,920 Thanks for having me. 37 00:02:39,920 --> 00:02:42,680 And now I've got to try and figure out if I'm going to be optimistic or pessimistic 38 00:02:42,680 --> 00:02:43,680 with the questions. 39 00:02:43,680 --> 00:02:44,680 We'll see. 40 00:02:44,680 --> 00:02:49,880 And you know what, the one thing we always tell our listeners is that this is for informational 41 00:02:49,880 --> 00:02:52,960 purposes only and it's always evolving. 42 00:02:52,960 --> 00:02:59,400 So what we will talk about today may change and that's completely fine, but I think it's 43 00:02:59,400 --> 00:03:05,040 up for discussion and there's always, in our profession, I think there's always things 44 00:03:05,040 --> 00:03:10,680 that are evolving and we just have to take that into consideration. 45 00:03:10,680 --> 00:03:17,080 Today's episode, what I kind of wanted to focus on was your workout in Africa because 46 00:03:17,080 --> 00:03:23,680 you, I think have done a fantastic and commendable job in terms of the different areas that you've 47 00:03:23,680 --> 00:03:24,680 been working out there. 48 00:03:24,680 --> 00:03:29,600 And I think it was neat for me to hear it when we had our initial discussions and just 49 00:03:29,600 --> 00:03:31,520 hear about all the work that you've been doing out there. 50 00:03:31,520 --> 00:03:36,440 And I think it would be nice for some of our listeners who are actually interested in emerging 51 00:03:36,440 --> 00:03:40,800 viral diseases and a lot of the prevention work that you're doing out there as well and 52 00:03:40,800 --> 00:03:45,760 surveillance, to kind of hear about and maybe elaborate on the work that you are currently 53 00:03:45,760 --> 00:03:46,760 involved in. 54 00:03:46,760 --> 00:03:47,760 Sure. 55 00:03:47,760 --> 00:03:53,240 I mean, a big part of it is I work with extremely talented people that often tend to be leaps 56 00:03:53,240 --> 00:03:57,480 and bounds smarter than myself and keeping motivated in that. 57 00:03:57,480 --> 00:04:02,200 And I say that very specifically to my African colleagues, that people are the best in the 58 00:04:02,200 --> 00:04:03,200 business. 59 00:04:03,200 --> 00:04:08,440 So the program has developed really since I started at the University of Manitoba seven 60 00:04:08,440 --> 00:04:09,440 years ago. 61 00:04:09,440 --> 00:04:14,320 It really had already kind of been in development prior to that when I was still down at NIH 62 00:04:14,320 --> 00:04:16,120 in Bethesda. 63 00:04:16,120 --> 00:04:21,640 The key point was kind of in 2014, I had the opportunity to spend some time in Liberia 64 00:04:21,640 --> 00:04:26,680 during the West African Ebola virus disease epidemic, really providing diagnostic support 65 00:04:26,680 --> 00:04:31,860 kind of as that outbreak started to kind of hit its peak in the country. 66 00:04:31,860 --> 00:04:35,240 That really changed my perception of research. 67 00:04:35,240 --> 00:04:40,560 It kind of went from being this very kind of pragmatic kind of molecular biology based 68 00:04:40,560 --> 00:04:45,880 program, trying to understand why is one virus more violent than the other and try to understand 69 00:04:45,880 --> 00:04:49,800 the mechanics of it to suddenly saying, oh wait, there's a lot of people that get sick 70 00:04:49,800 --> 00:04:55,020 from these things and these diseases look awful when you see them upfront. 71 00:04:55,020 --> 00:04:56,680 What do we do to try to reduce the impacts? 72 00:04:56,680 --> 00:04:58,680 And that's a very simplistic way of saying it. 73 00:04:58,680 --> 00:05:03,880 So since that time point, we've tried to get a number of things off the ground. 74 00:05:03,880 --> 00:05:08,360 One of the big initiatives that we've been working on has been in regards to continual 75 00:05:08,360 --> 00:05:09,760 work with Ebola virus. 76 00:05:09,760 --> 00:05:15,600 So in Sierra Leone, one of the pieces that we've been able to get up there has been to 77 00:05:15,600 --> 00:05:21,220 work with about a thousand Ebola virus disease survivors to look at long-term health complications, 78 00:05:21,220 --> 00:05:26,040 as well as long-term stigma that's faced by survivors in the community. 79 00:05:26,040 --> 00:05:30,120 And I think one of the pieces that kind of comes out of this that's important is when 80 00:05:30,120 --> 00:05:35,400 we often think about outbreaks and this whole idea of outbreak response, there's almost 81 00:05:35,400 --> 00:05:41,600 kind of this view of the movie outbreak where we come in, you get everything contained and 82 00:05:41,600 --> 00:05:44,120 then everything goes back to normal and things are fine. 83 00:05:44,120 --> 00:05:46,920 The reality is very, very different, right? 84 00:05:46,920 --> 00:05:51,560 What we've seen in the cohort of individuals that we've worked with, a lot of long-term 85 00:05:51,560 --> 00:05:57,320 health complications, six to eight years post-recovery, a lot of general health complications, 86 00:05:57,320 --> 00:06:03,080 these are all self-supported, but neurological sequelae, eye pain, ear pain, we see some 87 00:06:03,080 --> 00:06:07,140 reproductive impacts, certainly menstrual impacts for women. 88 00:06:07,140 --> 00:06:09,720 And then of course we see a lot of mental health impacts. 89 00:06:09,720 --> 00:06:15,720 So a lot of very, very severe depression or chronic depression in survivors, and as well 90 00:06:15,720 --> 00:06:18,580 a lot of perceived stigma from the community. 91 00:06:18,580 --> 00:06:19,760 And we see it on the ground, right? 92 00:06:19,760 --> 00:06:28,080 There's still kind of that piece of somebody that survived is not always welcomed back 93 00:06:28,080 --> 00:06:30,000 into communities. 94 00:06:30,000 --> 00:06:37,120 So we've really tried to establish a program to identify what those needs are, knowing 95 00:06:37,120 --> 00:06:41,480 that we're working in a country and in an area of the world that doesn't have the support 96 00:06:41,480 --> 00:06:44,100 for the needs that are there. 97 00:06:44,100 --> 00:06:48,880 So we've really kind of used this as, first of all, a mechanism to be able to report what 98 00:06:48,880 --> 00:06:54,480 this looks like, to be able to put a spotlight on to our Sierra Leone colleagues that have 99 00:06:54,480 --> 00:06:59,080 been working on this for a number of years, but also to try and kind of impart the importance 100 00:06:59,080 --> 00:07:05,040 of this to the Ministry of Health in the country, as well as to the broader public health community. 101 00:07:05,040 --> 00:07:11,120 And I think it plays back into this idea that that outbreak was not an isolated incident. 102 00:07:11,120 --> 00:07:19,960 We've seen really nearly annual outbreaks in the DRC every year kind of following 2016. 103 00:07:19,960 --> 00:07:25,680 The outbreaks are not going away, and this probably doesn't just apply to Ebola, really 104 00:07:25,680 --> 00:07:30,040 to any disease that has a high morbidity cost to it. 105 00:07:30,040 --> 00:07:34,240 There are probably a lot of these long-term complications that we don't actually know 106 00:07:34,240 --> 00:07:37,920 about because we're not investigating them, because the systems aren't present within 107 00:07:37,920 --> 00:07:39,560 the community. 108 00:07:39,560 --> 00:07:41,280 So that's a big piece of it. 109 00:07:41,280 --> 00:07:47,080 The other piece of what we're doing in West Africa has been more about the idea of what 110 00:07:47,080 --> 00:07:49,080 happened in 2014. 111 00:07:49,080 --> 00:07:51,080 There's December 31st, 2013. 112 00:07:51,080 --> 00:07:56,640 There's this case of a young child that starts showing symptoms, and the contact tracing 113 00:07:56,640 --> 00:08:02,480 and the investigations go back to this idea that this child probably had a contact with 114 00:08:02,480 --> 00:08:03,960 an infected bat. 115 00:08:03,960 --> 00:08:08,600 We think bats are the likely reservoir host for Ebola virus. 116 00:08:08,600 --> 00:08:11,640 The kind of in-between gets a little bit more complicated because there are other animal 117 00:08:11,640 --> 00:08:18,480 species that can act as intermediate hosts between humans and bats, most notably non-human 118 00:08:18,480 --> 00:08:19,480 primates. 119 00:08:19,480 --> 00:08:26,240 And if we go back into the late 90s, early 2000s, some of the data that came out of Gabon 120 00:08:26,240 --> 00:08:31,080 by their local researchers and folks from France was that there was actually a pretty 121 00:08:31,080 --> 00:08:38,240 high impact of Ebola virus amongst great apes, so both mountain gorillas as well as in chimpanzees. 122 00:08:38,240 --> 00:08:42,620 So we know that these animals are potential hosts for the virus, but we don't know much 123 00:08:42,620 --> 00:08:49,440 about what it looks like in terms of circulation or how they play a role in ongoing circulation. 124 00:08:49,440 --> 00:08:55,680 For us, when we think about Sierra Leone, the virus kind of came out of nowhere in 2014 125 00:08:55,680 --> 00:09:01,360 for the first time, the end of 2013, and has really since disappeared outside of recrudescence 126 00:09:01,360 --> 00:09:04,240 in Guinea in 2021. 127 00:09:04,240 --> 00:09:05,560 These viruses often don't disappear. 128 00:09:05,560 --> 00:09:10,360 So the likelihood is that Ebola virus is still circulating somewhere in the wild, but we 129 00:09:10,360 --> 00:09:12,260 don't really know where. 130 00:09:12,260 --> 00:09:18,660 So we were actually working with a chimpanzee sanctuary called Takugama in Sierra Leone. 131 00:09:18,660 --> 00:09:23,680 The sanctuary serves to rehabilitate chimps that have been either orphaned or injured 132 00:09:23,680 --> 00:09:28,000 in the wild, and they bring them in, they rehabilitate them, but also acclimate them 133 00:09:28,000 --> 00:09:33,520 back towards non-human contact with chimpanzees that are at the facility. 134 00:09:33,520 --> 00:09:37,720 We have been working in partnership with that group for a couple of years now. 135 00:09:37,720 --> 00:09:39,480 They do annual health checks on the animals. 136 00:09:39,480 --> 00:09:41,820 It's basically a top to bottom health check. 137 00:09:41,820 --> 00:09:43,460 The animals are fully sedated. 138 00:09:43,460 --> 00:09:49,080 They do everything from digital x-rays to looking for scarring and tissue abnormalities, 139 00:09:49,080 --> 00:09:52,680 swabs, blood, urine, feces. 140 00:09:52,680 --> 00:09:57,600 So we've been assisting with those, but also trying to collect sera so we can look for 141 00:09:57,600 --> 00:09:58,600 exposures. 142 00:09:58,600 --> 00:10:02,720 And really what we see this as an opportunity to do is to be able to better identify where 143 00:10:02,720 --> 00:10:05,280 viruses are circulating in the wild. 144 00:10:05,280 --> 00:10:08,480 So we have that big initiative in DRC. 145 00:10:08,480 --> 00:10:14,800 We're actually looking at that, obviously it applies to M-Plox right now, but more broadly, 146 00:10:14,800 --> 00:10:20,160 one of the things that we're focusing on is the idea of certainly the wild animal trade, 147 00:10:20,160 --> 00:10:21,520 more so in terms of wild game. 148 00:10:21,520 --> 00:10:25,940 So the trading and purchase of meat from local markets. 149 00:10:25,940 --> 00:10:30,520 One of the things we don't really understand is the risk that there is to people in terms 150 00:10:30,520 --> 00:10:37,040 of exposures to animal tissues, certainly from species that we know are potential hosts 151 00:10:37,040 --> 00:10:39,240 for these different viruses. 152 00:10:39,240 --> 00:10:44,660 There has not really been a thorough study of what do those risks look like? 153 00:10:44,660 --> 00:10:49,160 What does testing of those tissues look like in terms of positivity for viruses or emerging 154 00:10:49,160 --> 00:10:50,160 infectious diseases? 155 00:10:50,160 --> 00:10:56,440 So we're working locally in South Kivu right now with basically acquiring samples from 156 00:10:56,440 --> 00:10:57,660 local animal markets. 157 00:10:57,660 --> 00:11:03,300 We want to be able to also move into dry blood spot analysis on folks that are involved in 158 00:11:03,300 --> 00:11:08,600 hunting to be able to look at those exposures and be able to look at potential risks for 159 00:11:08,600 --> 00:11:12,500 humans in terms of consumption or contact with those samples. 160 00:11:12,500 --> 00:11:17,140 And then of course we do a multitude of other things on the One Health front, but those 161 00:11:17,140 --> 00:11:20,440 two are the biggest initiatives that we're undertaking at the moment. 162 00:11:20,440 --> 00:11:21,440 Okay. 163 00:11:21,440 --> 00:11:22,440 That's fantastic. 164 00:11:22,440 --> 00:11:23,440 Yeah. 165 00:11:23,440 --> 00:11:30,360 So I think what we've learned from the pandemic and then also with even M-Pox in the situation, 166 00:11:30,360 --> 00:11:35,840 really having these surveillance networks is important because that is key to kind of 167 00:11:35,840 --> 00:11:41,240 mitigating the risks and disease spread and really finding out where there's high disease 168 00:11:41,240 --> 00:11:44,480 areas so that we can focus our efforts there. 169 00:11:44,480 --> 00:11:45,480 Yeah. 170 00:11:45,480 --> 00:11:46,480 And it's important for us. 171 00:11:46,480 --> 00:11:51,440 When we think about certainly again, going back to West Africa with Ebola, the virus 172 00:11:51,440 --> 00:11:57,040 emerged, had devastating consequences, not only in terms of human health, but also obviously 173 00:11:57,040 --> 00:12:02,520 economically within the region, those impacts continue to be felt 10 years later. 174 00:12:02,520 --> 00:12:07,680 There's really a need to be able to try and understand for the local communities where 175 00:12:07,680 --> 00:12:11,880 kind of those greatest risks lie in terms of potential exposures. 176 00:12:11,880 --> 00:12:17,520 While also kind of appreciating that we can't, certainly with One Health work, we can't go 177 00:12:17,520 --> 00:12:22,120 into communities and say, listen, just don't hunt or don't have contact with animals. 178 00:12:22,120 --> 00:12:26,440 That will reduce the risk because that's part of their traditional lifestyle and you're 179 00:12:26,440 --> 00:12:30,760 not offering anything in terms of sustenance alternative. 180 00:12:30,760 --> 00:12:34,360 So a big part of this is being able to try to understand what that exposure risk is, 181 00:12:34,360 --> 00:12:39,300 but also to try and work with communities to look for areas to try and reduce the potential 182 00:12:39,300 --> 00:12:40,300 for exposure. 183 00:12:40,300 --> 00:12:44,840 So are there basic kind of IPC things that we can do and we can work with communities 184 00:12:44,840 --> 00:12:52,280 on or be able to try to promote and engage people for self-reporting or trying to increase 185 00:12:52,280 --> 00:12:57,920 diagnostic capacity in the area so we have earlier detection of when these events occur. 186 00:12:57,920 --> 00:12:58,920 Yeah. 187 00:12:58,920 --> 00:13:02,880 So it sounds like awareness is a key component of this, right? 188 00:13:02,880 --> 00:13:08,400 And then, so if they are engaging in activities, which can increase disease activity, then 189 00:13:08,400 --> 00:13:16,440 they know from the infection prevention control, handling, meat handling, those types of practices 190 00:13:16,440 --> 00:13:19,400 so that they can kind of mitigate the risk of spread of the disease. 191 00:13:19,400 --> 00:13:20,400 Yeah. 192 00:13:20,400 --> 00:13:22,800 And still the caring of patients locally, right? 193 00:13:22,800 --> 00:13:27,280 Whether it's within a household or within a local healthcare clinic, being able to try 194 00:13:27,280 --> 00:13:33,160 and provide at least some recommendations to reduce risks where we can or where we can 195 00:13:33,160 --> 00:13:34,560 provide information on. 196 00:13:34,560 --> 00:13:36,080 Oh, that's fair. 197 00:13:36,080 --> 00:13:44,280 Yeah, and what I've seen in our practice over the years, and even when we had local centers 198 00:13:44,280 --> 00:13:50,820 preparing for any Ebola cases that were travel related, there was definitely infection prevention 199 00:13:50,820 --> 00:13:53,960 control was the forefront of everything, right? 200 00:13:53,960 --> 00:13:55,640 In that terms as well. 201 00:13:55,640 --> 00:14:02,680 But I think the most important thing was just being aware that these are the high risk areas. 202 00:14:02,680 --> 00:14:07,560 So if travel was coming from there and if anybody had really, I mean, fever was the 203 00:14:07,560 --> 00:14:11,320 main, one of the main signs. 204 00:14:11,320 --> 00:14:14,360 And if they had fever and they were coming and they traveled from this area, then the 205 00:14:14,360 --> 00:14:16,880 protocols were initiated. 206 00:14:16,880 --> 00:14:21,680 And I think that probably controlled most of the situation within most countries outside 207 00:14:21,680 --> 00:14:23,480 of the endemic areas. 208 00:14:23,480 --> 00:14:24,480 Yeah. 209 00:14:24,480 --> 00:14:29,840 And I think coming through COVID, I mean, I was in, kind of living in front of Maryland 210 00:14:29,840 --> 00:14:35,480 at the point where I was in Liberia, I came back into the US from my deployment, the day 211 00:14:35,480 --> 00:14:38,720 that the first US case was announced, things changed. 212 00:14:38,720 --> 00:14:43,280 And there was a lot of local concern about what that meant. 213 00:14:43,280 --> 00:14:48,000 I think where we were then versus where we are now, we know a lot more about the importance 214 00:14:48,000 --> 00:14:51,920 of infection prevention control, but also the importance, I think, for the public in 215 00:14:51,920 --> 00:14:53,200 terms of self reporting. 216 00:14:53,200 --> 00:14:57,720 I hope coming through COVID, that's one of the lessons we've learned is, if you're sick, 217 00:14:57,720 --> 00:15:01,400 you have symptoms, you think you've had a contact, these are the measures you should 218 00:15:01,400 --> 00:15:04,800 personally take to try and reduce potential transmission risks. 219 00:15:04,800 --> 00:15:08,240 And then the importance of being able to get for testing. 220 00:15:08,240 --> 00:15:09,880 We still need to keep promoting it. 221 00:15:09,880 --> 00:15:13,680 Certainly, Implox has taught us that, but I think we're in a different place than we 222 00:15:13,680 --> 00:15:16,000 were kind of pre 2020 as well. 223 00:15:16,000 --> 00:15:17,440 I agree with you. 224 00:15:17,440 --> 00:15:18,440 Yeah. 225 00:15:18,440 --> 00:15:22,680 And then in terms of, I mean, obviously there will be other emerging viral diseases. 226 00:15:22,680 --> 00:15:29,760 We currently are dealing with situations in Africa and the surveillance networks are well 227 00:15:29,760 --> 00:15:34,200 in place in places where there is more endemic disease. 228 00:15:34,200 --> 00:15:39,720 Is there something, is Canada doing something different now post pandemic from the COVID 229 00:15:39,720 --> 00:15:45,240 pandemic to kind of ramp up surveillance so that we can pick up on some of these emerging 230 00:15:45,240 --> 00:15:46,680 viral diseases as well? 231 00:15:46,680 --> 00:15:47,680 Yeah. 232 00:15:47,680 --> 00:15:48,680 I would say so. 233 00:15:48,680 --> 00:15:52,680 I say that in a bias perspective, because I'm somebody who has been able to get grant 234 00:15:52,680 --> 00:15:56,760 funding to do some of this work and also works with others who do as well. 235 00:15:56,760 --> 00:16:02,960 I think it's kind of a two-sided coin because the one side is, yep, there's been greater 236 00:16:02,960 --> 00:16:04,520 investment certainly in surveillance. 237 00:16:04,520 --> 00:16:09,960 I think a greater appreciation that surveillance is actually a science and it belongs in terms 238 00:16:09,960 --> 00:16:13,460 of funded research and science. 239 00:16:13,460 --> 00:16:15,000 So that's the positive side. 240 00:16:15,000 --> 00:16:19,800 The kind of more pessimistic side is much of that surveillance again is based off of 241 00:16:19,800 --> 00:16:20,800 grant funding. 242 00:16:20,800 --> 00:16:25,680 So, you know, your surveillance networks that you're creating, they're usually coming in 243 00:16:25,680 --> 00:16:30,960 with like a two to a five year period where you know that you have sustained funding. 244 00:16:30,960 --> 00:16:35,560 After that, it's, you know, you're either going back to try to reapply or hoping somebody 245 00:16:35,560 --> 00:16:39,080 else is coming forward to be able to try and sustain the network. 246 00:16:39,080 --> 00:16:46,400 I think that's one of the areas where we still need some work is what does sustained investment 247 00:16:46,400 --> 00:16:52,120 look like and how do we sustain researchers or sustain groups to be able to do this type 248 00:16:52,120 --> 00:16:58,640 of work on the ground and also ensure that we are doing this in a way that is building 249 00:16:58,640 --> 00:17:04,640 capacity and not just kind of providing hands and saying, yeah, we'll do the work. 250 00:17:04,640 --> 00:17:09,200 Please just let us have access to, you know, to your country and to all of your equipment 251 00:17:09,200 --> 00:17:10,760 and let us have at it. 252 00:17:10,760 --> 00:17:15,000 We need to be able to do this from a partnership perspective and ensure that we can move funds 253 00:17:15,000 --> 00:17:23,360 to partners rapidly and also appreciate the expertise that those partners often have for 254 00:17:23,360 --> 00:17:25,480 far greater amounts than what we do. 255 00:17:25,480 --> 00:17:26,480 Yeah. 256 00:17:26,480 --> 00:17:28,760 And always it goes down to funding, right? 257 00:17:28,760 --> 00:17:35,680 And so the problem we have sometimes with research and even some of these surveillance 258 00:17:35,680 --> 00:17:38,920 networks or programs that we're developing, it comes down to funding. 259 00:17:38,920 --> 00:17:42,860 And like you mentioned that having that sustained funding is really important. 260 00:17:42,860 --> 00:17:46,780 So there's a lot of discussion in literature in terms of the spillover. 261 00:17:46,780 --> 00:17:53,400 So from zoonotic reservoir, we've seen a lot of environmental changes over the last decade, 262 00:17:53,400 --> 00:18:00,480 I would say constantly like areas are flooding, we're dealing with global warming, areas that 263 00:18:00,480 --> 00:18:03,240 never really had much tick activity. 264 00:18:03,240 --> 00:18:04,960 Now we're seeing the spread of that. 265 00:18:04,960 --> 00:18:12,120 So your work obviously out in Africa, you're working closely with seeing that zoonotic 266 00:18:12,120 --> 00:18:18,080 transmission and we know that emerging viral diseases commonly kind of present that way. 267 00:18:18,080 --> 00:18:25,960 And so in terms of kind of what the potential of this is and what are we doing, are there 268 00:18:25,960 --> 00:18:34,680 other diseases that you're currently on the rise or you're looking at and what kind of 269 00:18:34,680 --> 00:18:36,240 surveillance are you doing there? 270 00:18:36,240 --> 00:18:37,240 Absolutely. 271 00:18:37,240 --> 00:18:41,720 I mean, I think the easiest one that I think most people will kind of have top of mind 272 00:18:41,720 --> 00:18:44,560 is H5N1 avian influenza, right? 273 00:18:44,560 --> 00:18:49,760 So earlier this year, now I can't separate months and years anymore. 274 00:18:49,760 --> 00:18:52,760 So I think it was early 2024. 275 00:18:52,760 --> 00:18:59,720 We saw the introduction of H5N1 from wild birds into dairy cattle in the US. 276 00:18:59,720 --> 00:19:03,080 We are continuing to see movement of the virus through dairy cattle. 277 00:19:03,080 --> 00:19:06,320 We've seen some human infections that have accompanied that. 278 00:19:06,320 --> 00:19:09,400 Those have been fairly mild in nature, which has been great. 279 00:19:09,400 --> 00:19:13,820 The cattle, it's largely been a self-limiting disease, but we've seen also spillover from 280 00:19:13,820 --> 00:19:19,520 those animals into other species like farm cats or I should say farm cats, the cats that 281 00:19:19,520 --> 00:19:21,000 are found on farms. 282 00:19:21,000 --> 00:19:23,160 We've seen high fatality rates in those animals. 283 00:19:23,160 --> 00:19:29,320 We've seen certainly prior to that, the broad movement of H5N1 globally the last couple 284 00:19:29,320 --> 00:19:36,720 of years and really moving and having really profound impacts on marine mammals all across 285 00:19:36,720 --> 00:19:40,880 North America, moving into South America and now obviously moving into Antarctica. 286 00:19:40,880 --> 00:19:46,540 And I think now every continent has had avian influenza introduction. 287 00:19:46,540 --> 00:19:49,600 So those types of events are things we're following. 288 00:19:49,600 --> 00:19:54,920 We pretty quickly, when it was established that you could start to look for fragments 289 00:19:54,920 --> 00:20:03,460 of H5N1 virus in commercial milk, as FDA reported, we set up really an academic network across 290 00:20:03,460 --> 00:20:09,520 Canada to start testing retail milk samples and really just to try and provide where we 291 00:20:09,520 --> 00:20:12,760 could because Canada had not seen any case at that point. 292 00:20:12,760 --> 00:20:17,200 We still haven't seen any introduction, but to be able to provide some additional surveillance 293 00:20:17,200 --> 00:20:18,200 coverage. 294 00:20:18,200 --> 00:20:19,960 So we've been very active there. 295 00:20:19,960 --> 00:20:24,220 There's another piece of this, which of course, avian influenza, so we know that wild birds 296 00:20:24,220 --> 00:20:29,520 are really the, you know, the kind of the reservoir host that we need to focus on. 297 00:20:29,520 --> 00:20:32,960 There's a piece of this, which is still, what is that risk for people that are in close 298 00:20:32,960 --> 00:20:35,320 contact to wild birds? 299 00:20:35,320 --> 00:20:39,560 People that are doing bird handling, those that are hunting, those that are consuming 300 00:20:39,560 --> 00:20:40,640 wild birds. 301 00:20:40,640 --> 00:20:45,600 So we are working on getting some serosurveillance networks up and running right now to be able 302 00:20:45,600 --> 00:20:50,040 to address some of that, to look at exposures over time, to also be able to provide confidence 303 00:20:50,040 --> 00:20:55,160 for people that are taking in these activities and also to look at infection prevention control 304 00:20:55,160 --> 00:20:56,160 mechanisms. 305 00:20:56,160 --> 00:20:57,880 Those things continue to be top of mind. 306 00:20:57,880 --> 00:21:02,540 For tick-borne diseases, you know, right now, you know, obviously, you know, wine continues 307 00:21:02,540 --> 00:21:07,040 to be a big concern in Canada with kind of greater geographic spread. 308 00:21:07,040 --> 00:21:12,920 Powassan virus is top of mind for, you know, the kind of, you know, northeasterly direction 309 00:21:12,920 --> 00:21:15,240 we've seen coming out of the US and the movement into Canada. 310 00:21:15,240 --> 00:21:23,000 But we're also watching other arthropod-borne viruses as well, including dengue and obviously, 311 00:21:23,000 --> 00:21:26,160 you know, still focusing on Zika and chikungunya. 312 00:21:26,160 --> 00:21:30,040 And then, you know, working in Crimean Congo in the background of all this, because of 313 00:21:30,040 --> 00:21:34,240 the kind of more sustained transmission that we're starting to see, or at least, say, sustained 314 00:21:34,240 --> 00:21:37,120 circulation we're seeing amongst ticks in Europe. 315 00:21:37,120 --> 00:21:42,600 You know, we're kind of looking at that movement out of Africa now to, you know, to additional 316 00:21:42,600 --> 00:21:43,600 continents. 317 00:21:43,600 --> 00:21:48,880 So the unfortunate reality, I think, for us is I try to be very maneuverable. 318 00:21:48,880 --> 00:21:52,440 I think all my collaborators are trying to be very maneuverable with what we work on. 319 00:21:52,440 --> 00:21:54,800 We're pivoting all the time, though. 320 00:21:54,800 --> 00:21:58,120 Either we're doing much better surveillance and we're much more cognizant of what's going 321 00:21:58,120 --> 00:22:03,320 on around us, or we're seeing, you know, a greater emergence of these infectious diseases. 322 00:22:03,320 --> 00:22:06,800 And I would suggest we're probably seeing the latter. 323 00:22:06,800 --> 00:22:09,440 I think we continue to need to be prepared. 324 00:22:09,440 --> 00:22:13,080 We continue to need to figure out where we need to do surveillance, what surveillance 325 00:22:13,080 --> 00:22:16,960 looks like, and overall what exposure looks like for humans. 326 00:22:16,960 --> 00:22:23,240 Again, we kind of tend to focus on mortality and morbidity for many of these diseases. 327 00:22:23,240 --> 00:22:28,240 M-Plox is certainly, you know, kind of top of mind, but of course Ebola and avian influenza 328 00:22:28,240 --> 00:22:29,240 and others. 329 00:22:29,240 --> 00:22:32,760 But we tend to know about the cases that are presenting, right? 330 00:22:32,760 --> 00:22:37,120 The piece that we don't understand yet is how many cases do we not know about and what 331 00:22:37,120 --> 00:22:38,840 does that circulation look like? 332 00:22:38,840 --> 00:22:44,020 So for us, a big part of this is trying to get those networks created and try to get 333 00:22:44,020 --> 00:22:48,760 a better idea of what exposure and circulation looks like, more broadly for emerging infectious 334 00:22:48,760 --> 00:22:49,760 diseases overall. 335 00:22:49,760 --> 00:22:54,560 Yeah, and I think like even what I've learned, like being in infectious disease position, 336 00:22:54,560 --> 00:22:55,560 right? 337 00:22:55,560 --> 00:23:01,560 I was a staff like right at the peak of the pandemic, a new staff. 338 00:23:01,560 --> 00:23:08,240 And so just kind of learning and also going through the whole pandemic and answering questions 339 00:23:08,240 --> 00:23:14,660 and just, and really seeing this, even now, the strains evolve and the variants come through. 340 00:23:14,660 --> 00:23:16,680 And I think that's always really challenging. 341 00:23:16,680 --> 00:23:18,480 You know, you talked about like pivoting. 342 00:23:18,480 --> 00:23:23,400 I think it also makes it very challenging because you see newer strains and newer variants 343 00:23:23,400 --> 00:23:26,960 come from these strains that then makes your work so complicated. 344 00:23:26,960 --> 00:23:32,160 Well, and it gets, I think the piece that gets probably the most complicated to, at 345 00:23:32,160 --> 00:23:35,440 least in my mind, is communicating back to the public. 346 00:23:35,440 --> 00:23:40,720 Like, you know, M-Plox, a perfect example, when we talk about clade 1B, trying to explain, 347 00:23:40,720 --> 00:23:43,320 well, how does clade 1 and clade 2, how do they differ? 348 00:23:43,320 --> 00:23:45,480 Then how do the subclades differ? 349 00:23:45,480 --> 00:23:49,320 And how does this compare to what we've seen reported historically? 350 00:23:49,320 --> 00:23:54,200 That piece of community engagement and knowledge translation is so important. 351 00:23:54,200 --> 00:23:59,720 I think one of the things coming out of COVID that I hope we appreciated was ensuring that 352 00:23:59,720 --> 00:24:02,560 that messaging, again, is not a one size fits all. 353 00:24:02,560 --> 00:24:07,040 There are communities in Canada and Manitoba, Saskatchewan, certainly more broadly in the 354 00:24:07,040 --> 00:24:12,840 global community that are disproportionately affected by these viruses or may also have 355 00:24:12,840 --> 00:24:18,240 underlying concerns in regards to what their perceived risks are. 356 00:24:18,240 --> 00:24:23,240 How do we ensure that information is getting to those communities and is being done in 357 00:24:23,240 --> 00:24:28,120 a way that, or communicated in a way that's respectful and transparent based on kind of 358 00:24:28,120 --> 00:24:29,120 local customs? 359 00:24:29,120 --> 00:24:31,400 Like, that's a big piece for us. 360 00:24:31,400 --> 00:24:33,560 We learned in 2020 on the fly. 361 00:24:33,560 --> 00:24:38,160 I think now we really have to ensure that we integrate that piece into all the work 362 00:24:38,160 --> 00:24:39,160 that we're doing. 363 00:24:39,160 --> 00:24:40,760 Oh, yeah, that's fantastic. 364 00:24:40,760 --> 00:24:41,760 Yeah. 365 00:24:41,760 --> 00:24:48,200 I think definitely, I mean, all of the information that we've provided till now is factual, but 366 00:24:48,200 --> 00:24:51,840 then there's always this component of, you know, you're working at the front line of 367 00:24:51,840 --> 00:24:52,840 this. 368 00:24:52,840 --> 00:24:54,600 You've seen the surveillance networks. 369 00:24:54,600 --> 00:25:02,240 Do you feel like the evolution from 2020 till now, have we evolved as a society to kind 370 00:25:02,240 --> 00:25:03,680 of fight the next pandemic? 371 00:25:03,680 --> 00:25:06,000 And this is obviously an opinionated question. 372 00:25:06,000 --> 00:25:10,160 So this is the pessimistic side of it. 373 00:25:10,160 --> 00:25:12,240 So yes and no. 374 00:25:12,240 --> 00:25:16,240 And I know that that's kind of an easy way for me to get out of this. 375 00:25:16,240 --> 00:25:22,660 I'm more optimistic because of the fact that things like M-Plox right now, we're talking 376 00:25:22,660 --> 00:25:23,720 about it. 377 00:25:23,720 --> 00:25:26,880 It's on the global stage. 378 00:25:26,880 --> 00:25:30,960 We're seeing, you know, kind of rash and very, I should say rash, but expedited movement 379 00:25:30,960 --> 00:25:37,640 of vaccines and hopefully sustained funds into the areas of need. 380 00:25:37,640 --> 00:25:41,760 The pessimistic side is, yeah, but it took until now to do that, right? 381 00:25:41,760 --> 00:25:47,520 We had 20 months prior to this where we knew that this was kind of the trajectory. 382 00:25:47,520 --> 00:25:50,720 So I weigh the optimism with some of that pessimism. 383 00:25:50,720 --> 00:25:56,400 I think H5 is a perfect example where people immediately picked up on those cases. 384 00:25:56,400 --> 00:25:57,840 We had broad testing networks. 385 00:25:57,840 --> 00:26:03,140 There have been certainly limitations in the robustness of those networks and the reporting 386 00:26:03,140 --> 00:26:09,880 and certainly the acquisition of human data that are related to those farms or those agricultural 387 00:26:09,880 --> 00:26:10,880 centers. 388 00:26:10,880 --> 00:26:11,880 But I think we're moving forward. 389 00:26:11,880 --> 00:26:16,160 And I think the rapidity at which that was done is a good indication that we're in a 390 00:26:16,160 --> 00:26:18,400 very different place kind of post 2020. 391 00:26:18,400 --> 00:26:20,720 So I'm optimistic from that side. 392 00:26:20,720 --> 00:26:27,040 Every time I see an Ebola or even a potential Ebola outbreak being announced, I'm more optimistic 393 00:26:27,040 --> 00:26:31,440 because I know that that means vaccine deployment is going to be occurring quickly and the areas 394 00:26:31,440 --> 00:26:37,600 where we've seen these emergency events in the past, their local capacity for testing 395 00:26:37,600 --> 00:26:38,600 is much greater. 396 00:26:38,600 --> 00:26:42,720 Certainly the folks in DRC, it's kind of like within hours they're testing, they've got 397 00:26:42,720 --> 00:26:44,420 teams moving out. 398 00:26:44,420 --> 00:26:46,360 It's a very, very good system. 399 00:26:46,360 --> 00:26:51,520 Globally, I still worry about this idea of the division between the global north and 400 00:26:51,520 --> 00:26:52,520 the global south. 401 00:26:52,520 --> 00:26:58,760 Coming out of 2022 with M-Pox, we did very, very well with M-Pox containment, certainly 402 00:26:58,760 --> 00:27:03,080 in Canada and more broadly amongst non-endemic countries. 403 00:27:03,080 --> 00:27:04,320 Cases work or tailed quickly. 404 00:27:04,320 --> 00:27:09,840 There's been local transmission underneath that, but that's been fairly well contained. 405 00:27:09,840 --> 00:27:11,720 But we always knew where the source was. 406 00:27:11,720 --> 00:27:16,720 And there's that period of saying, well, we still haven't gotten vaccines into Nigeria, 407 00:27:16,720 --> 00:27:18,960 into DRC, into other endemic regions. 408 00:27:18,960 --> 00:27:24,360 We haven't necessarily built up the surveillance networks or the sustained capacity for testing. 409 00:27:24,360 --> 00:27:29,040 Where in DRC we have massive limitations for being able to test samples. 410 00:27:29,040 --> 00:27:34,480 Can we do that without finding ourselves in a new emergency to kind of provoke us to then 411 00:27:34,480 --> 00:27:35,480 do it? 412 00:27:35,480 --> 00:27:41,440 So I think we're getting closer to that, but it's coordination and money. 413 00:27:41,440 --> 00:27:45,240 And those are decisions that are made at much higher levels than me by much smarter people. 414 00:27:45,240 --> 00:27:47,760 So I hope we're getting there. 415 00:27:47,760 --> 00:27:51,920 I'm more confident than I was pre-2020, but we have work to do. 416 00:27:51,920 --> 00:27:52,920 Yeah. 417 00:27:52,920 --> 00:27:53,920 And I think that's fair. 418 00:27:53,920 --> 00:28:01,120 And when we look at even cases when Ebola, for instance, back in 2013 and that time, 419 00:28:01,120 --> 00:28:02,840 we've learned a lot since then as well. 420 00:28:02,840 --> 00:28:09,040 But even at that point, I feel like we were able to contain the infection from becoming 421 00:28:09,040 --> 00:28:10,440 a pandemic. 422 00:28:10,440 --> 00:28:13,080 And I think some of it is familiarity, right? 423 00:28:13,080 --> 00:28:19,480 So like we talked about the H5N1 response, probably some of our knowledge back from H1N1 424 00:28:19,480 --> 00:28:22,920 outbreaks probably helped us at that time too. 425 00:28:22,920 --> 00:28:27,640 And so we know way more information than we did previously. 426 00:28:27,640 --> 00:28:29,680 And I think the real thing is the importance. 427 00:28:29,680 --> 00:28:37,040 We know the importance of being aware that something like this is out there and that 428 00:28:37,040 --> 00:28:43,380 we have surveillance networks in place so that if there is any case that is reported 429 00:28:43,380 --> 00:28:47,440 outside of kind of that endemic area, it's picked up quickly. 430 00:28:47,440 --> 00:28:50,560 And like you said, deployment is quicker. 431 00:28:50,560 --> 00:28:55,840 So it does make you feel a little bit better that things are in the works. 432 00:28:55,840 --> 00:28:59,200 And I think the other piece of this too is that all this is being done in a multidisciplinary 433 00:28:59,200 --> 00:29:00,200 fashion, right? 434 00:29:00,200 --> 00:29:04,920 I think one of the things that's come through during the pandemic is you have this old branch 435 00:29:04,920 --> 00:29:10,880 that's been extended across between healthcare workers, physicians, physician researchers, 436 00:29:10,880 --> 00:29:14,960 researchers, social scientists, people that are working in natural sciences. 437 00:29:14,960 --> 00:29:20,320 Like everybody is kind of banding together to figure out how can we build teams to combat 438 00:29:20,320 --> 00:29:24,200 this from a very kind of broad brush. 439 00:29:24,200 --> 00:29:27,160 I think we're doing better in that realm. 440 00:29:27,160 --> 00:29:28,520 And that's important. 441 00:29:28,520 --> 00:29:32,280 That way at the very least that information is able to get across all these different 442 00:29:32,280 --> 00:29:39,120 communities much faster and ensure that we're also not kind of missing areas within research 443 00:29:39,120 --> 00:29:42,920 when we have the opportunities to do very focused investigations. 444 00:29:42,920 --> 00:29:43,920 Yeah. 445 00:29:43,920 --> 00:29:46,800 And you make a very valid point about the multidisciplinary approach. 446 00:29:46,800 --> 00:29:53,320 I mean, even coming from during COVID and having kind of vaccine programs and vaccine 447 00:29:53,320 --> 00:29:57,040 development was a key thing at that time. 448 00:29:57,040 --> 00:30:03,760 And we saw that approach happen over several months, within like six months, I would say, 449 00:30:03,760 --> 00:30:11,520 that where we were able to have researchers come together, have companies help with production 450 00:30:11,520 --> 00:30:13,160 and deployment of these vaccines. 451 00:30:13,160 --> 00:30:14,160 So it does make you feel- 452 00:30:14,160 --> 00:30:18,840 And all these things, like it's fantastic. 453 00:30:18,840 --> 00:30:19,840 Yeah. 454 00:30:19,840 --> 00:30:24,680 And then coming from like, I think not only surveillance, but then lab testing, because 455 00:30:24,680 --> 00:30:26,240 that's huge too, right? 456 00:30:26,240 --> 00:30:27,240 So- 457 00:30:27,240 --> 00:30:28,240 Absolutely. 458 00:30:28,240 --> 00:30:29,240 Yeah. 459 00:30:29,240 --> 00:30:32,400 And has there been a lot of kind of in the microbiology world, because I'm away from 460 00:30:32,400 --> 00:30:38,320 that, although I work very closely with my colleagues in micro, are there advancements 461 00:30:38,320 --> 00:30:39,320 in terms of... 462 00:30:39,320 --> 00:30:44,760 I mean, I think like gene expert was something that has obviously revolutionized. 463 00:30:44,760 --> 00:30:50,240 PCR has obviously changed our world, and then there's the quicker diagnostics, but is there 464 00:30:50,240 --> 00:30:55,320 anything that's emerged since the pandemic that you would say is going to be helpful 465 00:30:55,320 --> 00:30:56,320 in the future? 466 00:30:56,320 --> 00:30:58,800 You know, I think one of the things that we learned coming through the pandemic game, 467 00:30:58,800 --> 00:31:01,200 you know, kind of, I'm just a virologist, right? 468 00:31:01,200 --> 00:31:06,600 So just kind of my naive viewpoint, but just thinking of the idea of like rapid antigen 469 00:31:06,600 --> 00:31:07,640 testing. 470 00:31:07,640 --> 00:31:11,560 That was something that, you know, for years people have talked about, we had seen some 471 00:31:11,560 --> 00:31:16,960 amount of deployment of it, then 2020 hits, and we have massive global deployment of rapid 472 00:31:16,960 --> 00:31:18,320 antigen tests. 473 00:31:18,320 --> 00:31:24,480 The ability to be able to do that type of testing on the spot, change things, I think, 474 00:31:24,480 --> 00:31:29,800 insurmountably, because this was also a technology that didn't require a constant power source 475 00:31:29,800 --> 00:31:34,960 and, you know, it could be done really in very, very resource-limited areas. 476 00:31:34,960 --> 00:31:40,160 So I think there's a move towards that, you know, our current situation with M-Pox, you 477 00:31:40,160 --> 00:31:44,480 know, we're still trying to figure out how we can do rapid testing. 478 00:31:44,480 --> 00:31:45,480 PCR is limited. 479 00:31:45,480 --> 00:31:50,560 We have to appreciate many of the areas that are hotspots for emerging infectious diseases, 480 00:31:50,560 --> 00:31:54,960 you know, largely are very resource-limited settings and tend to be very remote settings 481 00:31:54,960 --> 00:31:56,760 or rural settings. 482 00:31:56,760 --> 00:32:01,120 So it's often difficult to be able to kind of deploy infrastructure that requires constant 483 00:32:01,120 --> 00:32:02,120 power sources. 484 00:32:02,120 --> 00:32:06,200 But things like rapid antigen tests, if we can get those deployed and if we can identify 485 00:32:06,200 --> 00:32:10,880 those cases faster, these are technologies that can be used by individuals that don't 486 00:32:10,880 --> 00:32:16,720 have medical training or don't require diagnostic training outside of being able to understand, 487 00:32:16,720 --> 00:32:21,000 you know, what the lines mean and what, you know, the potential confounding variables 488 00:32:21,000 --> 00:32:22,560 might be. 489 00:32:22,560 --> 00:32:27,680 That faster ability to be able to identify a suspected case to then do for what testing, 490 00:32:27,680 --> 00:32:30,800 I think will really revolutionize things. 491 00:32:30,800 --> 00:32:31,800 I agree with you. 492 00:32:31,800 --> 00:32:37,360 I mean, I see that even currently with COVID too, that we still have these antigen tests 493 00:32:37,360 --> 00:32:43,560 that general public can use and can really identify, okay, I shouldn't go to work or 494 00:32:43,560 --> 00:32:48,680 I shouldn't be around people if this is positive, which then, you know, takes you to the next 495 00:32:48,680 --> 00:32:53,360 step, which is then goes into prevention because we have less circulating strain. 496 00:32:53,360 --> 00:32:56,880 And can reduce the stigma associated with having to go somewhere for testing, right? 497 00:32:56,880 --> 00:33:01,440 I mean, I think that's a big piece of me, especially like M-Pox with what we're seeing 498 00:33:01,440 --> 00:33:07,840 in Congo with the link back to sex worker, to those that identify as GBM SAM. 499 00:33:07,840 --> 00:33:09,880 So they have a stigma attached with that. 500 00:33:09,880 --> 00:33:14,360 So you know, being able to have testing that can be done in the home that then pushes somebody 501 00:33:14,360 --> 00:33:19,920 to go to a local healthcare clinic or gives them the impetus to do that, I think is good. 502 00:33:19,920 --> 00:33:24,120 You know, being able, we still need to figure out the whole idea of how we can take kind 503 00:33:24,120 --> 00:33:29,200 of self testing to be able to then be integrated into like national databases or at least to 504 00:33:29,200 --> 00:33:32,400 be recorded data of just positives or negatives. 505 00:33:32,400 --> 00:33:36,440 That's a bigger question, but I think we're moving towards something that is easier for 506 00:33:36,440 --> 00:33:37,440 the user. 507 00:33:37,440 --> 00:33:39,200 Yeah, I agree. 508 00:33:39,200 --> 00:33:42,240 I think you're doing a fantastic job out there. 509 00:33:42,240 --> 00:33:46,960 It's commendable to see that you have a huge team and your team is, you know, looking at 510 00:33:46,960 --> 00:33:51,840 such great work like surveillance and the long-term effects as well, because I think 511 00:33:51,840 --> 00:33:54,640 that's really important to kind of evaluate. 512 00:33:54,640 --> 00:33:58,960 And so I think your workout in Africa, but then also the work that you're doing locally 513 00:33:58,960 --> 00:34:01,800 as well, I think it's super helpful. 514 00:34:01,800 --> 00:34:08,600 And folks like yourself are the ones that are, you know, the reasons why we're optimistic 515 00:34:08,600 --> 00:34:12,560 that we are getting closer and closer to being more prepared. 516 00:34:12,560 --> 00:34:19,080 And obviously there's holes in every system and it takes time to learn how to fill some 517 00:34:19,080 --> 00:34:20,080 of those holes. 518 00:34:20,080 --> 00:34:24,040 So, but after having this conversation with you, I definitely feel my answer would be 519 00:34:24,040 --> 00:34:28,600 that we are definitely more prepared than we were back in 2020. 520 00:34:28,600 --> 00:34:29,600 I appreciate that. 521 00:34:29,600 --> 00:34:30,600 It's humbling. 522 00:34:30,600 --> 00:34:33,360 I'll use it in my next annual performance review. 523 00:34:33,360 --> 00:34:39,560 But I say the feeling is absolutely equal on my side for our healthcare workers. 524 00:34:39,560 --> 00:34:43,560 You know, you all have been taking it on the chin with COVID and M-Plox and everything 525 00:34:43,560 --> 00:34:48,920 in between the work that all of you have been doing and as well the work on community engagement, 526 00:34:48,920 --> 00:34:53,080 public engagement, the stuff that you're doing with podcasts like this for the public. 527 00:34:53,080 --> 00:34:55,800 It makes a massive difference for us as well. 528 00:34:55,800 --> 00:34:57,760 So very, very much appreciate it. 529 00:34:57,760 --> 00:35:00,080 Again, it's working together, right? 530 00:35:00,080 --> 00:35:05,440 And so I think we learned that from the pandemic and that's what's going to help. 531 00:35:05,440 --> 00:35:08,000 And yeah, it's great to see all of your work. 532 00:35:08,000 --> 00:35:12,540 And I honestly, it was a pleasure to have you on the podcast today. 533 00:35:12,540 --> 00:35:14,720 We had a fantastic previous episode on M-Plox. 534 00:35:14,720 --> 00:35:17,160 Everybody will tune into that, I'm sure. 535 00:35:17,160 --> 00:35:20,360 And then we might see you again on the podcast. 536 00:35:20,360 --> 00:35:23,320 Or hopefully there won't be another outbreak and everything's fine. 537 00:35:23,320 --> 00:35:26,080 Nice chatting. 538 00:35:26,080 --> 00:35:27,080 Thanks so much. 539 00:35:27,080 --> 00:35:28,080 Take care. 540 00:35:28,080 --> 00:35:31,320 Thank you, Dr. Kinderchuck, for joining us again. 541 00:35:31,320 --> 00:35:32,800 Have an episode suggestion? 542 00:35:32,800 --> 00:35:39,480 Email thecanadianbreakpoint at gmail.com and be sure to follow us on x at CABbreakpoint 543 00:35:39,480 --> 00:35:41,000 for updates. 544 00:35:41,000 --> 00:35:57,800 See you again soon at the Canadian Breakpoint.