Thank you, Mr. Chair.
I would like to start by thanking the members of the Standing Committee on Health for giving me the opportunity to appear before them today and share my thoughts with them.
My name is Emilia Liana Falcone, and I am an infectious disease physician at the Centre Hospitalier de l'Université de Montréal, or CHUM. I also work at the Montreal Clinical Research Institute, or IRCM, where I am the director of the microbiome research unit and the founder of the Post‑COVID‑19 Research Clinic. We do a comprehensive evaluation of long‑term COVID‑19 patients and work with colleagues from other institutions to improve the management of these patients.
The COVID‑19 pandemic has weakened our health care system. More than 3.9 million Canadians have contracted COVID‑19. As we estimate that between 10% and 30% of Canadians could have long‑term effects, more than 1 million Canadians could potentially experience long COVID‑19. and probably 200,000 to 300,000 of them will be sick for months or years, often unable to return to work. The burden on our health care system will be major, and the socio‑economic impact will be significant. It is in this context that I would like to share with you the challenges and major issues we are currently facing.
The first challenge is diagnosing long COVID‑19, which is complex. It is a heterogeneous disease with many associated symptoms. These symptoms can fluctuate or even occur after recovery. In addition, many symptoms, such as fatigue and shortness of breath, are the same as those of other illnesses. We therefore need to find biomarkers that would facilitate the diagnosis of long COVID‑19.
The second challenge is to better understand the causes of long COVID‑19 from a mechanistic perspective. This will allow us to have more accurate diagnostic tests, to better understand the course of the disease and, above all, to develop new and better targeted therapies.
At the same time, we need to study the impact of new variants and vaccination on the incidence of long COVID‑19. We know that individuals can be reinfected and have post‑vaccination infections. In our experience, even if an individual did not develop COVID‑19 after a first infection, this doesn't mean that they aren't at risk of long‑term sequelae after re‑infection.
We also need to better understand the role of antiviral drugs, not only to treat acute COVID‑19, but also to prevent or even treat long COVID‑19, especially considering that there may be virus particles hiding in some tissues.
The pandemic has taught us that we need to be agile in our ability to adapt to evolving clinical situations as new information emerges. An effective way to do this is through the systematic integration of a research infrastructure into clinical care pathways.
As I have mentioned in my previous participation in a meeting of this committee, my eight-year experience at the National Institutes of Health in the United States led me to suspect early on in the pandemic that there would be long-term sequelae from COVID. This is why I created the IRCM Post-COVID Research Clinic thanks to the support from our governments. My objective was to integrate our clinical evaluation with a research platform and biobank that would lead to a better understanding of long COVID in an effort to identify diagnostic biomarkers and develop novel therapeutic strategies.
Our research clinic model could be extended to specialized centres across Canada. This model would be even more effective if it were integrated into a network that would use standardized protocols and have an established infrastructure for real-time data sharing and integration. With this coordinated and rapid approach, we would further distinguish ourselves as a country, not only in the context of long COVID but also in the management of other complex and chronic diseases, and in preparedness for the next pandemic.
Finally, such an infrastructure that systematically integrates research with clinical evaluation would foster national and international collaborations between governments, industry and academic institutions.
There are several other thoughts I'd like to share with you, and I'd be happy to continue the conversation during the question period.
Thank you for your attention.