Thank you very much for that question.
What I would like to share are more concrete examples of how we can implement a setting where we integrate research platforms into clinical care.
Based on my experience at the National Institutes of Health, this was something I lived on a day-to-day basis. Concretely speaking, it means that, when a patient is admitted into clinical care—be it an out-patient or in-patient setting—they consent to being part of research protocols from the get-go. These research protocols can be granular, comprehensive and detailed—or not—depending on the infrastructure and resources available. Having the ability to collect clinical information with informed consent, in a way that can be harmonized among different research groups locally, nationally and potentially even beyond, would already be one major step that would, for instance, increase our agility. We would be able to collect and analyze these data in real time and have this information inform our next steps insofar as the pertinence of certain clinical evaluations and how comprehensive they need to be.
We know that patients with long COVID, when they're not in a long COVID referral centre where there is an awareness and acknowledgement of the disease, are often bounced around among different specialists, leading to lots and lots of tests. Some are helpful and some are not. This is a huge waste of resources and time, and of patient energy, as we heard from Ms. Goulding. Small efforts can translate into big functional setbacks for these individuals.
That's one example.
If we add another layer to that and collect biospecimens, there's a lot we can do with just one tube of blood: genomic evaluation, gene expression data, or looking for biomarkers—a lot of these are easily found in a substrate of a blood sample, such as the plasma or serum. It's in small amounts with our current technology. All of this can be harnessed into improved clinical care and possibly more rapid identification of new therapeutic targets.
We speak a lot, at least in Quebec—and I'm sure in other areas, as well—of analyzing big data, artificial intelligence and harnessing this kind of ability for us to learn better. One thing you need for these kinds of scenarios is a lot of data. You need to have access to those data in a way the patient is aware of and has consented to. The only way to do that is to start collecting it from the beginning.