 Today's webinar, again, entitled CLSA COVID-19 Research Update. Please allow me to introduce our esteemed panelists. We have Dr. Praminder Reina, Dr. Teresa Lou Mbrose, and Dr. Nicole Basta. And I'll just do a very brief biography overview of each now. So, Dr. Reina is the lead PI of the CLSA, the scientific director of the McMaster Institute for Research on Aging and a professor in the Department of Health Research Methods, Evidence, and Impact at McMaster. He holds a Tier 1 Canada Research Chair in Geroscience and the Raymond and Margaret Labarge Chair in Research and Knowledge Application for Optimal Aging. Dr. Reina specializes in the epidemiology of aging with emphasis on developing the interdisciplinary field of geroscience to better understand aging from all the way to society. Next, we have Dr. Teresa Lou Mbrose. She is the site lead at the University of British Columbia for the CLSA. She is a professor in the Department of Physical Therapy and she is also a Canada Research Chair in Physical Activity, Mobility, and Cognitive Health. She is the research director of the Vancouver General Hospital Falls Prevention Clinic and director of the Aging, Mobility, and Cognitive Neuroscience Laboratory. Dr. Lou Mbrose is known internationally for her work in randomized control trials of exercise with cognitive and mobility outcomes amongst older adults. And last but definitely not least, we have Dr. Nicole Basta. She is an associate professor in the Department of Epidemiology, Biostatistics and Occupational Health in the School of Population and Global Health at McGill. She is an infectious disease epidemiologist and interested in the prevention and control of infectious diseases, including evaluating the uptake of vaccines and the impact of vaccination programs and in identifying factors that increase disease risk and risk of severe outcomes. She began collaborating with the CLSA when she joined the McGill faculty back in actually earlier this year in 2020 and I may just say she's been a great person to work with and a valuable asset to the CLSA. So now I will pass it over to Perminder who is our first speaker and I'm going to go get a glass of water after that long introduction. Great, thanks Jennifer and thanks to Theresa and Nicole for doing a call presenting at this webinar. This is a quick update today about the CLSA COVID research that we have been doing for past I guess eight months. It's amazing that eight months or 10 months that's flown by and we are still talking about COVID-19. I'm going to give you a quick overview of what's happening in the context of the CLSA and then Theresa is going to talk about one of the sub studies, brain COVID and then Nicole will talk about some of the dashboards in relation to some of the data that is coming out of the questionnaire based CLSA study. Okay surely I'm trying to advance it. Okay here it is. So what I would like to do is to remind some of you who are probably on the webinar are not familiar with CLSA. I will give you a quick overview of CLSA. It will be very quick and then launching to three studies that we are pursuing as part of the CLSA COVID-19 studies. One is a questionnaire based study, second one is a seropravolence and then on the brain health and brain health as I mentioned will be presented by Theresa and then the dashboard. And before I begin the presentation I want to acknowledge co-principal investigators of the CLSA Christina Wilson who's at McGill University and Susan Kirkland who's at Dalhousie University and they all have been involved in the design and the execution of the first two studies and to some extent with the third the brain study as well. So quickly reminding you CLSA is a research platform of 50,000 Canadians between the age of 45 and 85 at the baseline and CLSA has two cohorts even though it's a one study within that we collect data two ways which is the 20,000 which is a random sample of the Canadian population across 10 provinces and data for this group of people we only collect by telephone interviews and each one of these individuals are followed every three years for the until 233 or until their death and then we have a more comprehensive component of the CLSA that is 30,000 individuals and actually the number was 30,097 and these individuals are selected randomly within 25 to 50 kilometer of 11 data collection sites that exist in Victoria in Vancouver Surrey, Calgary, Winnipeg, Hamilton, Montreal, Sherbrooke, Ottawa, Halifax and Memorial. So it's a mixture of small cities, medium sized cities and large cities. This is where much of the more in-depth data are collected we do home interviews but that is done we set up appointments for people to come to our data collection sites in any of these 11 sites that I mentioned and they go through detailed physical assessment and also provide blood in your samples. Again, that there are common sets of data that are collected from both the 20,000 cohort and the 30,000 so we can pull them to be a 50,000 cohort but there are unique features in either one of those data collection processes and we also get the consent of the participants collect their health card numbers so we can do some time in the future linkage with the healthcare databases and this gives you a bit of a sense of where the where the CLSA participants come from as I mentioned the names that are written there those are the sites and then the other dots in other in each one of the provinces represents the the tracking cohort as well and together the tracking and the comprehensive actually gave us a national sample. Obviously we were in the middle of our follow-up to data collection for the CLSA when the whole issue of SARS-CoV-2 came into and we had actually suspended our data collection on March 8 anticipating that it was going to be an issue and we didn't want to at that point in time because there was so much unknown in order to expose our participants who are generally older and our staff so the face-to-face collection of the data was suspended and it is still suspended to a larger extent for the CLSA core but we very quickly migrated to telephone interviews we established all our staff members to work from home and collect these data and during that time it also became quite apparent that we were in an ideal position to also launch some of the COVID-19 studies and on April 22nd very quickly this was one of the fastest we it was one of the fastest organization and implementation of questionnaire in the context of the CLSA and we launched it on April 22nd so within a month we were collecting data and I'm going to talk about that a bit more and the idea was that we wanted to sort of collect data that can help inform some public health policy relevant questions and also allow us to understand that the dynamic of this infection, people's behavior and generally how it impacts their psychosocial outcomes related to all the things that are happening related to COVID-19 pandemic now and we are also in a great position to look at the data we have collected as part of the baseline follow-up and sort of look at what is becoming turning out to be a new terminology long COVID and I think CLSA is situated well to look at some of those types of questions as well whether it be from genetic perspective or social risk factors perspective or general health related risk factors and their consequences during the COVID-19 pandemic and so as I mentioned already the CLSA data includes so much rich data and then collecting data that we are doing in relation to the COVID-19 questionnaire study it actually provides a great opportunity for us to look at many of the risk factors in many ways when we started with this we were thinking mostly from the point of view what would agency like public health agency of Canada would want to know in order to design some of the public health policies related to lockdowns related to restrictions social isolation and so on and so forth but as I mentioned it also provides opportunity to look at some of the long-term questions related to pandemic as well it was last in April we had two modes of data collection one web based and also telephone questionnaire and this was done to there was 20 to 25 percent of the CLSA participants don't have access to internet so we wanted to make sure we captured them as well and the way we designed study that for a month we were going to be after the baseline was done the questionnaire which was a bit longer questionnaire and I'll come to come in a bit to describe what was included in that questionnaire we also sort of struck to weekly data collection for a month and then after that we were moving into bi-weekly for a month and then for and then for three months we were going to do monthly data collection and over time this we have tweaked a bit because I think we were putting a lot of burden on our participants the amount of data we were collecting so so there are weekly thereby weekly and then there's a monthly and right now we are in the field collecting the last monthly which is a bit longer questionnaire which we are talking we sort of labeled it as an exit questionnaire now the question which we are discussing because the pandemic just won't still happening surge is happening so should we be collecting additional data some point in future or that becomes part of the core CLSA when we do launch our follow-up three and those discussions are ongoing so for this study from our reliable sample we recruited around 28,000 people and this was originally funded through the McMaster Institute for Research and Aging McMaster University and at McMaster we have a Jo Winske Research Institute and more recently this is my final life but we are acknowledging that Public Health Agency has also contributed to the collection and analysis of these data so what is what was the data collection look like in relation to the COVID-19 questionnaire study obviously we wanted to collect data on risk of infection and severe outcomes we wanted to look at COVID-19 symptoms we collected data on how many people in the CLSA tested positive if they went for a test or their physician had told them that they have potentially they're positive it's ours code too we also wanted to understand their behaviors in relation to the public health type of behaviors that have been introduced over this pandemic and we also wanted to look what other social challenges that people are facing including access various various to access to healthcare services economic impacts access to transportation and obviously anxiety and mental health type of outcomes as well and so that's the questionnaire based study and then in October as CLSA is really situated now to understand what was the overall burden or what is the overall burden of infection in older population like the population CLSA has working with the Canadian Canada Immunity Task Force and Public Health Agency of Canada we received additional funding to actually understand the serial prevalence of infection at a population level and these types of studies are generally known as serial prevalence study and mostly what we are doing is to collect blood samples from people and look at the presence or absence of antibodies in the CLSA participants now this is this was launched on November 2nd by 2020 and what a time to launch something like this as the nature of the pandemic is changing rapidly this is being done on 19,000 CLSA participants and we are collecting now we'll describe that in a minute we are collecting blood samples and these will be analyzed on a Roche platform at our collaborative laboratory in Calgary the clinical laboratory in Calgary as I mentioned the CIT apps and public health agency of Canada the government of Canada has invested 4 million dollars to collect these data and these data will be merged with other serial prevalence studies that are ongoing in Canada to give a overall picture of what's happening in Canada in relation to antibody prevalence so how are we doing this study we are doing some venous blood collection because when we planned it the pandemic was stabilized a bit and we are running into some challenges and if we have time we can talk about this later we we are collecting some venous blood that means that people have to come to our data collection sites we target around 6,000 people across Canada who will provide blood samples to us and we are collecting around 50 notes of blood and in addition to that we are also administering a telephone questionnaire that is designed by CITF and we are looking at again some of the similar things that we collected before but we wanted to collect at the same time as the blood collections will happen and and there is a proposal right now it needs to which still needs to be determined is that we might depending on how this study goes do another sample collection in six to eight months from now and in addition to this 6,000 that we are collecting venous blood that is a face-to-face data collection because generally we have collected blood only in our comprehensive part of the CNSA but if we really wanted to have a good sense of serial prevalence of SARS-CoV-2 we actually wanted to like to collect on everybody so we have we have also included the tracking participants in this study and and there's total of 15,000 people where we are mailing this device which you see on this slide where people will prick their index finger and they take few four to five drops of blood place it in that red holder and then there are little capillary tubes in that device it sucks the blood up and puts it on a filter paper and and as part of this south collection we are also descending either the telephone or online questionnaire and we want to collect data on how they are collected samples so we know we can look at the any pre-analytical issues that might be of the quality of the sample collection again this is a pretty labor-intensive work it's simple to collect but then we have to take this device apart take the filter paper and take the dried sample and extract it make it a liquid and then send it to our lab in in Alberta and this is a collaboration with the Boston Microfuels and FedEx because they are really helping us collect this sample and we got very good collaboration with Boston Microfuels and FedEx is helping us take it to door-to-door and pick up many of our samples within as soon as the sample has been collected so this is the the structure of these studies and we are still collecting we are still beginning to look at some of the initial data but they are being clean as you can imagine these are not simple data sets that can be cleaned quickly so our staff at at data data curation center are working really hard and our goal is that we will be disseminating these data to researchers sometime in the newer once we have we do have some obligations to produce some publications and reports as as a condition of getting funding to launch this study and the way we have thought about the data dissemination to general research community is that once the data are ready the people who already hold CLSA data their current holders of CLSA data they will if they want data as part of their current agreements they will receive this data added to their existing database so this will be an update to their database and and then it will be available to other researchers and then they apply for a regular data access to the CLSA and and as part of that if they will require they will check the checklist to say they would like to have the COVID-19 data set as well so there's some internal data analysis that has to happen as per funding agreements and there is a current holders of the of the data they will be given priority to have access to these data and as per usual data access people can apply and ask for these data so I'm going to stop here as far as this overview is concerned and I'm going to pass it on to Prisa to talk about a third study which is the impact of COVID-19 on cognition and brain health I just want to make sure I there's no other yeah this is over to Prisa now somebody has to hand over the ball to Prisa oh she has it yes thank you I'm just trying to figure out which slide or at here oh perfect okay thanks for linger and so and thanks for having me today here at the webinar so I'm glad to take probably next 10 minutes just to briefly describe the upcoming CLSA COVID-19 brain health before I start I just want to acknowledge that funding for this particular subset study of the CLSA is provided by the Canadian Institute of Health Research as well as the Western Brain Institute of course the entire CLSA team is involved but in terms of this particular sub study I also like to acknowledge that Eric Smith who's from the University of Calgary is also a co-lead of this particular study so in terms of the COVID-19 brain health study our goal is to actually explore the impact of both the intermediate and perhaps a longer term aspects of COVID-19 on human cognition and brain health so I think in the initial months of the pandemic most of us quickly realized that COVID-19 seemed to impact the nervous system and such that individuals with COVID-19 infections were presenting with strokes as well as delirium and acute inflammation of the brain and now what has emerged over time is that it appears that COVID-19 may also have fairly covert implications as well such that it's been documented that individuals who perhaps had a mild case of infection upon recovery there's still fairly tangible cognitive effects that's being observed and certainly there is also more reports coming out now that those who have been infected are reporting the you know the feelings of being in a brain flog and so where the CLSA COVID-19 brain health stands apart I think from existing efforts in understanding the neurological impact of COVID-19 is that we're more focused on the covert neurological consequences and again the longer impacts so how we will approach this particular sub-study is that from the CLSA COVID-19 questionnaire data so Parment just already described what that is so within that questionnaire we can identify individuals who either reported experiencing COVID symptoms or have been tested positive for COVID-19 and we want to compare them to those who have not reported having any COVID symptoms or tested negative for COVID-19 and in terms of neuroimaging aspects we're very interested in again in more covert manifestations including markers of cerebral small vessel disease looking at white matter integrity as well as efficiency of brain functional networks in terms of the study flow we are aiming to initiate this study in January of 2021 where we would acquire baseline MRI in terms of the sample the minimal sample size we're hoping to achieve is roughly 656 to a maximum of 1000 along with the MRI we would be also implementing a brief phone assessment of people's cognition as well as nude and lifestyle behaviors which I'll describe in the subsequent slide in more detail then within the cohort of individuals assessed that baseline a subset will then be reassessed one year later so it will be the first 240 individuals scanned at baseline again a brief phone assessments will accompany that to repeat of MRI and then two years later we hope to rescan all individuals who are assessed this year again come with a phone assessment accompanying the neuroimaging aspect so we have a fairly tight temporal assessment of individuals that brain health as well as their cognitive function what we also hope to do is that if we could prioritize individuals who are also part of the cerebral prevalence study is to include them within the neuroimaging study as well however it's not an absolute but is a it's a goal that we're working towards in terms of who's involved essentially eight sites of the CLSA are will be involved and they basically were selected based on the feasibility of acquiring neuroimaging using a 3 Tesla as well as whether these sites were also already involved in multi-site studies including neuroimaging from other national studies we do appreciate this fairly complex a study to initiate especially given this current circumstances so we are proposing to have three sites initiate the study and then sequentially add sites as we move along in terms of the scanning protocol for those of you who may be interested we are using the Canadian dementia imaging protocol and it is chosen because it is already a protocol that's used wide widely again among many national studies neuroimaging it's also been shown to be robust across different types of scanners including Philip Siemens etc within the protocol we would be able to acquire structural information regarding the brain as well as detection of covert lesions such as white matter lesions microbleeds we also will be looking at white matter integrity using diffusion imaging and again 10 minutes of resting state functional MRI will be acquired so that we can look at functional connectivity because this particular protocol has been established for for a while now we are also working with Simone Duchamp from LaValle University to essentially provide a little bit of an upgrading to this protocol so that it is more kind of aligned to current standards so for instance for instance for the diffusion imaging we are hoping to add more directionality to it so that again it is a part of what is expected for current neuroimaging studies in terms of the paired phone assessment as I mentioned it will focus on acquiring cognitive function using again the current cell assay battery in addition to cognitive function we'll also look at aspects of sleep as well as new discractivity in subjective cognitive decline as and then including anxiety as well height and weight will be self-reported and then lastly just to flag I guess the sort of the potential of acquiring these neuroimaging scans at this point in time so as again everyone appreciates cell assay has been following the current cohort for a number of years now since 2010 and we're currently just sort of in the completion of follow-up two. This neuroimaging study essentially will be occurring during follow-up three if you look at the years by which the acquisition will occur from baseline to the two-year scanning estimates and so while we're kind of currently I suppose only acquiring neuroimaging within follow-up three because the cohort or because the cell assay participants will be continually be followed prospectively and their cognition will be reassessed repeatedly we could technically then look at whether there's any potential effects of COVID-19 infection on the risk of dementia over time which again I would say other platforms right now or other initiatives cannot provide that sort of long-term potential and I think that's it. Thanks Teresa. You're welcome. So if anybody has any questions I see a couple of them have been starting to post for either Dr. Reina or Dr. de Ambrose please feel free to put them in the chat box and I'll turn it over to Dr. Basta. Okay thank you so much Jennifer and thank you Parmina and Teresa for your excellent overviews of all the CLSA COVID studies. I'm going to be sharing with you today some of the work that we've been doing to produce a COVID-19 dashboard that currently covers the baseline findings from the first COVID-19 survey. So this dashboard I mentioned a few months ago if you've participated in the CLSA webinars before it's now available online the address is here in the address bar it's at the normal CLSA website slash COVID-study results and if you click this link you'll be able to go to the English version of the dashboard the French version should be online later today and what I'd like to do is just give you a quick orientation or a quick tutorial about how to use the dashboard highlight a couple of key results and then leave time for questions. So when you enter the dashboard you'll see that we have six tabs on the side in addition a tab about the survey and these tabs kind of divide the baseline survey into different topics in different categories that you might be interested in. The dashboard is really optimized for use on a desktop or laptop computer rather than on a mobile phone and that is because the graphs are quite wide on each page we have a summary a set of summary boxes at the top that give some of the key findings or key statistics about the findings and you can also read about the survey in more detail to understand more about the sampling and what participants were included here. Beginning with the participant demographics if you click these three lines you'll be able to widen the dashboard and see it a little bit more clearly. Participants demographics includes the age of the participants that participated in the baseline survey, the location where they were residing at the time of the survey, their type of dwelling and the number of people that live in their household. The way that the dashboard works is that we provide an overview with very basic graphs and histograms of the distribution of each variable that's plotted and if you roll over any part of the graph it'll show you the percent of participants in that category and the count of the overall sample size. As Parminder mentioned 28,559 participants answered the baseline survey and the collection dates of this survey were April 15, 2020 to May 30, 2020 and that's important because you'll see that some of the questions ask about participant activities or behavior in the past month. The dashboard also has the opportunity or allows you the opportunity to filter the results by both age and sex for most questions. So for instance if we look at the distribution of respondents by geographic area within Canada we can also see whether the distribution by age group varies or and also stratified by sex. So here are the distribution for female participants and male participants and again if you roll over any of the bars you can find out what percentage of participants in that category responded to the survey. Once you've finished looking at a particular plot you can you can roll it up so that you can see more detail about additional plots below and again for each of these we try to keep a really consistent look by allowing you to filter by age and sex or to just review the overall summary for that variable. Once you've reviewed a single tab you can go back up to these three little bars and reveal the tabs again and look for the categories of questions that you might be most interested in. For instance if we jump ahead to the COVID-19 health tab you'll see that 73 out of the 28,559 participants reported that they had been diagnosed with COVID-19 during the baseline survey between April and May 2020. In addition, 237 were hospitalized for any reason in the month prior to the survey. About 12% had had a healthcare visit in that past month and about 26% reported that they had experienced a dry cough in the month prior to the survey. So a lot of these findings are actually very interesting and I won't be able to go through all of them but I really do encourage you to take a look at the dashboard and review some of the findings yourself. So for instance if we wanted to see what the age or sex distribution was of those individuals that tested positive that's this category right here. We would go back up and widen the plots a little bit and we could scroll over and see what percentage of each of the individuals that were positive weren't each of the age groups by sex. In addition a large number of participants were tested for COVID even though a few number had turned up positive so about 500 reported being tested for COVID in the month prior to the baseline survey. And then when we look at the most common symptoms of COVID-19 you can see that a high proportion of participants about 26% as I mentioned had experienced a dry cough but even about 15% had experienced shortness of breath or difficulty breathing in the month prior to the survey. We asked in the survey about many different symptoms so here on this plot you're able to choose any combination of symptoms that you might like and plot those in comparison to one another to see how commonly reported they were among participants in the survey. And then again you can filter by age and sex as well if you'd like to see how those different demographics play out with regards to these symptoms. Let's see another so then we have tabs about physical health so how participants physical reported their comorbidities and their physical health the COVID-19 results as I just showed you. Participant behavior things like whether they were in self-quarantine if they had left home and for what reasons and I encourage you to take a look at those many of these questions compare what the participants were doing in the month prior to the survey and in the past to try to see if there were changes in the early period of the pandemic. We have another tab looking at some of the questions related to working outside the home and volunteering outside the home and how work and volunteer activities were affected by the pandemic. And then this last tab looks at participant mental health during COVID-19 and I think this tab really drills down to a lot of the really significant effects that COVID-19 has had on participants even at this early period in the pandemic. For instance about 60% had experience separation from their family about 22% were unable to access usual health care during this time. About 20% had evidence of the presence of depressive symptoms and about 6% were experiencing moderate or severe anxiety during this period. So overall about 52% of participants indicated that the consequences of COVID-19 on themselves in their households was negative and about 4% and 5% indicated that it was very negative. So that's something that to explore and if you were to scroll down even further you could see how some of the consequences of the pandemic were on the absence or presence of depressive symptoms, on anxiety and on some of the specific experiences that individuals reported during COVID-19. Things like as I mentioned separation, unable to access usual health care, but also the loss of income or unable to be able to access necessary supplies or food or unable to care for those who require assistance. And a couple of other experiences that were less common but also reveal some interesting patterns. For instance increased time caregiving was most significantly reported by those in the youngest age groups shown here in dark blue and more commonly reported by females compared to males. So that is the quick overview of the dashboard. I did want to highlight that we have created this dashboard for informational purposes so you will see that these are really not the complete results. We haven't provided any confidence intervals or any more complex analyses. The idea is to provide trends to demonstrate how the pandemic has been impacting participants in the CLSA who completed the baseline survey and to kind of give an overview to kind of spark additional research questions and interest. In addition as I mentioned this is the baseline based on the baseline surveys, the baseline dashboard. We'll be working on creating dashboards that compare the changes over the weekly and monthly surveys and then with the exit survey once it's completed trying to compare what has changed over this time period as well. So I think like that I'll go ahead and stop sharing and I'd be happy to answer any questions if there are any about the dashboard as well. I just wanted to it's Jennifer here. I just wanted to touch base about data access with the CLSA. This was just I'm winging this because Shirley has just told me to speak to this a little bit. But the data is there another slide Shirley because this is all I'm all right. That's it. Okay so just data access will be I guess these are in my notes. You're catching me off guard here. Hang on a second. I'm just Jennifer I already mentioned that. So in the interest of time maybe basically I said that there are some internal analyses that are happening now as for funding conditions and the people who currently hold CLSA data they have active data access agreements. If they want they can apply they can call go through the CLSA access email and ask for these data when they become available they won't be available still sometime in early next year because we are still cleaning some of the weekly and bi-weekly and still collecting monthly data. So once the whole data collection is closed then it will be available to other researchers. And then the final as I mentioned that the data are going to be becoming part of the core CLSA data set so when people apply in the future and as part of the checklist and the data access application they can check if they would like to have access to these data. So that's our data access plan. I also wanted to add something that the dashboard right now is only based on the baseline data as Nicole mentioned but the plan is to add weekly bi-weekly and monthly tabs to the dashboard so it will be updated as those data become available. If I'm correct that that the weekly are going to be coming soon they are being cleaned up and prepared for the dashboard and somebody had asked the question about these are the COVID data that Nicole presented are all unweighted data they are not weighted for sampling weights we are working with our statistician to create sample weights sometime in the near future just there's only so many hours in a day and resources available to us. There was a question I think from Margaret a little while back during Theresa's presentation and it was why dilute your two main groups no symptoms does not guarantee a negative COVID status and many symptoms are consistent with COVID why not just test all who enter the study if you can answer that quickly so that we don't miss yeah sure no I read that as well and it's certainly like a core question that we were considering throughout our study design etc so I think one that's part of the challenge of working I guess the research within more community-based individuals versus looking at the effects of COVID-19 in those people who frankly are hospitalized because of a fairly serious manifestation of COVID-19 virus so we don't have the capacity so I guess just to clarify testing so I'm assuming they're talking about maybe swab testing everybody so one that we don't have that particular capacity and also to someone could have a negative swab but previously had the infection and then and that and so the other part is that that's partly why we're trying to pair with the seropropylene study as much as possible but again we don't know right now how long antibodies may last if it is if one has been previously infected so it is a challenge I fully admit to that and something we've been thinking about a lot I don't know if there's a perfect solution we are prioritizing those individuals who clearly either who are who have tested positive previously based on the sales day questionnaire city responses and we are not just using the baseline but really the most recent available data per individual to identify people from that perspective and I think what we see as the biggest challenge is that those who who may be deemed as you know negative or without COVID could again at any point along the way so not even at baseline but remember because they're following people over time depending on how long this pandemic persists for is that they would convert into a positive so that some of the challenges will have to consider as we model and look at the data moving forward but yeah I fully recognize it's a challenge and we have tried to think about every possible scenario but given the virus and it's not what we know that right now it's it's it's just hard to find an absolute absence of right now I'm actually I'm going to ask a question now which was directed to Dr. Basta about the software you used I don't think you replied to it in the chat but also beyond that technical question how do other researchers add the results to facilitate knowledge mobilization using using this the dashboard oh thank you Jennifer yeah the dashboard was created using shiny apps in R I don't know of a way for other researchers to add their results although I know there are plans to add each of the different dashboards on a main CLA landing page so perhaps there would be an opportunity there but right now the dashboards are sort of standalone and it's not possible to add additional plots there so it wouldn't need to be at another in another link or another location so there was a question from someone about the sequencing of the positive people but yes on whom we have DNA stored there are around 140 individuals right now either they told us that they went for a test and they tested positive plus either their doctor told them that they were positive so definite and presumed positives let's say their total number is around today 282 individuals in the CLSA out of that 142 or so are in the comprehensive from the comprehensive part of the CLSA where we did collect a DNA from them so we are sharing that with the again or the federally funded project which is the gen host that is looking at the sequencing of the people who tested positive that is based on the stored DNA so we are working with gen host and we are providing them with the DNA to do the sequencing I just before people start to leave I also wanted to remind you to fill out the evaluation that should have popped up on your screen now I don't see any new questions having come up so while I'm going through the last few bits and bites of the presentations please feel free to post the questions if we did miss a question we will follow up via email to get that answer so again once again I'd like to thank our three presenters for taking the time today we had a lot of interest in providing an overview of what the CLSA was doing related to COVID-19 research and as Dr. Reina said the CLSA data access request applications are ongoing the next deadline for applications will be on January 27th and that's in 2021 just to correct we the next year's deadlines are going to be changed so please view our website when we have that update on it I'd also like to so again the survey in the bottom right hand I believe corner if you can complete that and for our next webinar if you can join us in the new year for our next webinar it's I'm not going to say it in French because I will not do it justice but it will be a French webinar entitled health profile of Francophone seniors in Manitoba and it will be presented by Dr. Enday Rukahaya Gaye and please remember that the CLSA promotes this webinar series using the hashtag CLSA webinar and we invite you to follow us on twitter at CLSA underscore see under underscore ELCV it's going to I don't think I see any other questions does any of our presenters have any final comments yeah I'm just going to add something that the study that she said was talking about the brain imaging one we are adding additional two elements to it we are still working out one is that we are hoping to collect stool samples for doing microbiome studies and second part is that all factory testing so try to do assess the capability of people to do the small test and both are implicated in in brain health and that's that's another two elements to it there's also one more question I hope I hope I hope I do it justice are there serum COVID-19 IgM and IgG levels in the data and if yes are these levels at cross-section for their change and follow-up informative regarding time of exposure in any way I'm not sure I fully understand that question these are that the we will be getting the actual concentrations of those two antibody markers and they we will have to determine whether they are going to be available in the data set or we will be just giving the positive or negative that needs to be determined yet what the second part was that what was the question second part I sort of forgot it was if yes are these levels at cross-section or their change and follow-up informative regarding time of exposure in any way well we didn't have time to go into the design we've been trying to because the underlying dynamic of the pandemic is changing rapidly so and the sample collections are happening over a longer period of time so that poses some challenges so we have for collection not the same individuals unique individuals we are collecting data in three windows the first one is November 2nd to December 20th and so we will be able to estimate prevalence in that window for age and at the province level and then the second window of the new random sample of the CLSA participants will go from January 15th to March January 15th to end of February and then the third window is from March 1 to middle of April and with that we are collecting as much information we can through questionnaire to to know when they provided a blood sample and what was happening with the pandemic at that point in time to really understand when the potential I don't think we can really tell when they got exposed to it all we can tell is in that window when when they completed the blood sample and when we analyze and what the zero prevalence is at the extent of what you can do so it is a cross-section in that sense and unless we had more resources or capabilities to do some swaps there's no other way to link it to the exposure happened some point in time prior to the sample testing maybe Nicole you have something else to add to that no I think that was a really great response Parminder since these zero prevalence surveys are really aimed at trying to provide population level estimates of the zero prevalence across jurisdiction we hadn't really thought about trying to make an assessment of when the person was exposed and I'm not sure that the science is there yet to be able to determine enough about waiting immunity and the duration of the antibody response to know when someone had been exposed just from a single sample or even two samples I just there's one last question and I can't recall if it was answered or not it came in privately do you think it may be helpful to matching the CLSA participants with the COVID alert is it maybe COVID alert or would it be COVID alert application probably alert application to encourage them to use the application and collect that data difficult to answer that question because you run into lots of ethics and privacy issues that and I don't know I first of all I don't know what that app is and and what the implications of that are and I don't think we can technically link our participant to an outside app that easily is this the app for public health agency of Canada that they had or health Canada had introduced I think it's now on and we talked about it at one point at a time but ethics and privacy and confidentiality issue make it a bit challenging at least that's what I recall from previous discussions there are so many discussions that have happened about this whole topic in a very short period of time so it's hard to keep track of everything we decided and discarded or kept so I know we had an app conversation but can't remember what exactly the rationale was lots of potential here and hopefully everyone got a good overview of what the CLSA is up to these days I think we're right on time and there's no more questions so we can end there so thank you again for the presenters and for all the very positive comments that we received in the chat box I hope everybody has a great holiday season and we will see you again for our next webinar in January thanks everyone thanks thanks bye thank you