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Science is the way forward: how COVID-19 affected research at the University Health Network

Sponsors restricted the use of awarded funds In addition to a loss of revenue, some of our sponsors restricted the use of previously-awarded funding. Several agencies—including some philanthropic partners, the US government and industry partners from drug, device and technology companies—indicated that awarded grants, industry contracts and other forms of support were not to be used to pay salaries during the suspension. While the remainder of the funders did not reduce or restrict their funding, the previously-awarded research grants or contracts were lost for the intended purpose, as the funds to continue supporting suspended research personnel was expended and could no longer be used to support the research for which they were meant. Taken together, the suspension of research left the hospital-based research sector with no available options from the three main funding sources to continue with wage support for staff. In the absence of a stimulus package, large-scale job actions would be required to ensure the long-term sustainability of the enterprise.

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At the University Health Network (UHN)—Canada’s largest research hospital—our research mission is “Together we drive excellence in discovery and innovation to create a healthier World.” We believe that research is one of the few tools that we have to find new and improved solutions to prevent, diagnose, treat and provide care for today’s greatest health issues, such as cancer, heart disease, arthritis, diabetes, Alzheimer disease and all of the other major chronic diseases that affect us and our loved ones. 

We are able to carry out this important research thanks to our sponsors. Together with our peer organizations, Canada’s top 40 research hospitals comprise a $2.7 billion annual sector [1], which comes from three major sources: government, industry and philanthropy. At UHN alone, our researchers’ programs are funded by more than 900 different agencies within these three categories. This funding supports wages for our large talent pool of highly-skilled scientists, staff and students, operational costs for performing the experiments, purchasing and maintaining state-of-the-art research infrastructure, and more.

Earlier this year, however, all of this came to a standstill with the COVID-19 pandemic. While our research community pivoted quickly to enable critical COVID-19–related research projects and clinical trials, we, like virtually all of our peers across Canada, were forced to suspend research activities in other areas for several months to ensure safety for all. As a result, more than 80% of UHN’s 5,000 or so research staff were unable to continue their research—halting the discovery of new treatments and tools for delivering care across all of the disease areas mentioned above. 

This suspension created an acute, critical financial situation for UHN and its peers across the country because of the unique—and complex—nature of how hospital-based research institutions are funded. There were three main categories of costs for which funding was lost, restricted or unbudgeted: wages for research personnel; costs associated with suspending and restarting research; and costs associated with maintaining essential research infrastructure.

There were three main categories of costs for which funding was lost, restricted or unbudgeted:

1.   wages for research personnel;
2.  costs associated with suspending and restarting research; and
3.  costs associated with maintaining essential research infrastructure.



"As a result, more than 80% of UHN’s 5,000 or so research staff were unable to continue their research—halting the discovery of new treatments and tools for delivering care across all of the disease areas mentioned above."


 

Revenue for research personnel wages was lost

As public institutions, Canadian hospitals were excluded from federal support packages such as the Canada Emergency Wage Subsidy (CEWS), and like all hospital-based research institutions across the country, were legislatively prohibited from receiving funding for research from the respective provincial ministries of health. Moreover, while many hospitals are formally affiliated with universities, they are nevertheless independent organizations and are thus not eligible for supports that were targeted to academic institutions. These restrictions initially left our sector without government wage supports that were put in place to help businesses and academic institutions with retaining their personnel.

Many of our researchers were funded by external industry revenue that was lost because of this suspension. One such example at UHN was the loss of more than $5 million each month from suspended industry-sponsored clinical trials, which enroll research participants onto experimental research studies. Funding for this type of research is typically received only after these participants are entered into the study; thus, revenue was lost as of the date of the suspension of research activity. This lost revenue supported approximately 680 positions for highly-qualified clinical research coordinators, research nurses and other essential personnel to perform these necessary trials to improve treatment options for patients. At UHN, this revenue also brings in more than $2 million each month in ‘overhead’ costs (i.e., facilities and administrative costs) that is used to fund research space, research infrastructure and research administration.

During this time, we were also in discussions with many of our philanthropic funders. These organizations were similarly affected by COVID-19, and as a result, indicated that they were likely to reduce awarded grants and/or reduce new funding competitions due to the consequences of COVID-19 on their own fundraising ability. For example, one of our major funding partners estimated that their revenue would be reduced by $100 million this year. UHN is fortunate to have dedicated foundations—The Princess Margaret Cancer Foundation and the Toronto General & Western Hospital Foundation—that also face a challenging fundraising environment going forward.

 



"Collectively, the estimated costs of suspending research at UHN was upwards of $6 million each month due to staff wages and unbudgeted costs highlighted above."


 

Sponsors restricted the use of awarded funds

In addition to a loss of revenue, some of our sponsors restricted the use of previously-awarded funding. Several agencies—including some philanthropic partners, the US government and industry partners from drug, device and technology companies—indicated that awarded grants, industry contracts and other forms of support were not to be used to pay salaries during the suspension.

While the remainder of the funders did not reduce or restrict their funding, the previously-awarded research grants or contracts were lost for the intended purpose, as the funds to continue supporting suspended research personnel was expended and could no longer be used to support the research for which they were meant.

Taken together, the suspension of research left the hospital-based research sector with no available options from the three main funding sources to continue with wage support for staff. In the absence of a stimulus package, large-scale job actions would be required to ensure the long-term sustainability of the enterprise.

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Research hospitals advocated for financial relief from the Government of Canada

We needed to take action. Along with our peers at the Toronto Academic Health Science Network and at the Ontario Hospital Association, and with the health advocacy groups Research Canada and HealthCareCAN, we led an intense campaign on behalf of the Canadian hospital-based research sector to lobby the federal government for support.

This advocacy culminated in the announcement of federal support packages to address the financial situations for government-, industry- and philanthropy-funded research at universities and hospital-based research institutes across Canada. We continue to be extremely grateful to the Government of Canada for their investments in health research and for supporting the creation of new knowledge and health care solutions to improve care for people around the world. It signals the value of medical research—not only as the key to fighting COVID-19, but also that to find cures and treatments for all diseases.

If there is one thing that the pandemic reaffirmed, it’s that our research community is resilient, agile and unwavering in our dedication to creating a healthier world through discovery and innovation. We have a renewed appreciation for science as the one and only tool to guide us through this pandemic, and we hope that you will join us on the journey.

[1] Research Infosource (2019), https://www.researchinfosource.com/top-40-research-hospitals/2019 
Photo credits: UHN Public Affairs and Communications