Dr. Rupert Kaul completed his medical training at the University of Toronto (UofT) in 1995 followed by a specialization in Infectious Diseases. After his medical training, Rupert took on a research fellowship in Nairobi, Kenya,where he investigated the epidemiology of HIV transmission within cohorts of Kenyan sex workers. Now, Rupert is a principal investigator in the Department of Immunology at UofT and the Director of the Division of Infectious Diseases at the University Health Network (UHN)and UofT. I had the pleasure of sitting down (virtually) with Rupert and discussing his career as well as his take on the current COVID-19 pandemic.

Introduction

Rupert completed his PhD in 2002, following an exciting graduate career under the co-supervision of Dr. Frank Plummer and Dr. Sarah Rowland-Jones. However, this was not what Rupert had originally planned for himself. As a medical student, Rupert did not anticipate that he would eventually complete his doctoral studies and run his own research lab:

“They were just starting the MD/PhD program when I was in first year medical school. And so they were looking for people…they were coming around saying, ‘Anybody want to go in this MD/PhD program… anybody at all?’ …I remember thinking to myself, why would anybody do that? I’m training to be a clinical doctor. Why would I need to do that?”

After completing his medical education and his sub-specialization in infectious diseases, Rupert moved to Nairobi, Kenya for his clinical epidemiology training. Anticipating the help of a skilled technician, Rupert was surprised to find that there was no technician and that he was expected to run several immune assays that he had never done before: “I hadn’t even held a pipette before…I had no idea how to do any lab research.” Through this fellowship in Nairobi, Rupert realized that he wanted to learn more and expand his technical research skills. This led to his enrolment in a PhD program where his research consisted of investigating immunological topics through a clinical epidemiological lens. Upon completing his degree, Rupert returned to Toronto and established his own lab investigating the genital immune response in both HIV-infected and at-risk individuals. To this day, Rupert continues to expand his international collaborations by working with groups in Uganda, Kenya, and the United States, to name a few.

A Career Focused on Infectious Disease

Initially, Rupert had thought that he would sub-specialize in cardiology after medical school. However, after a rotation in infectious diseases, he realized that a career as a clinician scientist focused on infectious disease prevention was what he wanted to pursue. 

It’s kind of neat, [the field of] infectious disease. One of the neat things is that most of the people that you interact with wind up getting cured and so that’s very rewarding, I think, as a clinician.”

And while Rupert’s research area is predominantly focused on the prevention of HIV, a chronic virus with no cure, he appreciates that the scientific advancements over the last 30 years have made it so that outcomes from the infection are fantastically better.

When discussing the most fulfilling aspects of his roles, Rupert had different answers for each role. As a clinician scientist, he emphasized that the balance of engaging in cutting-edge research while also making an immediate impact with patients was important for him. This differs slightly from the most fulfilling aspect of his role as the Director of the Division of Infectious Diseases at both the university and hospital levels, where he stated that he enjoys being able to shape the incoming faculty and see them succeed.

Despite these differences, all of his roles consist of a mentoring aspect, so I inquired about his mentoring philosophy and how he measures success. He emphasized that availability and affability were two of the most important things to him as a mentor. Additionally, he believes that being a good mentor also consists of being a bit of a sounding board: “I’m not saying it’s like being a counselor or something like that, but a lot of the time to be a good mentor is just for people [to have] somebody to run ideas by.” Although judging success in others is difficult, he emphasized that seeing his former students go out and fill different roles, while employing the skills they learned during their graduate education and enjoying what they do, is a measure of success to him.

The COVID-19 Pandemic Response and Global Research Efforts

At the time of our interview, Rupert had just put together a report discussing infectious disease outbreaks over the last 10 years and commented that there have been substantial outbreaks occurring every two years or so – the current one being COVID-19.

Rupert emphasized that in these situations, hospitals and academic institutions are often required to plan for the worst. Non-essential research was shut down immediately upon the declaration of COVID-19 being a pandemic. Hospitals worked tirelessly to establish protocols to ensure the safety of their staff and patients. These safety protocols often include tasks that are not even thought of by the general public, such as garbage and wastewater disposal.

With regards to his specific role during the COVID-19 pandemic, Rupert mentioned that he was specifically focused on making sure the right people have the resources to continue their important research in topics such as viral transmission and general virology, and in coordinating clinical studies. Additionally, he became involved in a new outreach program called ECHO Ontario Coping with COVID, which was launched by experts from CAMH and works to connect health care professionals in rural communities with clinicians from across the province. ECHO encourages collaborative efforts to combat the pandemic in rural areas of Ontario by ensuring that local clinicians have the knowledge to treat patients with complex COVID-19 disease.

Overall, this quick and collaborative response of hospitals, academic researchers, public health, and government officials, as well as compliance by the majority of Canadians, resulted in a drop in the reported cases of COVID-19 in Canada over the last few months (Figure 1).

Figure 1. COVID-19 cases in Canada by date of illness onset as of July 7, 2020. Source: https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html

Adjusting to Life During a Pandemic

As many of us in the Department of Immunology transitioned to a working-from-home lifestyle over the last few months, Rupert and his lab were no different. With daily Zoom calls and many emails, Rupert kept his lab running by meeting with his students weekly to discuss the virtual projects on which they had been working. However, he emphasized that this situation affected his students in different ways and posed some challenges:

“For the [students] who are pretty advanced in their training, it’s been relatively straightforward actually. Cause hey, you know, they’re forced to sit at home…typing up their thesis. So, I think that it’s been useful for them, and I think they’ve been able to use that time wisely. But for the new [students] it has been much harder. We’ve been running weekly lab meetings. I’ve been trying to interact with people, but it’s hard to stay motivated, I think, when things are shut down and you don’t know when it’s going to open up again.”

However, with research starting up again, Rupert is hoping that his students will be able to pick up their projects where they left off with a new drive. And as we begin to transition back to the lab, I asked Rupert how his working-from-home experience had been, and he laughed before stating he was not too keen on it:

“The very first day that I worked at home… I was working at the kitchen table and I went outside to do something, and while I was outside, [my family] set the table for dinner and they dropped a glass of water all over my laptop and destroyed it and so, working from home has been very damaging to my research… so I’m back in the hospital and very happy to be here working out of home.”

To end the interview, I asked Rupert what suggestions he has for us on how to stay fit during lockdowns to avoid gaining the dreaded quarantine-15 (the term used to describe the weight gained during quarantine):

“Is that 15 kilos or 15 pounds… I won’t even ask whether you’re giving me it in imperial or metric. There were a couple of places where they had excellent outbreaks in gyms, so I wouldn’t rush back into the gym…I would say get outside and do some stuff outside. Get on your bike, go walking, just make sure that you distance yourselves appropriately.”

References:

1. Figure 1 Reference: https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html

2. Centre for Addiction and Mental Health. ECHO keeps clinicians connected during COVID-19. July 3, 2020. https://www.camh.ca/en/camh-news-and-stories/echo-keeps-clinicians-connected-during-covid-19

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Baweleta Isho

Baweleta is a Ph.D. student at the University of Toronto in the Department of Immunology. She is currently under the supervision of Dr. Jennifer Gommerman and researching how maternal mucosal immunity influences autoimmune diseases. Apart from research, Baweleta enjoys hiking, attending musicals, and engaging in scientific outreach events for the general public.
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