 Thank you for joining us this morning. We are joined by provincial health officer Dr. Bonnie Henry in Victoria and Minister of Health Minister Adrian Dix in Vancouver. As a reminder to media on the phone line, please press star one to enter the queue. You're limited to one question and one follow-up only. I will now hand it over to Minister Dix. Please go ahead, Minister. Thank you very much, Lindsay. I'm honored to be here in Vancouver on the territories of the Squamish, the Musqueam and the Slava Tooth First Nations. Dr. Henry, of course, in Victoria. On the territories of the Laquungen speaking people, the Songhees and the Esquimalt First Nations were both honored to be here on their lands. Today we're providing an update on COVID-19 and answering your questions. I want to give you a sense of the coming week that on December 27th and December 28th, we will be providing in the afternoon written daily numbers on vaccinations, case counts and preliminary case numbers. Regular reporting will be back on Wednesday, December 29th along with the media availability in the afternoon on December 29th. So we're going to continue to provide our preliminary case counts and those will be confirmed in the numbers provided on Wednesday, December 29th. And with that, it's my honor to introduce Dr. Bonnie Henry. Thank you very much and good morning. As many people are beginning their holiday celebrations, it felt it important to update what we know right now about what is happening with Omicron and how it is spreading in British Columbia. And to provide some guidance on what to do if you are developing symptoms or have developed symptoms of COVID-19 and of course to talk about when one needs to get tested. What we are seeing across this country and across the globe is that Omicron is different. It is spreading in a way that is very different from previous variants. In a sense, we're in a different game, a different pandemic now. Some parts of it we know more about. We're putting that puzzle together globally. We know more about the infectiousness of Omicron right now and it is more highly infectious than any of the other strains of this virus that we've seen. We know more about breakthrough infections and about reinfections. And there's data that's showing up from around the world that tells us that we can get more breakthrough infections in people who have been fully vaccinated. But they tend to be less severe. Those are things that we're still watching. We also know that people who have had previous infections are much more likely to get reinfected with Omicron. So those are important things to remember. We still do not have a full picture about how severe Omicron can be across the board. And that is something that we need to continue to monitor and watch. And that's why we're talking today about the things that we need to do until we understand that in the coming weeks. Earlier this week, I mentioned that all of us would likely be exposed to this virus, to Omicron, knowing the way it was spreading in our communities. But this does not mean that all of us will get sick or will get severely sick. It's an entirely new game, as I said. What we are seeing is that Omicron is more likely to attach to the upper airways, to those ACE2 receptors in our upper airways. Which means it can spread with very small amounts of the virus. It replicates quickly. And it means that those smaller particles or aerosols are much more important. And it can spread more easily. Especially during activities like singing or talking closely to each other indoors where ventilation is poor or breathing hard. So people are getting infected with a much smaller amount of the virus and more quickly. And they're passing it on to others. And with this Omicron variant, what we're seeing is these pieces of the puzzle that are coming together. Is that the incubation period or the time between exposure and getting sick yourself and being able to pass it on to the others and to someone else is very small. What we were usually seeing in five to seven days on average is now down to around two to three days. So you can pass it on to others even before you realize that you're positive for the virus. We also know that Omicron is spreading faster in people who are not yet vaccinated. We know that because we see that transmission being explosive in some of those settings. And it's because our immune system has not developed those defences that are very specific for this virus, for the spike protein that vaccination gives. This means that if you are at all sick right now, if you think it isn't COVID, even if you think it's just a mild cold or flu, you need to take precautions because they have not been vaccinated or because they're older or younger. Even now, especially if anyone in your family is at risk, you need to stay away, even if you don't think it is COVID. The speed of transmission at this point also means that our case and contact tracing cannot keep up. We can keep up with people who have a test and we'll talk a bit more about testing, but we cannot find contacts and people know this within two to three days. It often takes a little bit longer. So it's really important right now that all of us pay attention to this. This virus is spreading, it's spreading in all of us. And we need to take those actions and we can take those actions, which keep ourselves, which make a difference to control the impact the virus is going to have both on ourselves and on those we are closest to that we are more likely to spread it to. This means we need your help to make sure that you are taking the actions you need to do and notifying people around you if you are positive for COVID-19. In addition, our testing centres are at their maximum capacity. We did over 20,000 PCR tests yesterday and that's the maximum that we can do. So I want to be very clear, do not go to a testing centre unless you have symptoms. And then we need to preserve the more accurate PCR testing for those who really need it. The testing centres are not for pre-travel screening, nor do they give you a green light to spend time with others. We've talked about this before, but this is more important than ever. A negative test is not a green light. All of our testing is for people who have symptoms or for people who need to rule out and for people who need to rule out that it is COVID. So this is important right now more than anything. The testing centres are to confirm that someone with symptoms of the virus has COVID-19 or to rule it out for those key workers like healthcare workers and emergency responders who need to be able to go into work. I encourage everybody to go to the BC CDC symptom checker online. It's a good tool to use to help you understand if you need to get a test. Right now, our PCR tests need to be used for those who are at highest risk. So that means people who are older, over age 65, people who have underlying illnesses and people with more severe symptoms where this makes a difference in how they get treated and access to treatment. So that is the first priority at our treatment centres and as well to test people with symptoms who are hospital workers, emergency responders and others who need this. Rapid testing is also now being used to supplement our PCR testing at many of our testing centres. It's also being used in a number of different settings like remote communities to really determine if COVID has made it to those communities. Rapid testing will be used again for people with symptoms to help you understand what you need to do. It will be mostly targeted to people who are younger with milder symptoms without risk factors for more severe disease. Given the rate of transmission that we are seeing, if you have any symptoms of COVID-19, Omicron is different now. If you have any symptoms, you must assume you have COVID and take measures to avoid passing it on. If you are younger and vaccinated and no other risk factors, you don't necessarily need a test. You just need to take these actions now. If you are fully vaccinated and have mild symptoms, you should assume you are positive, stay home and stay away from others for 7 days. If you are not fully vaccinated and don't have other underlying risk factors, you must isolate for 10 days. And this is because we know that vaccination helps us manage these infections more rapidly, so we shed less fires for a shorter period of time. You should as well notify your close contacts, and that's people that you spent time with, particularly indoors in close proximity without wearing masks, and they need to monitor for 14 days to check for symptoms themselves. Anybody who is unvaccinated, who you've had close contact with, if you have symptoms and positive for COVID, needs to stay away from others and monitor and self-isolate for 10 days. This means regrettably that we will need to adjust our holiday plans if we have symptoms right now that could be related to Omicron. You need to isolate yourself from those people in your household, particularly anybody who is at risk and anyone coming to your home. We all need to gather together now and continue to support each other, to support people who have symptoms who are doing their part to keep us all safe. Things like bring your turkey dinner delivered to you instead. Your close contacts and anyone you live with should limit their interactions with others and closely monitor themselves for symptoms as well. Anyone with someone in their social network who recently tested positive or who is waiting test results or is at home with symptoms, you should consider yourself a contact of Omicron. Don't go to group gatherings and particularly don't go to gatherings where you'll be with people who have risk factors for severe illness. If you do have symptoms and they worsen, or you're having difficulty breathing, chest pain, can't drink anything, and your self-care is not helping you manage your illness, then do not be afraid to call 911 if you need it. To call 811 to get advice or talk to your healthcare provider. While I caution about the need to get tested, if you are seriously unwell, please do not hesitate to seek care immediately. One by one, this piece of the puzzle that we didn't know yet, and the one piece of the puzzle that we are still working on, is how severe illness Omicron will cause. We're watching very carefully hospitalizations and ICU cases in this province and around the world, and we've had some positive results on that side, some positive tests coming in, positive studies coming in the last few days. Particularly, some hope that we see from what's come out of Scotland, from the UK and from South Africa, which seems to indicate that in many cases, this is a milder illness in most people. So that is hopeful news. We don't yet know that for our context here in BC, but I also am very hopeful. We have a lot of people who have stepped up and gotten the protection that vaccination offers, that have gotten their booster doses, and we have been good at taking these measures to protect each other. We will continue to be watching these measures, the data that's coming from around the world very closely. There's still some caveats that we don't yet know. Particularly, we think about the study in Scotland, which showed a much reduced risk of hospitalization. That was still in people who are younger, and we know that younger people have a lower risk of hospitalization anyway. As we're starting as this Omicron is progressing and moving into older populations, we need to know if that still holds. So there's still a period of time of uncertainty right now. So this is a different virus, this Omicron, that is now causing what we are seeing across our province. And once again, a different holiday season for all of us. For many, including me, physical activity, going to a gym or fitness center is a key part of mental and physical well-being. And I know that this has impacted people that we've required these to be closed on a temporary basis right now. This is a very high risk period. We see this as transmitting rapidly, and particularly in young people, and when we're doing those types of activities where aerosols can be generated. I know that all those in the gym community have been doing their part. And gyms and fitness centers have had really good protocols in place, and people have stepped up and gotten vaccinated to protect each other. And this part, I now need you to continue to have that contact and connect with those people in your community. Do things online. Go outside and meet for a walk or a run if you can. Connect and support each other virtually right now to slow down the spread, but keep that ever important connection that you get through your community, whether it's your church community, your gym community, or the people that you're closest to. I would like to assure you as well that the uncertainty around this virus remains high, but we will be back to doing those activities in gyms and fitness centers in all of those other places as soon as we know more. And while we need to keep our groups small right now, limit our in-person connections, let's ensure we are maintaining those important social connections in a safe way. Like we did last year, like we have learned to do, it's important to connect with each other, especially this time of year, and I encourage you to resurrect all those things that we were doing before. Now's the time to bring them back out again, whether that's reaching out to people who may be alone, sending them a text or note or calling somebody, deliver a meal or baking to someone who may be isolating. Continuing to connect virtually is so important. We know it's not the same, but it will get us through this next few weeks. We need to give each other a booster shot of communal kindness right now. It is incredibly important and safe connection. And I ask you, let's continue to do this together. We will get through this wave, this new challenge that we are faced with, and we'll get it through together by being kind, being calm and being safe. Thank you. I will now hand it over to Minister Dix. Thank you very much. So I want to start by expressing my gratitude, I think everyone's gratitude to people working in healthcare around BC, who are doing exceptional things right now to support people in very challenging, very difficult times, those that have been described by Dr. Henry just now. Dr. Henry mentioned that yesterday we processed 20,133 PCR tests for COVID-19 20,133 with a 24-hour turnaround and what that reflects is exceptional work by workers at our test sites but also in our labs who at this challenging time on December 22nd and 23rd did that extraordinary work but that reflects the work done in our hospitals and in the community and long-term care by our ambulance paramedics by all those at our immunization sites who are going to say the least above and beyond and I want to wish all of them expressed to all of them my gratitude, my personal gratitude and I think those of everyone in BC for their efforts Omicron as Dr. Henry has said takes every opportunity we give it to spread and it's up to us, all of us in all of our different ways to slow that spread. It's up to us to keep our emergency rooms and hospitals from being overwhelmed we need to adhere to public health orders we need to follow the latest public health guidance we need to use our COVID sense and right now we need to make sure that COVID test sites are there for the people who need them most if we're symptom free we do not go to get a test if we have mild symptoms we act like we've been exposed and stay home because that helps stop the spread if we have severe symptoms the system are here for us and we go and get medical help regarding booster shots just a brief update our rollout continues to be robust 807,094 third doses or booster doses have been provided in BC in addition 120,844 children from ages 5 to 11 have received their first doses of the Pfizer vaccine designed specifically for them yesterday for example there were 38,500 total bookings 34,000 of these were booster or third doses our original plan projected 32,000 doses this time of the year to be administered weekly then it was raised to 99,500 when we opened additional clinics and we have done 106,000 from Monday December 20 to last night we still have unbooked capacity when they received their invitation as of yesterday spots that are not booked include this week 7,000 and next week 25,000 of which 14,000 are in the interior in the first three weeks of January 203,000 are not yet booked with more appointments going up every day currently we have a total of 656 locations for vaccination around the province through to January 2nd including health authority clinics and pharmacies clinics offering vaccinations to children 5 to 11 around the province across these two holiday weeks so we can add to 120,844 children who are vaccinated against COVID-19 received their first dose vaccination from ages 5 to 11 a total of 147,371 vaccinations are projected for December 22nd to January 2nd and this does not include our drop in sites we are making progress with the number of patients who have received their third dose 75% of those 70 and older who are eligible have received a third dose or booster dose and that includes many other groups and this is specific to our effort to target booster doses at those who are at the greatest risk so our clinically vulnerable in categories 1 and 2 have been 135,253 of those groups have been vaccinated as of December 10th we started sending on our six month after second dose system to the third group of clinically vulnerable people and of course tens of thousands of health care workers more than 30,000 people who are double AstraZeneca or CovaShield in their first and second doses well over 50,000 indigenous people and so on our program continues to be targeted at those who are at the greatest risk and this is one of the ways we can prevent and help prevent the most severe outcomes from COVID-19 and the Omicron variant of concern yesterday those 63 to 64 who are eligible will receive their invitations to make an appointment next Tuesday those 61 and 62 next Thursday those 60 and that will continue including vulnerable categories and others in short this is an extraordinary effort by health care across British Columbia there will be opportunities to book and when you receive an invitation I strongly encourage you to book because if you are receiving an invitation right now it is because you are in a category of people either due to age or other circumstances where you should get your third dose and get it now and I encourage everyone to book Omicron and we can preserve our health care system in these challenging times we are taking the steps to do it and we all need to take those steps right now we must do both slow Omicron and protect our health care system no matter how we celebrate the holidays the greatest gift we can give this year is to protect the people we love and care about by slowing the spread of Omicron doing that and sharing that message with friends and families will make all the difference in the days ahead and with that we are happy to take your questions Reminders to media on the phone line please press star 1 to enter the queue you are limited to one question and one follow up First question this morning is from Lisa Cordesco Vancouver Sun Thank you I would like to get your reaction to the information put out by the BC COVID modeling group it is predicting a tidal wave of Omicron by the end of the first week in January by a hospitalization rate that will exceed BC's capacity what do you make of those conclusions I think modeling has been helpful for us from the very beginning but I go back to what I said from the very beginning models are dependent on the inputs that go into them and there is still much that we don't yet know about Omicron in particular about how it is spreading and about severity of illness so by necessity all models are wrong some of them are really useful and this modeling group has been part of our team we have others that we look at as well and being able to look at all of the different models gives us a sense of what potentially could happen but I think what we need to focus on is that we can do things to control this it is not a prediction of what is going to happen in the future it is a set of parameters that could happen and what we are seeing is the actions that we take can make a difference in what the outcome is going to be so we still do not yet know about severity of illness in our context here in BC but we do know that the things that we can do right now can slow this down and can help prevent that impact on our healthcare system and what we do right now Lisa do you have a follow up I wanted to ask about the vaccination and the booster program why have you not used medical students or even trained people to set needles instead of redeploying healthcare workers from hospitals to do it we actually have seven months ago I actually signed an order and it is up there on our website that shows all the different groups of people so we have medical students, nursing students physio and OT students all health professional students who have been trained specifically on vaccinations who are working in our clinics we have paramedics, firefighters pharmacists, pharmacy technicians we have expanded it dramatically to a whole class dentists chiropractors many many people including retired and recent retired nurses and physicians and other healthcare providers so we have expanded that dramatically some time ago and we are pulling people back in to support the latest booster efforts too Next question is from Christopher Folds, Camloops this week Good morning you touched on the gym closures and part of the health disorder recently was the gyms are closed and sports tournaments are cancelled the provincial championships and camloops were initially cancelled but I understand there's been an exception made for them and they will go ahead under certain protocols we have a group of business gym owners and camloops who remain open and they cite as you mentioned the need for the mental health help the gyms offer and they are staying open is there anything to be done like you did with the sports tournaments to allow gyms to stay open through this period so gyms must close during this period there are things that we can do and my gym does it very very well to connect people to be able to support us having that physical activity remotely right now what we are seeing is that this is passing so quickly in those indoor environments even when we have lots of space and when we have been doing everything right and I want to say that I have met with some of the representatives in the fitness and gym industry yesterday and they have been leading in making sure that we can do things as safely as possible right now we are in a place of real uncertainty with a lot of transmission in younger people in the demographic that really is connected to their gyms so they must right now stop that in terms of the same bonds bill that I understand we are looking at it really is about trying to have the higher level competitive sports being able to do things in a certain way so there is no spectators, there is a whole variety of things that are involved in that and I will say that the ultimate decision has not yet been made on whether that will continue or will go ahead it much depends on what happens in the next week yes thank you part of the gym owners sort of I guess their frustration and I have heard it from other people is what seems to be to the layman like myself and others the kind of inconsistency in the orders the real theater is a prime example they could not operate as a movie theater but they could as a sports pub the vaccine card mandate the customers must be vaccinated the employees don't have to be and then on that gym note their gym area is closed obviously but the sauna, the hot tub and the much closer, much smaller and closed pool area remains open so is there room for a better explanation for the rationale behind this for the layman you are talking about several different things that have different impacts and yes it is very much trying to find the balance of the highest risk activities and yes movie theaters were at a higher risk we have now tried to address those so we know that seated events when you are not exerting and right now one of the reasons why I have been focusing on those areas that are indoor where we are exerting so gyms being a classic example is that we are seeing a lot of transmission now through the very small droplets and aerosols and the measures that we had in place that we are working for delta for the other variants that we have seen are just not enough at the moment it is spreading very rapidly even amongst people and because of that shorter incubation period it is before people can notify that next generation of spread in terms of the BC vaccine card program and I have said this many times it is my responsibility to put in place the public health measures for people who are attending those places it does not mean in any sense that workers in those places have to be vaccinated it is their workplace that makes sure that employees live up to the standard that is needed in that workplace and if there is transmission in those places they will be shut down so we have different measures in place for workers and of course people who work in the hospitality industry for example cannot go to stay in the restaurant or go to visit a movie theater or other place unless they are vaccinated and I know that across the board most of the restaurants for example staff are vaccinated because they recognize the importance of protecting themselves in their workplace Next question is from David Mulco CTV Dr. Henry David Mulco at CTV I want to talk a little bit about testing and testing strategy I appreciate the clear clarification around that folks who have been in these lineups this week as you can imagine organized chaos perhaps that is being generous but my question for you is how is it that we are in this situation given we had at least a couple of weeks of lead time to prepare and what are we doing now to ramp up our testing capacity for the weeks to come I think our testing strategy has always been to use the PCR testing for those who need it where it changes your clinical management or for people who need to have an accurate negative test so they can work like healthcare workers for example and you can say that we have been planning the maximum that we actually capacity that we have in terms of machines in terms of people in this province is about 20,000 PCR tests a day that is how we have planned you can't create people to work in a lab out of nowhere we need people to focus on and we have been saying this from the very beginning testing is for people who have symptoms and we need to really focus on that and part of our rapid rapid testing strategy has been to supplement that and now we are using that particularly in our testing centers for people who are at lower risk of having more severe illness and so our rapid testing is able to support and be able to determine who has COVID and not so it is a challenge but the challenges we are facing across the country and around the world this is spreading very rapidly very quickly and we ramped up to the maximum capacity that we have here right now in this province follow up David one of the things I also want to ask you about I think I will leave Jim's alone because that has come up a few times and you have answered that pretty clearly but just talking a little bit about the inconsistency in terms of closures and capacity controls I personally have been in different retail shops malls spots where there are no capacity controls where there is no distancing where people are sort of on top of each other and I don't want to be a Grinch because it is Christmas Eve but help people understand Jim's are closed because people are exerting but why not bring in capacity controls for malls for retail shops 25% if that is a risk as well and we are seeing people gather in those locations as well Boxing Day coming up and so on your thoughts and you will know that we put in orders around what is happening in Boxing Day and other sales and we have been working with the retail associations it is a qualitatively different situation and this is really important this is where we have put in the mask mandate in all of those settings retail settings are doing a very good job at capacity limits and we know people were pushing that we have become a little bit complacent as we are making our way through what was our last wave in Delta we need to step that up again now and that means all of us doing our bit thinking differently again going back to recognizing that Omicron is different it is spreading faster it is spreading much more quickly giving people space we need for retailers to limit people limit those capacities give people the distance in the space but we also know that those transactional settings where you are moving past somebody where you may be standing a few feet away everybody with your mask on with the increasing ventilation those are less risky environments it really is the workers in those environments and that is why once again we need to go back to using our COVID sense as the minister would say so yes everybody now make sure you wear your mask if you are somebody who cannot wear a mask then you can take curbside pickup do online there are other ways that you can get what you need without going into those indoor environments and everybody I am feeling to you again now we need to take a step back and recognize we are dealing with something that is different that is moving through all of us so be respectful wear your mask keep your distance and be patient with each other it is going to be a challenging few weeks until we actually understand how this virus is going this strain of the virus how Omicron is going to move through our communities and we need to do that together oh hi there thanks for taking my question regarding the concerns of people going to get tested when they don't need to be tested and basically using up these PCR tests are any changes being made to procedures at the testing stations in terms of who can get tested I had a caller on the radio this week telling me that he was in line for three hours in Coquitlam when the son was taken out of line he was 40 years old he was told that only people over age 65 that everyone else was going to get rapid tests so again just given the concerns are procedures changing at the testing stations absolutely and they have as we have understood more about transmission and risk so yes there is triage happening at the testing stations particularly in Vancouver in the Fraser Health regions where we had long lineups and here on the island so we are using the rapid antigen test to supplement PCR testing depending on the situation people will be triaged and if you are younger and don't have underlying risk factors and particularly if you are vaccinated then rapid testing may be the most efficient way for you to get what you need and for people who may have underlying risk factors for more severe illness and that usually is people who are older or younger especially younger children then you will be prioritized for getting the PCR tests if you have a follow up Keith Yes more about the psychology of what is going on right now with so many people double dose is it harder to get through to those people to express the urgency of the situation many people probably think they are bullet proof right now with double doses and obviously they are not what can be done to get through to them You know I just think and we have been trying to say this as we have learned more in this last week that the vaccine has changed with Omicron we are in a different pandemic again and there is some positive things about it I think the fact that we have so many people who have got their vaccines means that hopefully we are going to get through this without having a lot of severe illness and so far we are seeing that it is a little bit hard to tell because it is mostly younger people and younger people who have stepped up with this positive thing we are seeing about this but we need to change our behaviors and we can control how this virus is going to affect us by doing those things that we know worked way back then in March of 2020 before we had vaccines so on top of vaccines we now have other measures that can help too so we need to go back to those other measures and we need to really recognize that this is spreading really quickly because of the illness in younger people who are vaccinated and that is great but we do need to change our thinking it is not the things that we were concerned about that we could do with Delta are not necessarily working anymore so we have to be that much more careful right now and I talk about we are learning that it is binding more to the upper airways which means we can get a lot of virus that can spread very quickly in other environments in very small droplets in the aerosols so it is thinking differently to get us through this period of time and the one big question that we don't have yet fully understand yet is how severe this is going to get what is the impact going to be on our hospitals so the timing is the worst I know that I think we are all feeling that but this is going to be a Christmas where we have control we can do things by advising again and supporting each other to stay away if we are feeling sick at all and we will get through this by doing that and I am sure the minister will have some comments on this too Go ahead Minister Dix Just to say that things have clearly as described today we have been seeing the numbers here and everywhere else in the last week 9,500 cases announced in Ontario today have changed significantly we have had an average test positivity of about 2% in the period leading into Omicron and that obviously people were adjusting to those circumstances at that time we have now seen those levels go up 8, 9 times in the course of a week and a half and that requires us to change our behaviour I want to note that for example yesterday tests were based on 20,133 so expansive testing and a high test positivity as a result of that essentially 20,000 tests and 2,000 test positives is across the province a 10% test positivity which is an increase across the province about 3 times what it had been a couple of weeks before so we do have to adjust and change as a result of this and it is difficult to adjust and change because we have had to adapt a number of times but I believe that people are absolutely prepared to do that to keep themselves safe and healthier and to keep the ones they love in their communities safer and healthier and to protect the health care system and we need people to do that right now you are going to see and I didn't mention this earlier but we are going to see this afternoon we are going to be providing that bulletin for everyone at 3 o'clock today and so you will see those numbers including all of the digital numbers and the updating of the dashboard on Monday and Tuesday of course you are going to get the case numbers and then on Wednesday we will be back with a full briefing on all of the numbers so you will be able to see that but what I encourage people to do is to see what is happening here and what is happening everywhere and to change our actions accordingly and to reduce in particular what we are going to do right now and I strongly encourage people to do that Next question is from Graham Wood Glacier Media Doctor Henry is COVID is this Omicron variant airborne? I think when we look at COVID all of the SARS-CoV-2 which in various different forms it has been transmitted through the air from the very beginning but the relative importance of the different size of droplets depends on the infectiousness of the different strains so it becomes much more important to have protection against those aerosols those smaller droplets and really it is a combination of physics so if a smaller droplet an aerosol has less virus in it but if that virus is more infectious you can get infected with the smaller droplets when we initially saw early on you needed a larger dose of the virus and so it was much more important to look at protecting yourself from the larger droplets but it can spread from all of them and that is what is so important right now so in terms of the definitions that we use in the healthcare setting for airborne transmission it really talks about viruses that can be suspended in the air and travel long distances and we are not seeing that behaviour the behaviour that we see with measles or chicken pox for example we are not seeing that behaviour and how this virus is transmitted but what we are seeing is that those aerosols become more important with the higher transmission variants like Omicron so that is why it is so important to stay out of those indoor settings where we are having close conversations with people without wearing masks making sure we have an appropriate mask for the situation that we are in so if we are going to be indoors with a group of people for a period of time then upgrading to a medical mask or an N95 if you can handle how the N95 fits or a medical mask with a good quality cloth mask that helps mold it better to your face so all of these things are wrapped up in how this virus is transmitted but it becomes much more important with the strains like Omicron for sure Graham, do you have a follow up? Yeah Are you still comfortable with the Kanaat game proceeding on Monday? Obviously we are looking at these on a day to day basis. We know that the increased space in some of those larger environments we have now of course increased capacity the importance of mask wearing, continuous mask wearing which we are not always being adhered to so we are assessing these on a day by day basis Next question is from Rob Monroe info news Thank you Dr Henry I am just a bit confused about the numbers we had 2046 new cases yesterday but the data said there was 975 Omicron which is the total we have so far so how long is it going to be before the Omicron is the dominant strain and why are so many people must be getting Delta? Yeah so the Omicron numbers are those that are confirmed by whole genome sequencing and so there is a delay so we are seeing that the percentage of cases on a day by day basis that are Omicron compared to Delta is rapidly rising and it is over 50% now we expect it to be the dominant strain this week so that is what we are seeing so people who get a positive PCR test they are notified right away that is what we report on a daily basis so the 2000 people were people who reported yesterday it takes a delay of several days to get the whole genome sequencing so what we get is a trajectory of what we are expecting so most of the cases the 2000 cases from yesterday will be Omicron Follow-up Rob? Yes we are trying to get some clarification on the rules for in-home visiting and you said 10 individuals or one of its larger but could we therefore have 10 people from 10 different households come and visit us tomorrow for Christmas dinner? You could but that is not our recommendation we want people to keep it small but there are some groups of people who are close connections they may be sisters and brothers and a family who come from different households so a maximum is 10 but you know what right now people need to think if I have any symptoms at all even if I think it is just the sniffles or cold then I don't want to be around my new nephew or niece or don't want to be around my grandparents or people who might have more severe illness if they get sick with this if you have any symptoms stay away from the gatherings right now keep those groups small if there is anybody who has compromising conditions people going through cancer treatment find ways to connect with your family and your close friends in ways that aren't going to put you at risk this virus is spreading very rapidly the 2,000 positive cases yesterday are just the ones that we tested we know that there are many more people that didn't go for a test there are many more people who are just doing the right things and staying at home we all need to rethink how we spend the next few days and if you have any concerns at all put it off find a way to connect as I will be doing with my family who don't live in this province find ways to connect that are meaningful and that will get you through this period of time and I know that means for some people disappointingly you are going to have to reassess your plans do the home delivery of turkey we have seen a lot of that that's how we get through this together we have time for one more question this morning John Hernandez, CBC good morning could we get answers for both in English and French for these what advice do you have for employers in non-essential sectors who currently require proof of a negative COVID test for employees with any cold or flu-like symptoms to return to work access to testing also earlier in the pandemic people who tested positive were prioritized to be notified those who were waiting longer to hear were negative is that happening now do you usually Dr. Henry do you want to go first and then I will follow up just to say that all the testing now is automatic for most people some people get a call but most people get a text or a message or positive so the testing notification is going out right away to people so that has changed from very early on in this in terms of employers right now there is programs in certain businesses particularly some of the essential businesses where there is sequential testing and that obviously can continue and we need to make sure that for those people who have symptoms that they can get the accurate tests and I talked about emergency services healthcare workers and others for those settings where right now they are not essential services or there is a pause over this period of time then the best advice right now is if you don't need to go into work if you can work from home you can do that from home then that is the recommendation right now go ahead Minister Dix I think that what Dr Henry just said is that the notifications are pretty automatic so for people they receive information pretty quickly after the positive test is confirmed by the CDC so this process has been going on for many months since the beginning of the year and so we see this everywhere but our recommendation is that if you are not essential and have a little work at a distance it is important to do it now so I think what Dr Henry just said is important for everyone of course we will have a lot of discussion here the recommendation number of people January 3rd, January 4th but for the moment we need more in all the elements so that it is in our personal context at work can you expand a bit on what you said about people who have already had COVID getting re-infected with Omicron how often is that happening in BC and again both in English and French I can start with the sorry I have forgotten already what the first question was the test positivity in Vancouver Coast on the Fraser it is still just under about 10% from yesterday's numbers but it has increased from around 2% which had been that for quite some time in those areas so yes 10% in the large urban areas with large numbers of people is very high numbers of people and that is only the people who were tested so that is one of the reasons why we are putting out this message today about if you have any symptoms at all reassess your plans right now don't go to gatherings for yourself sorry positivity we are moving to 10% as a 7-day rolling average in the Metro Vancouver Health Authority so when you see a climb in cases and test positivity and you are doing a 7-day rolling average you are dropping off the first day and you are adding the next day and obviously the trajectory yesterday will give you the exact numbers but it was 1621 cases or sorry 1621 cases in the two Metro Vancouver Health Authority so that is a test positivity a 1-day test positivity well over 10% and a 7-day rolling average it is approached 10% and so that is significant and if you look at across the province because the Vancouver Coastal Health has moved to having the highest test positivity that in the last number of days you will see that reflected slightly differently but it is going up everywhere I should say that people in the north and our health care workers in the north have been dealing with 15-25% 15-20% test positivity for months and doing an exceptional work under those circumstances but we saw the effect of that the less transmissive Delta variant although the Delta variant has had a very severe effect especially on unvaccinated people and indeed continues to so those are the rates and will be happy to give you the precise numbers on a daily basis but also the 7-day rolling average by health authorities which is obviously going to go up again today because it is significantly higher yesterday than it was 7 days ago I would say in French that we have had about 1600 cases in the two regions of health in the Vancouver region yesterday that is to say an average test positivity during 7 days of 10% more or less but much more yesterday of course so we have had 20,000 tests yesterday and there were 2,000 cases a little bit everywhere in the province for 1 day so what we see is that the ability to transmit this variant to the migrants is exceptional and we see it a little bit everywhere in the province so we have to take personal measures we are taking a health system to protect us to anticipate what is going to happen in our hospitals in January so we have to act now to protect people in January and I hope that everyone follows the advice of Dr Henry and public health at the moment it is absolutely essential and essential for everyone thank you very much if you want to say something more okay answer your second part of your question which is about reinfection rates so this is people who have been infected before and what we do not yet have those data from British Columbia it is one of the things that we look at from our linked data that we have and we are looking at that but as you know our rapid increase is really relatively recent here as I have talked about we have this puzzle we are putting these pieces of the puzzle together so there is some really good data from South Africa that shows that even though they had a very high rate of recent previous infection the reinfection rate was 10 times higher with the Omicron than what they saw with Delta with the Delta wave that went through there and beta prior to that and the other piece of information that came out just yesterday from Scotland and part of the study that they did looking at severity of illness and potential hospitalizations and risk of hospitalizations with Omicron compared to Delta they also were able to look at reinfections in the database that they had there in the UK in Scotland and particularly they have had this surge that has been going on a little bit longer than us so they have greater numbers of people and again it showed that and I won't have the exact numbers off the top of my head but it was less than 1% reinfection with Delta and it was 10 times higher so I believe it was 7.6% with what comes to mind somewhere around that reinfection rate with Omicron so even in the early numbers that they are seeing it is a much higher reinfection rate in people who were infected before and not vaccinated with Omicron so that is just a warning sign to us and really what it tells us is that this virus is spreading in a slightly different way it is causing infection it is causing infection faster and more severely in people who are not vaccinated and so if I can put a plea out your risk is going up right now because the virus is spreading even in people who are vaccinated although at a lower rate but still because there is more virus circulating people who are not vaccinated are at greater risk right now so please walk into a vaccine clinic get that vaccine get that your first shot that is going to start getting your immune system working on getting specific protection for this virus and you will need that so that is an important message to everybody right now and I hope you all have a very safe and happy Christmas that is all the time we have for you