 Good afternoon, everyone. I'm Adrian Dix, BC's Minister of Health. Joining me today is Dr. Bonnie Henry, BC's provincial health officer. We're honored to be here on the territory of the Musqueam, of the Squamish, of the Slewa-toothed First Nations today, and as we have in previous years in 2020 and 2021, the Ministry of Health, provincial health, public health, and and their teams across the province have been preparing for fall respiratory illness season. Those preparations, we know, and they have really assisted us and assisted patients in BC and health care workers in BC through the extraordinary demands of two public health emergencies. We know and we will remember at Christmas time 2020, we saw our first variance of concern and the ongoing issues that we dealt with just as we were beginning in that period, our vaccination program. That fall was prepared with the expectation that there would not be vaccines ready, and by December we had vaccinated our first person in British Columbia. In the fall of 2021, in April of 2021, first of all, we had prepared with a very significant set of plans and in 2021 to extend air ambulance services around the province, and of course we were tested in the fall of 2021 with the profound impacts, particularly in the north, particularly in the interior of the Delta variants of variants of concern variant and sub variants of concern and the need to fly people in the hundreds from those health authorities. So who required critical care and we're dealing with the COVID-19 pandemic and we have been preparing for the circumstances of this fall now the need to prepare for both COVID-19 and for influence of the need to ensure that our health care system and let's be clear our health care system has produced more in terms of output in July and August, but our health care teams have been working flat out in public health emergencies for two and a half years and they continue to need our support just as patients will as we deal with the challenges of respiratory illness season. A lot of the time I think when we talk about these things people feel that they don't have control, they don't have agency, they ask what they can do but what they can do very simply now is when invited to get their booster dose of a COVID-19 vaccine when invited or when the influenza vaccines are coming in they are basically here to get immunized against influenza. These are steps we can all take that show solidarity and stand in support of health care workers and health care professionals of patients you're those that you know and those that you will never meet but who may depend on your efforts. There's something we can do we can all do and that is to get vaccinated. I had the occasion to get vaccinated with the during a bivalent vaccine last Saturday along with about 300 people at the Croatian Cultural Center but they could have taken more people and I encourage people to book their appointment today and as we go through a briefing on what to expect this fall it's going to start with Dr. Henry taking you through where we are with the pandemic and also speaking about influenza and so it's my honor to introduce Dr. Bonnie Henry. Thank you very much and good afternoon and I wanted to take the opportunity to start this afternoon just sending strength and love to our my kith and kin in Nova Scotia PEI Newfoundland who are dealing with a very the recovery from Fiona and as they supported us when we were dealing with the battered and bruised events that we had for nature last year just want them to know that we're supporting them here this year. As Minister Dix indicated I do believe we are emerging from this pandemic but a lot of uncertainty remains and COVID-19 is going to be with us for the long term and we need to put that in the context of the other respiratory viruses that we are likely to see again come this fall but we do know a lot now about SARS-CoV-2, about COVID, about how it affects us, about who it affects and our approach remains the same. We are the highest priorities are on protecting people at the highest risk of severe illness and death and particularly we know that means our seniors and elders people older in age and people who are clinically extremely vulnerable and our focus will remain on that. We need to protect our health care system capacity we know that that has been a strain and on top of an ongoing strain that predated this pandemic and some of the important measures that we need to continue are ensuring that all of our health care workers have the best protection possible from vaccination both against COVID and influenza and the ongoing continuing use of infection prevention and control measures like masking in all of our health care settings. We need to keep people and communities safe but we also need to bring people back together safely. We know that the impacts of this pandemic and of the measures that we've put in place across the board to protect people have had a differential impact on some people more than others. We know that it's impacted racialized communities. We know that seniors have been impacted and while the measures that we had across the board undoubtedly saved many lives the impact on some individuals was extremely hard and we know that we want to find that balance to make sure that we can come back together that young people are able to have those activities that sustain their learning and development in school in social situations and that we find the balance of being able to come back together safely and make sure that we're protecting those who are most at risk and that's what we're focusing on now. Where are we today? We now know that about 58 percent of eligible closing in on 60 percent of eligible younger children 5 to 11 have received their first dose of COVID-19 vaccine. 86 percent of us over the age of 5 have had at least two doses so that's that primary series really important and almost 60 percent of people have had at least one booster dose and we know that that varies by age because booster doses have only become available for younger people younger children and teenagers very recently and we know we have a very high level of uptake in people who are more vulnerable and older and many of them received their second booster dose or a fourth dose in our spring booster campaign and they'll be coming eligible for another dose very soon now. As well we've been watching our hospitalizations and I'll have more to say about that we have a yes of yesterday there were 358 people in our hospitals with a COVID positive test not all of them were there because of COVID and we'll talk a little bit about that but it helps us understand the impact on our healthcare system. I also want to say that we have data now from Canada that shows in the first year of vaccination they estimate that 310,400 lives were saved by COVID-19 vaccines across this country and that is reflected what we see here in BC as well it means we're in a very different risk scenario than even a year ago so I'm going to talk about Omicron and where we are and what the epidemiology tells us about where we are from Omicron in the last year since January and I say Omicron because this is the longest period of time that we have had during this pandemic with the same variant that is causing illness and yes it has changed a little bit but it's still fundamentally Omicron and the spike protein that's in there is very similar with slight variations and we can talk I'll talk a bit more about that. The focus in 2022 is on 2022 and as you can see we had a peak of hospitalizations early on in January February and then it waned but it didn't go back down to levels that we saw when we were in between waves last summer for example and we've had an increasing wave over March and May and June I guess I better put my glasses on so I can actually see ways and then into August and September but as you know we changed to looking at all cause hospitalization so anybody who is in hospital with a positive COVID test and we've done some deep dives in in hospitals around the province and what we are seeing is a change as well change from Delta where everybody who was in hospital the vast majority of them were there because of COVID we now know that the about 40 to 50 percent of people in hospital right now are there because of COVID and the rest are there with a positive COVID test that was done for another reason and that reflects the risk in our community the same goes for our change in how we are looking at people who've died with a positive COVID test and our all cause mortality so anybody who's died within 30 days gets into our database and then we update it as we get data from vital statistics on exactly what was the cause of death and if COVID was related to any of the underlying causes of death and it takes time for that to happen and that means that our statistics change over time but one of the things that we can see when we look at this is his death rates from COVID remain low across the board and that is good news that tells us the impact of things like our immunization program I'm just going to unpack a little bit the 30-day mortality by cause of death and these are the data that gets reported weekly in our surveillance report as the information comes in and it can take four to eight weeks to get the cause of death from vital statistics and as they are updated we are able to update on an individual basis the database but it is challenging sometimes to understand why things are changing on an ongoing basis but what we can see reflects what we see in hospitalizations that 40 to 50 percent of people who die the deaths are not related to COVID so that is important for us to monitor over time and we'll be continuing to do follow-up with vital stats to make sure that we're not missing people. One of the things that we've done since the very beginning of this pandemic is be able to follow this virus through what we call whole genome sequencing looking at all of the proteins all of the genome and seeing how the virus has been changing over time and what we've seen from the beginning of 2022 in the pink on this chart is that Omicron has really dominated and it's changed a little bit but it is still Omicron and we remain in a period of uncertainty but we know a lot more now and we continue to learn and we know that when variants arise they're very unlikely now given the evolutionary pressures that we're seeing around the world and the amount of immunization and immunity that we have we're very unlikely to see a new strain arise in vc or in canada that evades all of our immune system and our vaccination so that's good news and we've been working with our teams at VCCDC at UBC and Simon Fraser to really try and understand what are the things that could happen and how likely would they be so yeah we have a scenario where there's something completely new and different that's likely to emerge somewhere else in the world but even that goes down in probability as more and more people have immunity particularly through vaccination and that's more available around the world. What we are likely to see in the next three to four to six months is more Omicron and maybe slight changes over time so that's important for us we're likely to be facing an increase in a surge in Omicron maybe a slightly different strain we've been seeing four and BA5 increase we're now seeing some that are more related to BA2 being more active in some parts of the province as well but the bottom line is they're all Omicron and the new bivalent vaccines that we have that have an Omicron component in them are effective against all of what we're seeing right now so that's important for us to look at the other important thing to look at is who is still at risk we know that Omicron from the most part is causing a milder illness in most people and particularly in people who have vaccination it's causing very mild illness in many people and it is still our elders and seniors who are at highest risk and we see that and reflected in in hospitalizations particularly people over age 80 and people who are at the immune compromising conditions transplant people undergoing cancer treatment and that is why we had our spring booster dose and that made an impact on preventing people from having that some more severe illness we're also and that's why it's important for us to focus on boosting up those antibodies as we go into this fall across the board though we are seeing very low rates of hospitalization severe illness or long-term supply in children and that is very good and we're thankful for that and we know that vaccination can help reduce that even more this is a really important slide this is a summary of what we know about vaccination and how many doses provide protection and again it's age standardized so that means compared to somebody my age who's unvaccinated the risk goes up by four times from somebody who's been vaccinated with three doses and twice the risk is twice as high of requiring hospitalization requiring critical care or nying and that's from omicron so despite the fact that omicron causes in generally milder illness if you have no vaccines on board to help prime your immune system to respond you're four times more likely to be hospitalized required critical care or to die from COVID and this tells us as well that booster doses make a difference for people who have that extra dose or doses on board it's made a tremendous difference in reducing the risk of severe illness reducing the risk of illness but reducing the risk of severe illness in particular it speaks to the importance of keeping vaccination rates high in all healthcare workers in our system but across the board for all of us as we go into this respiratory season as you know we are following and have been following wastewater samples over time and they're a really great way of looking at trends over time and they tend to happen ahead of what we're seeing in terms of hospitalizations in in the community we are this pattern is a little bit different to the visions that we're showing are a little bit different from what we've showed in the past and we're moving towards a more interactive weekly report that will be on the BCCDC dashboard that will allow you to see the trends over time as well in a little more interactive detail I am going to put up this slide of the modeling and show where we are now on the trajectory last time we presented this in June we were starting on that track of going up in along with the colored lines on the end and there was a concern that we could go whether we had a higher risk scenario or a lower risk scenario and what we have been is tracking very closely along the 20 growth advantage scenario that we were seeing with the BA5 so that's that's really important it tells us that the parameters that we've been using give us a good sense of what possibly can happen in the future and it's using this type of information that has helped us understand where we might be in the next few months and what we do know that both from infection and from vaccination we see a waning a decrease in those antibodies that protect us from infection we still see good strong cell mediated response so that complicated a second stage of our immune system response but the antibodies go down over time in about three to six months in most people and that means that we could potentially start seeing an increase again in COVID probably in November December so that's one of the things that we've been watching very carefully and looking at so that would be a worst case scenario that we start to see a surge that has impacts on hospitalization on severe illness in November December the other thing that we've been watching really carefully around the globe and and here in BC is influenza we've had very little almost no influenza for the last couple of years which means that most of us and there's a whole cohort of young people who've never been exposed to influenza and if we look at what happened in the southern hemisphere just this past influenza season for them they had a surge of COVID but they also had a surge of influenza earlier on in the season than their normal influenza season so if we look at that as a possibility of what might presage what happens here our influenza season generally starts to peak in December January and may be into March and then goes down after that so if we see a similar pattern to what we saw in the southern hemisphere we might be seeing influenza start to surge in November as well so that is a scenario that we need to plan about we have we know that other respiratory viruses as we're traveling more as we're coming together more they spread rapidly around the world we're going to see influenza I have no doubt and the worst case we might start seeing a surge at the same time that our immunity from our last booster doses of of COVID is surging as well in November and December so these are the things that we need to think about and look at what are the things that we can do individually and collectively to help mitigate that and prevent a surge on our health care system I'm going to talk really quickly about a seroprevalence study that was published last week and this is a this is a type of a methodology that we started Dr. Dono Soronski at the BCCDC has been involved in this and we put this together in 2009 to try and understand the impact of the H1N1 influenza pandemic and since the beginning of in March of 2020 we use the same type of study to help us understand serology and the patterns of infection in in our community so serology data so that looks at antibodies or anti in the blood in leftover blood at different age groups from people in the community it gives us a window on new infections and there's two things that we can measure one is the nucleocapsid and the nucleocapsid is a protein that indicates infection with SARS-CoV-2 the other measure that we can do is up the spike protein so we can tell if that spike protein came from vaccine or not so the anti-nuclear capsule nucleocapsid serology reflects new infections over a short period of time because we know that that fades as well what we saw in the most recent what we've seen in the seven snapshots that we've done across the pandemic is that we have very low rates of infection in the population over time so antibodies to the virus itself remain very low around 5% in most people until we started seeing increases in antibodies against vaccine which is great that means the vaccine was working and we saw a rapid increase particularly in older age groups but once omicron came on the scene we saw something different that it spread very rapidly and particularly in people who are vaccinated was causing milder illness that many people didn't recognize they're infected and it could spread more easily to other people and we've seen that reflected in the number of people who have evidence of antibodies against the virus itself and we now are about 60% of the population overall has evidence of being exposed to the virus having had infection which may or may not have led to symptoms or illness a severe illness and this is something that is not unique to bc we've seen this reflected across canada and the canadian immunoimmunity task force presented some data very recently that showed about 60% of canadians across the board have have evidence now have been exposed to this virus and have antibodies and that's about 18 million people but here in bc as well we look at the patterns by age and what this shows us is that those who are vaccinated early and had high levels of vaccination those who were we have targeted who were most at risk of infection had been well protected by vaccine so the rates of of infection related antibodies are much lower in older people also important for us to recognize that that means that we made to make sure that we keep boosting the antibodies and those people who are most at risk and why we need to target our immunization programs continually to target them on people who are older it also shows us that children they're not they have not had as much access to vaccine over time and particularly since omicron has come on the scene now have a very high rate of evidence of infection what that has not translated to is hospitalizations severe illness or or long-term consequences in children which is the good news still tells us the importance of people getting vaccinated and young people getting vaccinated even if you've had a previous infection because it can help prevent your your chances of reinfection and we see that with omicron particularly that about one in eight people who are not vaccinated who are infected with omicron don't develop enough antibody they don't what we call zero convert so they don't have that longer term protection so immunization is really important even if you've had a previous infection in the last few months the other thing that we've learned and it's reflected in this but in many of the other studies that we've done is that that second part of our immune system the cell mediated immunity remains strong even as the variants change over time and that's important that means that our that we continue to have good strong protection against more severe illness with vaccination and particularly even if we've had infection it can boost that protection as well so the bottom line is to protect ourselves and our healthcare system we all need to get our booster this fall i'm going to talk really quickly about how we understand what's happening in trends over time in in in bc we have a number of different things that we follow that give us what we call situational awareness or help us understand the trends that are happening i talked a little bit about the one zero surveillance study that we did we have a number of others that we do on a weekly basis we partner with canadian blood services we've been using the leftover blood from perinatal testing to help us understand in geographic areas across bc if we're starting to see increase in infection related antibodies we are also continuing to follow hospitalizations critical care deaths outbreaks and clusters and community settings in long-term care we have what we call a sentinel practitioner surveillance network where we use a multiplex test for people who go in to see a physician or clinic for respiratory illness you get tested for influenza a and b for rsv for para influenza and now for sars-cov-2 as well and we have over 300 sites around bc and we also partner with ontario kebac in alberta to have an understanding of vaccine effectiveness as well as the trends in in what is spreading where around the around the country we continue to use testing to help us understand the proportion of people who are testing positive and what age group and who's at risk for highest for more severe illness i'm going to talk just a minute about wastewater surveillance because that's proven to be a really helpful tool that we want to use for other things as well and it helps with pathogen detection we can use it for detecting whether we see monkey pups for example in and certain parts of the province but right now the most important thing that we've been using it for is trends in covet as sars-cov-2 over time and it's been very helpful for that and we use this as well to in our whole genome sequencing to see if new strains are arising so we are expanding the wastewater surveillance program we've been working a lot on this the team's been working a lot on this through the summer and on the the left hand side here this is just a schematic which shows the blue line shows the wastewater testing trends over time in the lower mainland and the yellow line is hospitalizations and this has been really helpful for us in that the trends precede what we're seeing in the impact on hospitalizations by about a week or so so it has been very helpful for us in understanding what what the COVID climate is in our communities so we are expanding to the island where Comox, Victoria and Nymal will be coming online in the next few weeks as well as Kelowna, Nelson and Kamloops by the end of hopefully the end of September and early October we are in negotiations and discussions right now to expand to a number of communities in the north where we also think it will be really helpful the challenge has been personnel people who work in the wastewater system there and how can we make it as easy as possible it's a very complicated process and what we do is take samples two or three times a week to get a better idea of what's happening because things can be influenced by rains by a number of other factors so those are ongoing and all of that data will be available on the dashboard on the BCCDC website and the other surveillance pieces we're going to make more accessible for people as well on the BCCDC website we've also evolved in and COVID testing and how important it is we're moving away from some of the standalone COVID testing sites that we needed when we were dealing with a different strain of this virus and now we have the ability for people to test at home the rapid antigen tests are available widely everywhere that people can use to help direct their own assessing their own symptoms and we do know though that we want to make PCR testing available to people where it might affect your treatment whether you're going to get into hospital or not whether you can access Paxlovid which is a treatment that's available for for COVID but also right now we're going to be testing for part of the surveillance is testing also for influenza because we have treatments for influenza as well we have a system set up knowing that in some remote parts of the province and other places access to healthcare workers may be a challenge so you can call in and be assessed whether you can access Paxlovid whether you're eligible for treatment and whether you're on medications that may interact with it we've distributed about 14 000 doses of treatment courses of Paxlovid already about 40 to 50 47 to 50 percent of people who access our pharmacists or physician assessments actually get Paxlovid and that's one of the challenges with the medication because it interacts with other medications people are taking but there is no issue of supply it is available across the board across the province for people as they need it and the rapid antigen test can be used to initiate treatment I think that's really important for people to know too so where are we now we know that this bivalent booster regardless of how many booster shots you've had in the past we want everybody to get it anybody adults it's available for adults over the age of 18 and for some higher risk teenagers if you've third dose or fourth dose or fifth dose the bivalent booster is the one you should be getting now we know that it protects against infection but that wanes off over time but does prevent against reinfection as well and we want people to have that boost in antibody levels as we go into November December January so now's the time to get it for people who are at highest risk and got that fourth dose in the spring the spring booster program you're coming up to five months now in October and we strategically plan that so that it is available for people and you'll be getting your your your invites to come and get your your bivalent booster dose and your flu shot in the next few weeks we know that it protects against reinfection as I mentioned as a reinfection with different omicron strains and it reduces your risk of having long-term complications from COVID and sequela for COVID infection really important we know we get a strong and quick response from antibodies to get us through this fall and winter season and we have less virus circulating that protects all of us even those people who are most at risk of severe illness and very importantly it helps protect our hospitalization our hospitals and our healthcare workers I do want to take a moment to speak directly to individuals who are at higher risk of serious outcomes of COVID-19 while the pandemic has challenged all of us in different ways for the group of people in our province who are severely immune compromised transplant recipients and their loved ones this virus has posed a very serious risk and as a result has created significant fear specifically due to that higher risk a primary goal of our pandemic response has been ensuring that people who are severely immune compromised those who receive transplants can access the most effective layers of prevention and we know from these data it's very clear the most effective layers of prevention against serious outcomes is staying up to date with your vaccinations and that's why those who are most at risk are routinely called up first for their vaccination in addition for those who are eligible accessing treatments for COVID-19 is another key layer of protection that we have now that protects against serious outcomes and I recognize for many people who are clinically extremely vulnerable there has been a fear and apprehension as collectively we have moved from all using the same levels of protection all the time for example the mask mandates to transitioning to individual layers of protection as we do for other respiratory illness and some people have even shared with me that they felt left behind are unimportant and at risk as we're moving through this phase of the pandemic and I want to say I honor your concerns and your fears and assure you that you are being heard and in response I also want to build your confidence in this new phase of our COVID-19 journey together and build confidence in the layer of protection and the actions that you have at your disposal including getting that booster dose of vaccine making sure you have the the means to get access to treatment and the areas that you can take to protect yourself and your family our data shows that for those who are fully vaccinated and boosted the risk of becoming very sick even if a child is in school even if you have children who are interacting and others interacting in the community your your risk of becoming very sick now has gone down greatly and that is the tremendous impact that we are seeing primarily of vaccination while some families with more vulnerable members may choose and will choose to continue to use additional layers of protection such as masks and keeping groups small we no longer require that of the whole community because vaccination community immunity and treatments involve offer effective protection against serious outcomes for everyone in this era of high community immunity and new COVID treatments the majority of people who are fully vaccinated and boosted COVID no longer poses that same risk of serious outcomes as it did at the onset of this pandemic and that means we can go back to safely doing a lot of the activities that we do and put COVID in the context of what we deal with every year in respiratory infections and I know that that's a challenge for many of us it's been a very difficult road for some people and we're working with BC transplant and with other teams of clinicians who provide care to people who are clinically vulnerable to make sure you have the information the tools and the access you need as we go through this period finally I do want to talk a little bit about influenza as I mentioned I have concern about influenza it's another one where we have a very effective tool to protect people from serious illness and that's vaccination so our provincial influenza vaccination campaign will start in earnest next week and for most of us the week of October 11th after the Thanksgiving long weekend we've started to receive vaccines and we'll be moving them out to people in the community and it'll be available in all of our pharmacies and community clinics by October 11th again this year it is recommended and free for everybody over the age of six months where we don't have vaccine yet for young children and this year as well we have enhanced vaccines for seniors and there are two different vaccines that have both been proven to be very effective in giving extra protection for seniors who need it and the flu zone high dose is available and we'll be giving it to seniors in long-term care and assisted living along with your bivalent COVID booster and for other people in the community it's the flu ad the adjuvanted vaccine is very effective at giving extra protection for community dwelling seniors so it is very important as another measure that we can take to protect ourselves to make sure we're not going to be passing it on to to people around us who may be more vulnerable and to ensure that we're taking everything we can to to prevent the risk of unnecessary isolation because of sickness over this fall season so what can you do we now have a very strong personal toolkit that we can all use depending on what's happening in our community so my job one of the jobs that we'll be doing is giving you a sense of what's happening with COVID as we move through this season as well as influenza and RSV and para influenza and the other things that cause respiratory illnesses that will be the COVID climate that we're in or the respiratory virus climate and from our surveillance data we'll know whether things are going up or down and what is the most likely thing causing illness in our communities and then on a day to day basis we need to look at you know what is the weather how am I feeling today one of the most important and very effective measures that we have is to stay home from and away from others if we're feeling sick and particularly if we have a fever having a fever and a cough fever and a rash those are signs that we might have an illness that's infectious to others it might be COVID it might be influenza it might be another respiratory illness we should stay away from others if we have those symptoms until we're feeling better we no longer have a fever and we're back to our usual activities the other things that we need to consider are am I up to date on my vaccinations and for now that means getting your bivalent fall booster for COVID and your influenza shot and then we need to look at you know what am I planning on doing if I'm feeling a little bit off and not that well today I'm up to date on my boosters and I'm planning on going to visit somebody in a long-term care home I may want to postpone that visit until I'm feeling better again if I'm going to a setting that's indoors and crowded with people that I don't know then there's the option of masking if I'm looking at what's happening in my community right now we have treatment options we know that we will never be able to stop washing our hands that makes a big difference it does protect us from a whole variety of infections we have gathering options that we can do depending on how we're feeling depending on our vaccination status who we're going to be with we can keep our groups smaller we can meet outside we can pay attention to ventilation and open spaces and airflow that's something we're doing in our schools and workplaces we can look at clean surfaces we can look at using at-home tests to help us guide our actions as we get through this our best protection is to get vaccinated and that's important right now to get us through to protect us to protect our health care system and protect each other as we go into the phone thank you very much and I'll turn it over to minister Dix you've kept the clicker though that's good news for everybody thank you very much dr henry thank you uh tall of your team and all the work that they do all the teams and all the regional health authorities and public health and the teams of the bccdc who assist us extraordinarily in our task of planning and preparing for the challenges of every season of the year but particularly for fall respiratory illness season i want to go to the next slide in a general sense and we talked about these numbers quite a bit and i have frequently in previous covid briefings that we have as a base bed capacity about 9229 we have what's called a surge bed capacity of 2353 but that is mitigated i mean the base bed capacity is basically what we fund in our core capacity in the system and in many places in particular in this past year well in land hospital for example the nine regional general hospital were well above our base bed compliments so what we try and do and if you look at those numbers as i do every day over the course of a week they tend to go from lower on monday to higher later in the week and they tend to flow between about 9200 and about 9450 beds occupied right now people our hospital census is in that range and we want and we think reasonably that our hospitals can reasonably accommodate not easily i can tell you and if you spend any time in hospitals as i do and have in recent weeks our hospitals are extraordinarily challenged uh in addressing this we can reasonably deal with about 9400 patients in in the hospital on a daily basis so we're planning based on the evidence and the work put forward by Dr Henry and her teams for additional potential hospitalizations this fall looking at the situation in the summer southern hemisphere looking at what we've seen in past seasons for example the 2016-17 influenza season which was very high which reached a peak of more than a thousand people in hospital dealing with influenza at a given time we have to deal with both COVID-19 surges in the community and other respiratory illnesses so if we go to slide 22 we see that well these are anticipated the actual volumes are difficult to predict but we have to prepare for all scenarios including the most difficult COVID-19 projections suggest up to 700 additional patients may require hospitalization in the coming months that means on top of the 350 we have now there's an expectation we might get to 700 and that is a significant number of patients influenza influenza projections suggest a peak of up to up to and it's important to emphasize that 1200 additional patients may require hospitalization at a given time their peaks those peaks tend to be sharper but again we have to prepare for that we're planning bed management to support bed availability based on moderate to high projections so that means planning for 1500 more beds that doesn't mean 10,900 people in hospital that means ensuring that we have room for those potential additional patients so our on slide the 23 our bed management strategies they're being refined to manage hospital capacity planning is underway to open up additional hospital bed capacity but of the currently admitted patients approximately 1300 of them could be cared for in the community and 500 are awaiting care home placements patients are being identified now for potential transfer to the community reducing hospitalization in case the 500 to 800 beds are needed this is an important step and we're doing it in different ways in different places we'll know that the new vista care home has been refurbished and that may be one place that we will be able to have people come there's there is capacity in other care homes around bc so that's on the care home side but the most important side of that is supports in the community to support patients who might be discharged from hospital but may need to receive and must receive uh outstanding care on slide 24 we talk about the operational task group that's focusing on improving emergency department efficiency hospital access and flow seven day a week bed management teams will be implemented to optimize inpatient bed utilization and we're going to continue to do as we have done in an extraordinary way over the last 18 months and continue to have enhanced air ambulance teams to expedite transfers when needed the worst case scenario of planning is underway we're at a last resort and we're needed and you've seen this in the past you saw this in march of 2020 you saw this in september of 2021 and then more broadly in december and january of 2021 service reductions including postponing non-urgent like scheduled surgeries could be required we obviously want to avoid that it's why we have increased surgical capacity so significantly in the pandemic to increase the number of surgeries we do when we don't have other high pressures on the community it's why wait lists have come down in the COVID-19 pandemic why we've done more surgeries this summer than in any other summer in history so that all of that work is being done and prepared for based on the evidence that dr henry has provided today based on our best expectations but also preparing for the outside of that which are worst case scenarios obviously we hope for best case scenarios and it's why i want to emphasize again that all of us have some power and some control over that we can get immunized against influenza immunized the bivalent vaccine against COVID-19 these are critical steps that we can take because it's not just the vaccine as exceptional as the development of these vaccines have been and these new vaccines are it's the vaccination it doesn't it doesn't do to have the vaccine in the bottle it needs to be in people to work and i want to encourage everybody for your personal health for your family's health for your community's health if we think of people who have worked their guts out in health care over two and a half years and how are continuing to do so and producing more care in health care than we have ever seen before against a very significant amount of demand we can all do something and that something is to get vaccinated against influenza get vaccinated against COVID-19 there are appointments available there if you have been invited please book an appointment and please get vaccinated i want to because it's our vaccine getting vaccinated that helps all of us make the difference that matters thank you very much and we'll be happy to take your questions thank you as a reminder to the reporters on the phone please press star one to enter the queue you'll be limited to one question and one follow-up please also remember to take your phone off mute as you are not audible until your name is called we will do questions in the room first there's a microphone there please state your outlet and you'll have one question and one follow-up hi penny daftloss from ctv news um you're talking about a two-fold increase anticipated in COVID patients but already through the summer we've seen so many in a time when we're not supposed to be seeing very many respiratory illnesses you're also concerned enough about a pandemic that you're removing patients from hospitals which is a really big move so i guess i'm struggling to understand why you aren't doing more to try to prevent all sorts of respiratory illnesses if they're threatened to collapse our healthcare system yeah so i think you know we are in a different place and the the the issue is that we do have tools at our disposal to do this ourselves and we haven't seen a massive surge in hospitalizations and that's that's key we have a high level now of protection but that protection may fade over time and we have things that we can do to stop that from happening and that means getting vaccinated boosting up that protection again over the next few months so that we aren't seeing a surge in hospital what we've presented is a possibility a scenario that we can plan to and we need to plan to because we have seen this and i think we have to recognize that viruses like influenza like RSV that you can't stop them from coming when we have a mobile community we have people moving around the world and they come in waves and we can take personal actions to try and protect ourselves and then we take communal actions so having my vaccine protects me and that protects the level of people around me and my community as well you have a follow-up i do yeah and perhaps this one's for the minister i mean we're at a point where we're already decanting hospitals which is incredibly serious i mean this i think is not a lot of people were anticipating to be back discussing this again at this point at the pandemic and i just want to know like are you trying to get more healthcare workers in has there been any tangible movement whether it's to improve working conditions or pay or anything else to try to incentivize some people to come back to help with what sounds like you're very concerned could be a really dire situation in the coming months well the short answer is we have and we will we have as you know through the hcap program and our other programs in long-term care added close to 7 000 healthcare workers to that sector which is an exceptional thing in a time when many people are talking about labor shortages and we did that by specific action to do that and it's significantly important we want to leverage those workers and others to ensure that people and it's not a question of decanting it's a question of ensuring that people who should be in long-term care get to long-term care so that those based in the hospital can also be there should we have a push of influenza should we have a push of COVID-19 that's just planning and that's what we need to do it's why we've added in the last number of years since i've been minister of health net net 38 000 healthcare workers but the demands on those healthcare workers continues to be significant and there are other there are other forces around including the 15 000 and 54 people last week most recently who are off sick which is five or six thousand more than normal and they don't happen in a uniform way that'll happen inconsistent across things and their people are most affected in places where one or two people can affect the service in a smaller hospital or in a smaller facility for example so we've added in the facilities bargaining unit association so we count this negotiate when 26 percent in four years we've added in the nurses bargaining unit but 18 percent we've added in the ambulance paramedics 27 percent and what you'll say to me and what people justifiably say to me it's not enough there is very significant demand and we need to respond to that demand and i'll have more occasion to speak in detail about not just the situation now in this fall this is the planning we should be doing now as we see what's happening in other parts of the world but over the next period of years the next five years when i present our health human resources plan tomorrow we have our next question please state your name and who you're with hi it's Andrea Wu from the Globe and Mail my question is also from the minister i wanted to ask you about lay times for cancer treatments in british clumbia which have been growing over the years due to staffing shortages and other issues as one example only about 20 percent of patients referred to an oncologist are able to get in for a first consult within the recommended two weeks and in some cases people are waiting two or three months or sometimes even longer this of course leads to disease progression a huge amount of anxiety in comparison in Ontario but 75 percent of people are able to get in in two weeks or less in your view what is the reason for these growing wait times and is the province doing anything to bring them down well yes and i think it's always important to look at all of the comparisons chi high compares on diagnostic care for example we've heard some about that in the last couple of days and bc has gone from some of the worst in the country is some of the best in the last few years because we dramatically increased that that's true in cancer as well where we've added pet CT scanners not just in vancouver but in cologne and victoria they do about 5 000 scams a year in that area so that's been a significant improvement what we've seen in the most recent period is really a surge we saw an immediate decline in in diagnostic testing and a request for pre-testing and other tests during one period of the pandemic and now we've seen a surge in that demand and we're working hard to meet that i think the broader question as well is it's our certainly our expectation as the number of people for example over 75 doubles between now and 2034 we're going to see a continued growth and in bc unlike other jurisdictions where they're expecting a decline in in the number of older people in the period after that in bc that will continue to grow because people especially seniors come to british columbia in large numbers and we expect they'll continue to do so so that being the case we have to meet the absolute test now and working hard to do that in terms of our testing and our response to testing and you see that in the massive increase in ct and mri capacity which is one part of testing and the very significant increase in pet cct scanning in the cancer system and we have to recruit dramatically because if you would expect a significant that kind of population increase given the number of cancers that are age related we can expect a 50 to 75 increase and that means we need more more specialist nurses more oncologists more support for the cancer system so we're facing a challenge now absolutely and it's our our goal to address that in the midst of many many challenges of demand in the in the short runs that are meeting the health care system and in addition we have to we have to grow and respond over the next 10 years significantly to what is going to be a very significant growth in in in cancer cases bc a study not long ago has the the third highest life expectancy in the world after 65 and that is wonderful news if you're you know within an eyeshot of 65 as i am and everyone else but that will present challenges for our health care system and obviously the fact that people want to be here as well is presents challenges those are good challenges to have because we want to have a place that people want to come to but on the other hand it puts challenges on our system do you have a follow-up spoken with four past presidents of bc cancer leadership together spins 25 years they all traced a lot of the issues that we're seeing now like capacity issues growing wait times staff burnout stress to a change in governance structure beginning with when the agency was moved under phsa in 2001 so some of their concerns they said they no longer have a direct line to the ministry of health some of the concerns that they raised were being ignored there was a priority shift from excellence in cancer control to fiscal management and that's led us to where we are now at least three of these past presidents resigned early because they felt that their hands were tied and they could no longer be effective at their jobs what is your response to them saying that this governance structure is not working that i that i think that we have and what we've tried to do across health authorities uh and across agencies that are so important such as bc cancer is to bring stability to those agencies you're quite right there was a revolving door particularly in the 10 years prior to my becoming minister of health and that's just back then that had an impact on bc cancer i think people in brish columbia are justly proud of bc cancer of the research work done there of the care provided and i know at a personal level and knowing who are getting care bc cancer how strongly people feel about the agency and supporting the agency so we've absolutely got to provide support and direction at bc cancer and so i don't think and you're talking about a structural change that was made under the previous government i don't think this is simply an issue of structural change i think this is an issue of significantly growing demand and us having outstanding leaders as we do now in dr kim wen chi uh outstanding leaders like dr david byers at the provincial health services authority who um who can lead us through this time but they need resources we need more oncologists and more nurses in bc in 2017 we were last in canada and registered nurses we were 10th and that didn't put us in a good position to deal with circumstances we're working to change that we've led the country in increase in registered nurses since that time but we were starting from a low base so we've got to continue to do that work because the demand is going to grow so i don't think it's just a structural issue although i'm always interested to hear the advice from people who were leading the agency i don't think it's just a structural question but i think it's it's ensuring that we have the resources and the plan in place so that our doctors and our nurses and our healthcare workers and most importantly our patients have the support they need when they need it any other questions in the room okay we will now transfer over onto the phone lines our first question is from richard zussman global news richard please go ahead for dr henry i think at this point it's hard to keep track what wave of covid we may be in what is the province projecting in terms of waves into the fall and could there be multiple waves of covid and at what point do we expect some sort of peak in terms of the combination between the flu and covid yeah so i think you're absolutely right richard it's i've never liked the the analogy of waves um covid is here and we see it going up or down depending on changes in the virus changes in the immunity in our communities it affected as you know different communities at different times so we are likely to see increases in cases in specific areas depending on when it's introduced to how what level of immunity we have and right now the modeling that we're you doing gives us some sense of of when we might see increases or surges so we don't think about influenza in waves and we shouldn't be thinking about covid in waves anymore it is now in our communities it's spreading it's still spreading right now there's a fair amount of it out there it's not causing severe illness in most people but as things change and the virus changes and our immunity levels change we may start seeing more to cause more severe illness in different people at different times so what we need to think about now is how much of it is around how much of it is in our community and then one of the things that i can do to best protect myself and those around me knowing how much of it is in our community over the next number of months so i i don't see it as waves what i see it is we're likely to see an increase and when we look at the modeling it may just crumble along like what we're seeing right now because people are stepping up and getting that extra protection to keep it from surging to higher levels over the next few months Richard do you have a follow-up for minister Dix and this extends on to what Penny was asking about but considering right now our healthcare system is at its max but we can't find staff in essence to do daily tasks where are we possibly going to find people to manage a surge and is it possible that healthcare workers could be moved from different areas of the province to address areas of highest need or from other parts of the system into hospitals like is that the sort of planning we're looking at because of the staffing challenges I don't think that's exactly it Richard last year as you know we we did support the northern region significantly with some support in terms of staff and other communities we have been and there's often discussion about how this is done but we support communities when they need support and and that will continue last year as you know it was a very significant thing in in 2021 and into 2022 where critical care capacity was overwhelmed in the north and we took the decision because we had a very high number of patients at that time the delta variant of concern unvaccinated who required critical care and we used the enhanced air and ambulance capacity to move those patients so so we didn't create the new capacity in the north we moved the patients to where the capacity was and we took actions on other things in the health care system to ensure that that it was available and that's the planning that takes place all of the time what we're proposing here is to create with resources in the community and in long-term care some reduction in the current levels of bed so we have capacity to meet the test that may come at the surge of influenza and COVID cases look we're in the midst of two public health emergencies we went within a few weeks from zero to 1500 contact tracers launched the largest immunization campaigns in the province's history we're in one right now yesterday and we want these numbers to be higher but yesterday between 24 and 25 000 people in vc were vaccinated against COVID-19 in the coming months we're hopeful that a couple of million will be vaccinated against influenza and again a little million more at least against COVID-19 these are all massive demands on capacity it wasn't somebody from somewhere else who who vaccinated me last saturday it was it was a public health nurse from Vancouver coastal health and so these these are the people that do all those works so the demands on health care to public health emergencies the largest surgical effort in history and the largest levels of surgery the largest levels of diagnostic care more primary care visits than ever before by compared to pre-pandemic approaching a million and a half more this year all of those things that we're doing and of course the public health emergency that we hear about every day that is the overdose public health emergency which creates pressures on everyone on our ambulance paramedics on our whole system so this is us preparing and managing looking at what we might expect and preparing for it and that means if we need to doing what we've done before which make very tough decisions for example potentially as we've done before for example this is just an example we're hoping to avoid that this year to defer non-urgent scheduled surgeries so that we have that bed capacity and we have those that staff more available because all of them are working flat out more available to deal with the surgeon patients that comes with a surge link to say a respiratory illness such as COVID-19 or influenza so that's the planning that we do we do it consistently and it doesn't happen some of the time it happens all of the time and so this is what we're presenting to people that we're doing this preparation we did it in 2020 and it really helped deal with some real challenges in that year in the sort of pre-vaccination fall season in 2021 in the very significant challenges of Delta which I think with the year passing with other challenges having come forward we forget about all the significant issues in long-term care which is why we added the HCAP program and added the some 6,800 workers through those programs and infection control in those sectors so that is the planning that takes place all the time and what it tells us is that demand is going to continue to increase and we've got to meet that demand by training more people doing a better job retaining people and supporting the people that actually work there recruiting people and redesigning our system so that we can use all of the resources in health care that vaccination campaign we're talking about very significantly done this year at a difference than the beginning of 2021 by pharmacists. Our next question is from Mira Vaines, CBC. And this question is for Dr Henry. How concerned are you about COVID restrictions being lifted for travelers to and from Canada considering past concerns you've raised during the height of the pandemic? Yeah you know I think we are as I said in different place right now globally and we have to balance the measures that we take and you know very early on when I thought about you know the unknowns and the potential impacts we made decisions to do more rather than less and particularly around we knew viruses were traveling with people and when people moved around they brought them with them and brought that risk with them and took that risk back from where they came and we now are in a different place because of vaccination both here and globally so it doesn't we don't need to have the same level of broad restriction so I think it is a timing thing that we're at a place now where the risk to the population here of somebody coming in with COVID is different and we presented that today we don't have that same level of risk and susceptibility and vulnerability across the board here in Canada because we've had such high rates of vaccination and because of the impact of Omicron over the last few months so I think the timing is right we've been having cruise ships for example who've come in and out of Victoria and we've managed that and we have the tools now to be able to get back to more normal activities so we'll watch and see and part of our job is to continue to monitor to see if there's impacts from from this but I think it's I think we can't expect that we can limit travel and the impacts that that has on people around the globe right now in the same way that we needed to when we didn't have we didn't know about the virus we didn't know what was going on and we didn't have ways of protecting ourselves particularly vaccination Mara do you have a follow-up? Yes and this is a question for a colleague Dr Henry you said that school can't be blamed for the spike in COVID transmission highlighted in your study how can you say that definitively given that we have no contact tracing that basically to speak of at this time? So when we look at the timing of when we're starting to see that increase and in infection related indicators and anti antibodies and really what we see is it's across the board it's not just in school age children and we have other different surveillance pieces we have studies that have shown that we don't see an increase in in COVID infections in teachers compared to age-related people who work in other professions in the community and there was a good study that we did in that with the partnership with the Surrey school district that showed that looking at taking snapshots of seroprevalence over time that teachers weren't more at risk we've managed outbreaks we had contact tracing in schools we did look at in different studies that we've done around the province whether school age children had more risk or less risk and we don't see schools amplifying transmission what we see is that kids in schools reflect what's happening in the community that people are more likely to be exposed in those everyday activities they're doing in the community and to develop COVID and now we know that the tools that we have protect us from having more severe illness protect us from having those long-term consequences and for children thankfully COVID and particularly home with Ron has been relatively mild for most of them and now that we have vaccine we can protect even those who are most at risk so we have many other pieces that help us put that picture together and the seroprevalence is one of them our next question is from Rob Buffham ctv vancouver island oh hi my question is for the minister minister i wanted to give your reaction to a situation in san it here on the island we're a terminally ill elderly woman who relies on care workers to come to her home to care for her that are employees of island health or conversely a business subcontracted island health two times in the past week these care workers did not show up and the company failed to tell the family that nobody was there to care for their mother i'm hoping to get your reaction to that as well as concerns from the family that says island health doesn't have their short staff when it comes to in-home care workers who they understand are paid less than those work in working in long-term care homes well one of the things we have done is the hcap program i refer to is is providing support for community health workers as well health care assistance to work in communities part of building out the important capacity because of what we want to do and what we need to do um if we're going to support our acute care sector is to have excellent service in the community i'm looking into the case that you've talked about and to the details of it i don't as you know as a matter of uh i think correct practice talk about people's individual cases but we're certainly looking into that issue and uh and i've asked island health to report to me on it rob do you have a follow-up uh yeah i do have a follow-up i'm hoping to get a minister's reaction to criticisms that bc has been dragging its feet in terms of approving uh drugs and that its system is redundant because the drug benefits council sort of duplicates the role that the national body does when it comes to approving drugs i'm thinking specifically of the cystic fibrosis community which was critical that bc was the last province or territory to approve tricafta for young children every other province did it ahead of bc and they say that's an example of this redundant process slowing getting these valuable drugs covered in in the hands of people who desperately need them would you consider streamlining our process and you know advocating to eliminate the drug benefits council or in some way speeding up the process here in dc um bc on tricafta was the national leader working with other provinces the key issue on tricafta was working with the drug company vertex to ensure that we got access to the drug and most places you're talking about we had access of course but expanding it to a new group of children who would get access to tricafta and they are getting that access in bc i think the difference in most jurisdictions was in a couple of cases some days but all of the provinces worked together as part of our pan canadian negotiations to to ensure that we could get access to this drug i'm very proud of our our group including those who work in the drug benefit council including those who work in the ministry of health our national leaders in that regard and it's why we've been able to continue both to take initiatives such as the biosimilars issues initiative to reduce um uh to reduce costs so that we can list and ensure that people have access to the newest drugs so i think the drug benefit council serves a very good job independently defending the interests of both patients and uh and ensuring that there's a public health lens on drug decisions we make they do a good job in that i think we're very similar to other jurisdictions on that question uh in a general sense uh what's our approach been on pharma care our approach has been to uh to increase access for people whether it's continuous glucose monitors for people take one diabetes or access to drugs such as tricafta and we're going to continue to do it there is a challenge though and this is a challenge that's a national challenge in canada and the federal government has talked about action here which is uh which is the challenge of expensive drugs for rare diseases we're seeing both the cost of those and the growth of those increasing dramatically tricafta is one of those talking about drugs that cost per patient are in the six sometimes seven figure ranges including number of the drugs that have been approved in british columbia and we need collective action in canada both to reduce costs and ensure that people who need it like people with cystic fibrosis get access to the drugs that they need and that means us working together with all the provinces we do that every day and that means the federal government playing its role which is not just to say it's legal to sell the drug in canada but to be uh but to work to support the listing of expensive drugs for rare diseases and they've committed to doing that and we're hoping and there's an upcoming health ministers conference which i invite you all to on the outside anyway in in uh vancouver coming up at the beginning of november and that's one of the issues that we'll be discussing this concludes thank you oh sorry no this concludes today's event thank you everyone for joining thanks very much