 Good afternoon. I'm Adrian Dix, BC Minister of Health. Beside me to my right is Dr. Bonnie Henry, our provincial health officer in British Columbia. We're honored to be here on the traditional territories of the Songhees and the Esquimalt First Nations. Just to give you a sense of schedule for the next couple of days, tomorrow we'll be briefing at 10.30 in the morning. The briefing that has been promised about modeling. And that will be preceded by a technical briefing, an off-record technical briefing at 9 o'clock, and you'll get information from that. Members of the media will in by email. Later on tomorrow afternoon at 3 o'clock, we'll be releasing a regular daily statement, which will give information about case counts and so on for that day so that you'll have that information. And then at noon on Saturday we'll be back briefing. So there'll be one substantial session tomorrow where all questions of course can be asked. There'll be written information at 3 o'clock and then on Saturday there'll be a new briefing. So with that, I wanted to introduce Dr. Bonnie Henry. Thank you. Good afternoon. So a couple of things on the agenda for today, but first off, we have had 66 new cases in the last 24 hours, bringing our total up to 725 here in British Columbia test positive cases. That includes 359 in Vancouver Coastal Health, 241 in the Fraser Health Region, 52 here on Vancouver Island, 62 in Interior Health, and 11 now in the Northern Health Region. As you are aware, we have nine long-term care facility outbreaks that are ongoing. There's no change in that number today. And all of the stats stay the same with the exception of the two. One, the Lynn Valley Care Centre, we've had an increase in four residents and three additional healthcare workers who have tested positive. And in Harold Park, we have an increase of two residents and one additional staff member who's tested positive in that outbreak. All of the others continue to be investigated and managed. Of our 725 cases, we now have 66 people in hospital in BC, of those 26 are in the intensive care unit, and 186 people are fully recovered. We have no new deaths today, thankfully. A couple of things that have come out in the last day or so. One, of course, is one that you may have heard of. We have new prescriber guidelines to support people who use drugs and people who have issues with substance use disorder or addictions. And this is particularly to support people in places like the downtown east side who may be affected by COVID-19. And so these guidelines are to enable us to provide a safe supply for people and to ensure that they're able to comply with our public health advice around isolation or quarantine should that be required. So I think that's a very important piece to help ensure that we can support people in those situations as best we can. In addition, I mentioned in yesterday's briefing, I've made two additional orders under the Public Health Act in BC. One is enables health sector workers at all public and private facilities to remain at one facility only for the duration of the pandemic. This includes long-term care, assisted living, extended and acute care. So this is one of the key things that we've talked about is being a risk, particularly for our more vulnerable elders and seniors who are in care homes or in assisted living where we've had a patchwork system of care providers, healthcare workers of various different kinds who move between facilities. And that is one of the things that has facilitated movement and outbreaks in a number of different facilities, unfortunately, so far in British Columbia. So this will be really important to help support those workers to be able to work and to maintain the support that we need in those facilities with decreasing that risk. So decreasing the potential for transmission both between healthcare workers but also, most importantly, between facilities. The other thing that was announced earlier this morning which you would have heard is that Minister Farnworth has come out with a number of enhanced provisions and made it quite clear around the Provincial Emergency Declaration under the Emergency Programs Act. And I'm really pleased that he has done some things that have defined essential work for the province and this will help clarify things. As I know, a number of different municipalities were looking at different definitions of who essential workers were and what types of essential services we needed. As well, there are enhanced powers to enforce the orders that we have in place in British Columbia, whether they're orders for isolation, quarantine for people who have returning travelers. And along with that, the government of Canada has now determined that they are going to use the Quarantine Act to enforce a 14-day quarantine for all travelers entering Canada. So that became effective as of last night and we are and will be working with them to ensure that we can align our enforcement of these orders if needed. And I think it's, you know, which said before, although it was an expectation at the federal level, it has been an order for people here in British Columbia and we have had good compliance with this order, although in a couple of occasions we need to enforce it. So every day that we stay home, that we do what we have been asked to do, we stay apart but staying connected brings us a day closer to being able to manage this response. There are still many, many things that we can do and we should be doing together. We can connect with friends online, we can share stories about our day, we can share pictures, we can share videos. We can have celebrations together virtually and there's lots of those that have been examples lately of people having birthdays where their community can celebrate without having the physical connectedness that puts people at risk. We can all make a difference but we need everyone to be 100% committed to doing this. That doesn't mean 100% of people all have to stay in their host but each and every one of us needs to right now make that commitment to stay away from people who are vulnerable, to stay at home when we can, to go out for essential things only, to make sure that we are able to provide those essential services if you're a healthcare worker, if you work in a grocery store, we're depending on you but we need you to do that safely and that means maintaining the physical distance between people. But we also need to continue to coming together as a community and to do that virtually. So we need to take care of each other right now. We need to be kind and we need everybody to do their part. Thank you very much Dr. Henry as Dr. Henry has said we now have 725 confirmed cases in British Columbia that's up 66 from yesterday's report. 66 people, the same number currently in hospital that's an increase of 2 and 26 people currently in ICU. 14 people have died from COVID-19 in British Columbia. I wanted to update on a couple of facts that are occurring out there. First I want to thank the incredible current team of patient navigators and nurses at 811. For the first time yesterday we answered calls answered 5,070 and the average wait time yesterday was 5.3 minutes which reflects the extraordinary number of both new staff and the commitment of those staff that we've seen at 811 which is enormously helpful to people as they deal with both anxiety around COVID-19 and the reality of feeling sick in BC at a difficult time. I wanted to note as well and this is of interest I think to people that we now have more registrants in BC. People have come back and registered as doctors and nurses, 26 doctors and 248 nurses. And as well we have many care aides who have joined and rejoined in support of healthcare facilities in BC and all I can say and I want to speak for Dr. Henry and the premier and the whole government is how much we appreciate how much that demonstrates our shared commitment and the extraordinary commitment of all healthcare workers to the care of people in BC. Finally I wanted to note that we have as of March 26 as of today 3,903 total beds vacant in the acute care system in BC that the current occupancy is 63.6% overall. The current occupancy of critical care beds is 54.8% which is pretty consistent and the total vacant critical care beds are 371. Tomorrow we'll be Dr. Henry and Stephen Brown and myself will be providing some briefing on what we've described as modeling which is to let people know some of the models of what could be expected in BC including what we see based on BC data but also taking worst case scenarios. So what you're going to see tomorrow is our preparations in the face of what could be worst case scenarios in BC in comparison to places such as Hubei and Italy. There is obviously been a lot of concern and talk about personal protective equipment. I wanted to say that obviously there's huge international demand for PPE and a lot of disruption in what you would call the global manufacturing capacity and all the supply chains that all of us use that our primary focus is to protect healthcare workers and it's our determination to continue to do so. How are we managing that? Well by conserving and micromanaging our existing inventory and there's a number of steps we've taken to do that to ensure that the equipment is there and in place and prepared and can be moved around quickly for the needs of our teams and our staff and finally securing supply and sources of PPE. We have received and we are receiving small sources of supply both from the national government and the national bank of supply and also small sources of supply that we have received. Obviously we are working very diligently and have been virtually every hour of every day to also seek new sources of supply as well and that is I'm sure a situation of concern to all healthcare workers and we want them to know that we're thinking of them and supporting them every day on that question and there may be more questions about that when we have a question period. I want to just talk brief substance use disorders who are infected with have confirmed exposure to or otherwise need to self-isolate in the context of COVID-19. It provides a number of options for opioid use disorder, provides guidance for ongoing patient support and voice contact during self-isolation and for safe delivery of the medications in the context of COVID-19. We all know and you're all aware that British Columbia is facing two public health emergencies and this world-leading treatment protocol is strongly connected to both emergencies at the same time. A necessary public health measure to assist patients to self-isolate and help their community. As I said you'll be hearing significantly more from that and some detail from Judy Darcy and I can tell you that while the guidance protocol originated with the team at Vancouver Coastal Health it has been unanimously endorsed by all the stakeholders for the BCCSU including the Ministry of Health to adopt as a provincial guidance and I want to express my appreciation for the leadership of my colleague Minister Darcy and the whole team involved in that question. And with that I just say two more things one our continuing concern about care homes is reflected in the order made by the provincial health officer today which will be followed up by the work of medical health officers and a number of health authorities. It's critical to protect people in care and it's critical to ensure that people are not working in multiple care homes and that's the intent of that order and it's of central importance and I wanted to again express my appreciation especially to both providers of care both public and non-profit and private all combined and especially to the hospital employees union for their leadership. Let's say finally that what we do today matters physical distance and self-isolation and everything Dr. Henry is telling us to do matters. It matters today and it matters for the days the weeks and the months ahead this will be a difficult time as difficult as we've ever seen as a province but we know this if we do what we're asked if we do what is right we can take the steps we need to bend the curve to ensure that all of us have the resources to deal with this really unprecedented in our live times public health emergency the action we take today matter and you'll see this tomorrow as well there what will help us help save the ones we love perhaps tomorrow working apart we're standing together the distance between us unites us I've said it before I'll continue to say it Dr. Henry just said it to you we need 100% of us to be all in 100% of the time today and all the days and weeks ahead we have to work 100% as a whole society from each individual in every community in every corner of BC to the provincial government to the federal government to municipal government all of us have to be all in to do what we can to defeat COVID-19 that I'll take your questions oh wait one more thing there's a few words in French 66 new cases of COVID-19 today for a total of 725 cases in BC each health system in BC when patients reach COVID-19 359 is in Vancouver 241 52 in Vancouver 62 in the interior 11 in the north COVID-19 the health system the health system the health system of course of absolutely 1.5 1.5 1.5 2.5 1.5 1.5 1.5 1.5 We have the risk of transmission of COVID-19. I would like to thank you and we are happy to take your questions. Please press star one to enter the queue to ask a question and limit yourself to one question at a time. And please unmute your phones, you will not be audible until we put you into the queue. So, yes, always remember to unmute your phones. We will start with Cichordesco at C-H-R-Y. Go ahead, Lisa. Thank you, Dr. Henry. Almost every day you refer to cases at long-term care homes on the lower mainland. Without divulging the locations of towns or individuals, what can you tell us about the cases here on Vancouver Island? Are they in care homes or in clusters or are these a bunch of individual cases? So, there's a couple of things. We announced all of the outbreaks and we talked a little bit about this yesterday. We have a protocol that's going to be in place and we have a protocol that we have had for many years for outbreaks in care homes. And so that's part of what we are doing to continue that protocol. So, there have been no care home outbreaks on Vancouver Island yet and there's been a combination of people who have returned from travelling, some of them individuals, some of them have passed it on to close contacts. And others have been other community contacts. There have been people who have been positive for COVID-19. So, there is also, as we know, knowing more and more with the testing that we are doing, that there is community transmission both in Vancouver Island and across British Columbia right now. Next question comes from Matt Pryprost, Alaska Highway News. How many of the cases in the northern health region are related to travel versus community transmission and are you able to provide any details about perhaps how many people here in the north have recovered? I do have the number who have recovered. I believe it is one or two but I can get that for you. I don't have the data on whether they are all travel related or not. I know the initial ones were but my understanding is there has been some exposures. There are five recovered cases in northern health. So that is good news. There is a mixture of close contacts as well as travel related cases that I am aware of in the north. Next question comes from Ian Mulgrew. This is for the minister. It is about the cancellation of scheduled surgeries which means that about 3,000 British Columbians a week who have been waiting to have diagnostic treatments to find out how far cancer might have spread as well as those who have been waiting to have treatment are now living with both the fear that their situation is deteriorating but also with fears of the virus. I wonder if you might speak to some of their concerns and when scheduled surgeries might start again and what plans you have to make in the backlog or will they just be put back into the lengthy queues? I think Ian I have spoken about this four or five times. I think it is of all the decisions that have been made since the beginning of this. This was one of the hardest because what we call them elective surgeries as you know they are scheduled surgeries and they are all important. The appropriate space in acute care hospitals and ICUs in critical care units is a necessary step. It is a step that was not taken in other jurisdictions. It is dealt with an influx of COVID-19 patients while their hospitals were at 100% capacity. That is not what we are prepared to do in BC so we prepared the situation and I would note that had that happened then obviously in the last election and I should say that in every hospital assessments have been made because some surgeries defined as scheduled surgeries are urgent especially in oncology and so those surgeries continue to happen. But you are correct. We are talking about the cancellation of thousands of scheduled surgeries which will tell you in the opening up effectively of hospital beds that tells you how seriously we take the situation, how seriously we take the need to be prepared and how difficult these decisions are not just for hospitals and doctors and nurses who are not doing the work that they were born to do that they have done to restore life and movement to people who were waiting for surgeries not just to them but of course the many people who will be affected about this and yes, in this area as in many others there will be once we get through this and it is going to take a while once we get through this urgency and getting back to work in every area and health care is one of the most significant ones. We operate this time of year in general a health care system in the acute care sector at 103.5% which means we are going to the max all the time. We are going to be able to restore those surgeries and get back to work because that will be a huge priority and the cost of delay will also have been felt in the months where things are delayed. My heart goes with them. I have been in touch with a number of people who have been in touch with people who have been in touch with people who have been in touch with people who have been in touch with a number of people who face this circumstance and I have to say many of them have been extraordinarily courageous but also obviously they are worried and concerned and have all the same anxieties that we have about COVID-19. Next question is Victoria Chang. Ming Pao. Hi. You mentioned that there are patients under age of 10. That is China. That is a trial. So do you have any updates for these trials condition right now in the hospital? I don't at the moment but we can provide some more information about children tomorrow in our briefing. I don't believe the person is still in hospital. But I could be wrong. Next question comes from Simran Singh. Go ahead. Hi, Dr. Henry. With the increase of cases we are at our park entrance, could you please explain what carers and nurses are doing in that center when they come home to their families? Should they be self-isolating? How do you best suggest they do that? Especially if they live with their kids or their partner? So people in the care homes there are processes that we are putting in place around the outbreak. So yes, we do ask them to stay away to go directly home to stay home and stay away from others. If they do not have symptoms we still feel that the risk is low for others. But because we know it's a high risk setting we are asking people to take measures to prevent transmission to others. And there are ways of doing that. We have been supporting people. I know it's an incredible challenge for some people. And I know some people have taken that step of having their children or their family live elsewhere or staying with others during this period of time when we are going through this because of the concerns about the risk. Next up is Lisa. Go ahead. I'm wondering with this issue of social distancing we are seeing people flying into airports. They are not distant on the plane and they are not close to get to the airport. How is that being managed? We have had lots of issues about talking about who gets on an airplane and who gets off an airplane and how it's all done. That is of course managed by our partners in the federal government particularly the Canadian border service agency. And I know they have been taking steps to make that more efficient and effective in terms of distancing, physical distancing in those settings. That is a challenge. They have as you know restricted flights coming into the country to four major airports including YVR and the processes that they put in place have been ramped up. I keep hearing stories particularly not all of the flights from the U.S. or from some of the Sun destinations go through those four airports and there is a variety of ways that people are managed in those settings. It is one of those challenges. We know that it's only for a short period of time and we have been encouraging them and assisting them ensuring they try and put in the best measures possible in hand hygiene making sure people are screened is something that is happening and now it will be mandatory if anybody has symptoms they will be quarantined at their place of arrival and if they don't they will be directed to isolation and told how they can get to their place of residence so they will not be allowed to go on public transit for example. There are more restrictions coming in but it is a challenging environment for sure. Keith, ball during global news. Dr. Henry I know we are going to get some pretty bleak numbers tomorrow with the scenarios but yesterday you said you were heartened and the vaccination numbers didn't go up as much as they had the last couple of days and today was barely an uptick on that front as well. Do you continue to be heartened by what you are seeing on hospitals? I don't dare hope at this point. We are still very much in the first incubation period from when we started putting in these restrictive measures. There are people out there who are incubating this disease. We know there has been transmission. We have been in the hospital for five to six days and then I will maybe if we continue this way. But there are many things that can happen. We can have an outbreak in a small community. We can have a hospital outbreak. There is so many scenarios right now that I, you know, we take it day by day. And I guess reinforces again there are many things that we need everybody to do because this is the time where we can make a difference. The physical distancing is something that all of us have to take seriously right now because that is our best buffer. It's our firebreak. It's our firewall. So that we can put out all the little sparks that are happening in our community now based on what occurred five, six, seven, eight, ten days ago. We are able to do that better and we can try and control this in a way that is going to manage the ability to care for people both in the hospital with COVID-19, but everybody else who needs health care as well. And the only way we can do that is everybody committing to taking the physical distancing seriously and continuing to do that on a day-to-day basis right now. Vonn Palmer, Vancouver Sun. Go ahead, Vonn. Question for Health Minister Dix. You said a while ago that you would update us on the number of medical supplies when they got here, not when they were ordered. And I'm hearing reports now of the states that some of their manufacturers and suppliers are telling customers with regret that they can't fill their orders. Is British Columbia hitting that problem and is that why you said today that really we've only had a small increase in the number of supplies and we've not had any update on the numbers you gave us 10 days ago on the number of ventilators in the system, for example? So I was going to say that 15 ventilators that arrived yesterday and that's what we're going to do. We're expecting another arrival of ventilators tomorrow, but until they actually arrive they're physically with us, Vonn, and we won't be announcing anything. So yes, we're making small progress with supply. You know that the federal government has in some ways had the lead for Canada in seeking out international supply and I know they're working very hard on that. We don't just depend on them, we're making our own significant efforts to seek large supply as well. But a lot of there's lots of countries that export medical equipment, but two of those key countries of course are the United States, which is going through what everyone can witness now if they watch any kind of American television and China, which has gone through and has sort of come out, especially in some regions outside of Hubei Province, come out of the COVID-19 crisis for the moment. And those are key suppliers, but COVID-19 is in 100 countries in the world. And so the challenges that we face, the challenge everyone's facing, so that's why we're taking steps locally. We're doing everything we can to use the equipment we have properly to extend out the time we have with our equipment and we're making enormous efforts every day to seek more supply as well because that's got to be our commitment to the healthcare workers, all of those healthcare workers who out there preparing for COVID-19 patients are working with COVID-19 patients in the community are in acute care and we're doing our best to make sure that we're doing our best to make sure that we're doing our best to make sure that we're doing well. But you're right, the disruption in the United States is significant and the disruption in other parts of the world is significant as well. And so with that in mind we're giving it absolutely everything we have. Next question comes from Cheryl Jean, CKPG. Go ahead Cheryl. Yeah, obviously a shelter is a challenging situation and there's been a number of different ways that people have been trying to address it at the same time trying to meet the needs of the people who are in that shelter. So I know some of our shelters have closed because they've not been able to put in appropriate things like being able to distance, being able to provide the appropriate cleaning products, having a plan for the community if need be but there's a lot of work going on to try and support that. I think when we have been thinking about shelters and the population in the shelters and the workers in the shelters our real focus is on prevention and preventing it from getting into that environment and so we're taking measures around that screening people. It's as we say a challenging thing. The other part of it though that we have to remember is that in many cases a person's only home for lack of a better word and so we need to make provision so that we can support people and do it as in the safest way possible but it is as you indicated it's a challenge and especially in some of the larger shelters I know there's many different ways that communities are looking at this some of it is moving people into smaller settings so that there's not as much people in smaller settings and here in Victoria they're looking at some of those provisions as well. Gail Johnson Go ahead Gail. Thank you Dr Henry my question pertains to babies so children under one year of age we're hearing occasional stories of babies either being tested for or diagnosed with novel coronavirus in one case out of the UK apparently the baby's mother and care provider initially passed on to her child what should a parent or garden be looking for and when should they have their baby assessed? Good question as we know most young children seem to be less affected by this but there have been case reports as you say very small numbers of infants who have been affected by COVID-19 and some of them severely affected so I think the same thing applies if you have concerns about your child to make sure that you connect with your care provider and ask about the issues particularly if you have had contact with somebody or have been in an environment where COVID-19 and I say that because we have now several public places where we know there's potential exposures so it's really challenging and it is a discussion that needs to be between your care provider and yourself and then in public health we can facilitate testing if it's needed. Next up we have Victor Kaiser Radio Kamloops. Victor? We're going to move on to Richard Sisman Global News. One of the questions that we've received Dr. Henry or potentially for Minister Dix is around custody battles and what the recommendations are for people who may be in their homes and whether that's recommended and considering the courts aren't open how is there guidance on doing that if there's potentially concern from one parent or the other that the home isn't safe in terms of protecting from COVID-19? That's a very challenging question and it's not one that I can give individual advice on although the courts may be closed there are ways of connecting with the legal system to address your own particular individual situation and really that's the advice that I have to give. There's no way I can say it blanket it should be one or the other. We do want to try and minimise exposure so it has a lot to do with how you can effectively care for children in those environments and every situation is very different. So I know my colleague in Quebec said they should stay away from COVID-19 but I'm not sure it's that simple. I think there is a lot of things in family dynamics that need to be worked out and my advice to people is to try and work it out in a way that makes the best sense for the children. Next question comes from Amy Smart from the Canadian press. Go ahead. Hi there. If we do reach our capacity to address COVID-19, how will doctors in DC make those decisions and is there a framework in place to support them? Yes, there absolutely is. This is something that is near and dear to my heart for a long time. Looking at what happened during the SARS outbreak and other things. So an ethical framework about how we approach these questions, incredibly important questions that we have developed in H1N1. We have refined it during the Ebola crisis in 2014. And we have used that background with a very strong group of clinical ethicists in our province that we have had ongoing discussions with over many years and I raise my hands to them. We have a really strong group of ethicists in this province who have assisted us on this. I think in January when this first started, I tasked them with looking at developing the framework that we can use and adapting the framework for COVID-19 and then addressing some very specific questions. One of those is around personal protective equipment and the other one was around ventilator and decision-making about who will get scarce treatments if that comes to pass. So we do have a very detailed framework. I thank all of my clinical care, my nursing colleagues who were involved in developing this framework. It does have a whole protocol for how we will manage this so that no single individual physician or clinician will have to make that decision on their own. There is a system that is being set up for clinical decision-making, ethical decision-making at each hospital that's involved and also a provincial strategy, a provincial, we call it a tripartite appraisal. I'm sorry, I can't TATT but I can't remember what it stands for. But we have people at the provincial level that include myself and a critical care lead, a nursing lead who will be imposing if we need to the framework and it will be under the specific circumstances and it is all laid out by the considerations that we have, the ethical principles that underlie the decisions that will be made. So it is and I want to reassure my colleagues because this is something we worry a lot about in healthcare is having to make that decision on our own. Next question is from Nick Eaglin, Vancouver Sun. Those ethics frameworks will be posted publicly once they are finalized. Go ahead, Nick. Hi, Dr. Henry, I'm sorry if there's any more details we can share about the state supply, like when that's going to happen and how that's going to be delivered to people. So this is a guideline for providers, physicians and clinicians who are supporting people who are living with addictions and substance use disorders. So it's to support them and how to make those decisions. So for example, I know that there are people supporting them and being able to support their clientele, the people who are living in that community. And there's also backup support from the rapid response team to be able to support the individual and the clinician in making sure this can all happen in a way that's safe. So the guidance is quite specific and I know it will if it's not already released publicly. It's been distributed and I think you'll expect something soon, Nick, from the Ministry of Mental Health and Addictions and it will be widely distributed and I think as far as I understand it, you'll be seeing it this afternoon. Great, and we have time for one more question. Devon Badal, Black Press, go ahead. Hi, there. I heard earlier this week that health officials in the UK announced that 3.5 million antibody tests have been ordered. Can you say when or if these tests have been approved? No, we are absolutely looking for an antibody test. There is still a lot of what, there's a lot of research going on about an antibody test and what an antibody test lets you do is determine who was infected. So right now the test that we have that is being used around the world to detect cases is one that relies on detecting the RNA of the virus and saliva in particular and other body fluids. And that one tells us the virus is present. So what an antibody test does is it lets me know one week or two weeks later if I had the infection. It's a measure of your body's response to the virus. So when I'm infected with a virus my immune system develops what we call antibodies to try and bind to that virus and kill it so that it can't create a virus. So an antibody test is not helpful in diagnosing me right now if I'm sick, but it is helpful in helping us understand where in our community people have already had this infection. So we are absolutely looking for an antibody test. There's been a number that are still experimental and I know I think it was Iceland or Finland was looking at doing some broad antibody testing as well. So we have already started with the VCCDC to take bits of syra, so blood that people have donated given to the lab for a whole bunch of laboratory tests and we can take that anonymized syra and we have it as a baseline and then we can do testing in three months, six months once we have an antibody test and see what proportion of the population has actually had this disease. So it's no helpful right now in determining on a day-to-day basis who's infected. But yeah, we're looking for it. That's all the time we have for today. Thank you.