 Good afternoon, my name is Adrian Dix, to my right, BC's Minister of Health, and to my right is Dr Bonnie Henry, BC's provincial health officer. This is our COVID-19 briefing for British Columbia for Tuesday, December the 7th. We are honored to be here on the territory of the people of the Songhees and the Esquimalt First Nations, and with that it is my honor to introduce Dr Bonnie Henry. Thank you very much and good afternoon. Today we will be sharing our latest updates on our COVID-19 public health response and our vaccine program. However, before we get to the update, I do want to begin by acknowledging that yesterday was the national day of remembrance and action on violence against women. And this day of remembrance is also part of the international 16 days of action against gender-based violence. We know that COVID-19 has been a heavy burden on all of us, but for some it has been significantly more. If you have or you know someone who has been a victim of COVID-19, I would be happy to know that if you know someone who has been experiencing violence, please know that it is not right, and there are resources to help you. Call or text 1-800-563-0808 or contact victim link at victim link B.C. at B.C. 211.ca. That is all of us pause and remember the people we have tragically lost and speak out against gender-based violence in all its forms. Reach out to those who may need help. As you know, we have been hearing a lot lately about Omicron, the latest variant of concern that has been identified around the world. We had our first case identified here in British Columbia last week, and we are now up to five confirmed cases. So an additional four cases have been identified over the weekend. And we have a number of others that are suspect and pending that are out to be this new variant as well. And I think that is not a surprise, as we have said, once we start to look forward, it is likely that we are going to find it. We know this virus travels quickly and it travels in people, and when people move, the virus strains move with them. So we will be updating on a regular basis as these results come in so that you have an understanding of what we are seeing here in B.C. The five identified so far. Three of them have been fully vaccinated with three different vaccination programs. Two people were unvaccinated. They ranged in age from 18 to 60. And all of them are associated at this time with international travel to places like Nigeria, Egypt, a number of countries in South Africa, and Iran. We will continue to do whole genome sequences. We have a rapid process for doing that now at the lab. We have been building up our whole genome sequencing program from the very beginning of this pandemic, and it has enabled us to understand how this virus has changed over the course of the pandemic here in British Columbia. So we will continue to do that, and we will continue to do the wastewater surveillance as well that has been giving us an idea of how much of this is going to affect the parts of the province. And we will be putting updates into our bulletins and updating as well here on Tuesdays. Also late last week, the National Advisory Committee on Immunization released their additional recommendations on booster doses, and we are very pleased to see that these recommendations are very much aligned with the approach that is already underway here in British Columbia. And what we have seen here is that in the breakthrough cases of COVID-19, so cases that caused people to be hospitalized in particular, we were starting to see in people in an older age group, and of course, people over age 70 and over age 80 were the highest priority for our vaccination program, which started, which is kind of hard to believe, started a year ago this next week. And what we saw were that we saw an increase in breakthrough cases leading to hospitalizations in older people, and that's why we focused on that group first. At the end of September, we invited those clinically immunosuppressed amongst our clinically extremely vulnerable populations for an added dose. So this was a dose three to the primary series, and in order to better protect people whose immune system don't respond as well. So also in the Nazi recommendations on Friday, is the data that recommends that a booster dose be offered to people who have had this three dose primary series. So we will be doing that as well. So those people who received their three dose primary series will be eligible to receive a booster dose at six months after their third dose. And on October 26, we announced our booster program, which is designed to reach the entire adult population 18 and over, over the next six to eight months. We will also be continuing to watch the data on younger people, the 12 to 17 age group, and determine whether a booster dose is needed in that age group as well. As we said, the interval from dose two is projected to be about six to eight months from the dose two, with the goal to ensuring that those who are more vulnerable to breakthrough infections, who we were seeing having more people to receive their booster doses first, and as close to six months post dose two as possible. Since the beginning of the vaccination program and with this booster campaign, we have taken a risk-based approach, and we know that the most important risk is age. And we have looked at our own data. So what we have seen here in BC, what we have seen across Canada and internationally, which showed that different groups are at different levels of effectiveness, and we showed that data from the work done at the BC CDC and in Quebec that shows that six months, seven months, eight months, most people with strong immune systems, especially younger people, do still have good strong protection. And we see that in our breakthrough data as well, where it is very unusual for a vaccinated person under age 70 to require hospitalization. So that is why we focused on our long-term care. We knew this made a huge difference. And we are seeing that now. We are seeing the impact of our vaccine mandate for healthcare workers and the booster doses with the fact that our outbreaks in long-term care have gone from over 20 to now two. We have also provided booster doses to people over the age 70 who are living in the community, First Nations, Inuit and Métis people, 18 years of age and older in all of the province. And those people who received an initial series of vaccine that we now know doesn't have a strong and long-lasting and immune response. So those are people who received two doses of AstraZeneca and they are now receiving and there has been quite a few who have received it already at six months after dose two, as well as people who had a short interval between dose one and dose two. And one of the reasons is that we went to that extended interval quite early on. So there is a limited group of people, mostly elderly residents of long-term care homes and some healthcare workers who received a shortened interval at the beginning. And those people have been prioritized again to receive their booster dose because most of them are beyond six months at this point. We are also working through healthcare services, healthcare services, assisted living and care providers in hospitals because this group we know continued to be broadened. We know that there are the people who are looking after people with COVID now in ICUs and our COVID units and we are extending that as we move through this to reach all healthcare workers in facilities and the community and that started already and will continue over the next two months. To date, over 500,000 booster doses have been offered to those who have passed these priority groups. Those living in long-term care and assisted living have all been offered vaccination with the booster doses and over 90% of those over age 70 will have been invited by the end of this week. And we know that about 81% of those have already been booked or have received their vaccine. Starting later this week, on December 3rd, Nassie also added new recommendations that included those and that is a new for Nassie recommendation but it is part of the program that we have had from the beginning and one of the conditions that we were watching to see looking at the data was what is the interval they are going to suggest and the interval aligns with what we were thinking all along, that is at least six months since dose two. And I know there has been a lot of people who have been sending me notes about the number of people who have received the booster dose within. As we know from our program, the vast majority of people, particularly those under age 70, received their second dose in June, July and early August. And that is why our booster dose program has been specifically ramping up because we know that people will become due for this booster dose after six months and that starts for the most part in January, February and into March. So if we have finished with the highest priority group, the next group will be receiving their invitations very soon. So our goal continues to be to vaccinate the entire adult population with a booster dose at six to eight months. And again, the Nassie guidelines that came out last week, they did show that there is increasing evidence that waiting that extra bit of time, up to eight months, gives longer lasting protection from the booster dose as well. For the very same reasons that we saw of increasing the interval between the dose one and dose two. So we are ahead of our plan and we will be inviting those in the 65-plus at about six months, starting the end of this week and early into next week. So please wait for your invitation. It is coming. We are making really good progress with the next few weeks and rolling out as we know over the next few weeks. And the other priority group we are looking at is the remaining people in our clinically extremely vulnerable group, those who are not immunosuppressed but are at highest risk of having more severe illness. And you will be looking to invite you to come for your booster dose in the coming weeks as well. After that, we will focus as we did from the beginning on age cohorts. We will start to receive their invitations early in January and it will be mostly at six months and will go down from there. So we know that this is a strategy that will allow us to tailor our clinics to make sure we have the vaccine available for people and that will optimize the protection that you get from the primary series and get the booster dose at a time that optimizes the length of protection from the booster dose as well. And we are looking to make this easier as we come into this large group of people who will be eligible in the coming weeks is we are partnering with pharmacies across the province. We have been making sure that these participating pharmacies are linked to our VCs get registered system. That means that when you receive your invitation to get your booster dose, your local pharmacy will show up on the list and you can check availability. You can book directly through the get registered system. So anybody now who is going to be due for your booster dose in the coming months, you can check on get registered to make sure that you are in there and when you receive your invitation, pharmacies as well will be options for you and will have more information to share on this soon. The other thing I want to mention is people who wish to complete their booster dose will be getting second dose with an mRNA vaccine, but if you have had two doses of AstraZeneca, or if you are waiting for your second dose of AstraZeneca, we have been told that we will be receiving some. We were hoping it would be earlier this week, but it looks like it will be late this week or early next week and will be reaching out to people who are due for your second dose of AstraZeneca. If you are not sure anything by the end of next week, you can call the call center at 1-833-838-2323 and let them know that you want to go on the list for your second dose of AstraZeneca. We continue to advocate to get more AstraZeneca to meet that need for people. We have also mentioned that we have some Janssen vaccine and again, if you want to get on that list, we are close to 2,000 people who have already been vaccinated. Many of them have already been vaccinated using this vaccine, but what you can do again is call the call center at 1-833-838-2323 and we will arrange for your health authority to have that vaccine for you in your area. Finally, I know we have our new children's 5-11 program is well under way in the health authorities and we encourage parents to continue to register their children in the get vaccinated BC and to get their invitations and I understand for many parents this has been something that they have been watching and have some concerns and have questions and if you do have questions, I want to point to some areas where places you can go to get the information you need and I want to ensure people, these vaccines are fully authorized vaccines that health authorities have been working on. The vaccine has conducted a thorough review of the data and the research on the safety and effectiveness and we can trust that independent review. I am very confident in the safety and effectiveness of this vaccine and we have seen now that millions of children across the U.S. and Canada and around the world have been safely vaccinated in the last few weeks. The protection this vaccine provides is not only for children who have been vaccinated, but also for any immunization program, including these ones. If you do have questions, we have some really great resources out there for you. In particular, I recommend that you talk to your children and go and review some of these resources together. The first one I would suggest is going to the BC CDC website. We have a vaccine in children's tab on the BC CDC website. There is also some interesting facts for younger children that would be helpful about what it means and what to do at the vaccine appointment and what to do if you are nervous about needles and as well there is some really interesting stuff for older children about how vaccines work. I encourage everybody to take a look at those or to talk to your family doctor or your pediatrician, your nurse or your doctor to get the information you need to have confidence to protect your children. Finally, I know there has been a lot of commentary about the Omicron and what does this mean and there are many things we still don't know. This is our latest variant of concern and it seems like we are on this never ending uncertainty. As these new challenges emerge, this uncertainty can create a level of anxiety. Our minds, our brains, a poor uncertainty. It is one of those things that can cause stress and depression in people. We have been living with this uncertainty for a long time. It is yet another hill in a very, very long journey. If you are feeling anxious or depressed or hopeless, I encourage you to focus on what is happening now. Recognizing that we do know how to get through this. We have been through this before. This is our worst-case scenario and we know what we need to do to prevent it. We have the tools to keep ourselves safe, to protect ourselves, our families, and our communities. We know so much more about this virus now. Whatever variant, whatever change it makes, there is action we can take today and that is one of the things that helps us manage our anxiety. We have been through this and we know what to do. There are things that can help us on a day-to-day basis too. I know for me, things like going outside and going for a walk, doing a little bit of deep breathing and meditation. These are some of the things I have talked through with young people in my life in the last little while, with this anxiety that has come, with the not knowing what is going on, and sometimes a little bit of anxiety and fear about the vaccine. Remembering to do some deep breathing, to support others who are friends, support others who have been going through all of the things we have been going through together in this province. Helping out and reaching out to others and supporting others helps us too. Finding that joy in the small things every day, we need to remember to do that now with this uncertainty too. Rather than wasting that energy and emotion on wishing things were different, we need to accept and focus on the things we are doing today, that we can get through today, that we can support each other, and that we can see ways to use this energy to protect ourselves, whether it's getting vaccinated, arranging for our children to be vaccinating, getting our booster dose when it's our turn, wearing our masks, keeping our gatherings small, our family and close friends together. We have seen so much altruism supporting each other in our community and in our community. We have seen so much of this pandemic, but also the endless crises that we have been facing, and we need to continue to do that. This helps us all. It's what gets us through. Focusing on the actions that we can each take together and by ourselves is what we need to continue to do to get us through this pandemic and this phase now. Although the days may be darker, we are still reaching out and connecting with friends and neighbors, particularly people who may be alone or struggling. There is light in keeping our close friends and groups small, spending time outside, enjoying the things we can do instead of focusing on some of those things that are higher risk. Together, we will get through these challenges and we will do it by being kind and being calm and being safe. Thank you. Thank you, Dr. Henry. Just to start with, I want to briefly comment on the situation in Prince George. As you know, yesterday, the RCMP received reports of protesters at a vaccine clinic in the city and reminded the public of the new Access to Services Act. We recognize, of course, that there are differing opinions in society and people do have the right to express those opinions. We also have the obligation to ensure that the public and the public of the clinic patrons feel safe and able to access services and do their work without being obstructed or confronted or made to feel unsafe. Getting a vaccine can be a stressful experience for some children and parents. Needless to say, to begin with. And they don't need the added stress that being confronted presents. I know Northern Health appreciates the support and ensuring the safety of the public and the public. 91% more over 12, and everyone really understands the need to treat others with care and with respect. And that is why we passed the Access to Services Act unanimously in the legislature just a couple of weeks ago. And it's why we'll continue to work to ensure that people can, when they decide to be vaccinated, can be vaccinated safely and peacefully. As Dr. Henry has said six weeks ago, we announced in detail the rollout of our booster campaign, of our third dose campaign. And as Dr. Henry has gone through in detail today, the campaign has been, I think, extremely successful so far. And you see that in with respect to our outbreaks in long-term care and the assisted living and independent living and the difference that it makes with the vaccine mandates we put in place. Just to put, get people in some context, six months ago, B.C. had given 314,246 second doses. As of today, as of last night, there were 505,073 doses administered in B.C. So obviously, for the moment, we are ahead of schedule. Also note that there have been 4,253,637 first doses and 4,073,643 second doses. And importantly, and this is an important group, obviously, seniors over 70, now one-half of seniors over 70, one-half have already received their booster dose, which is good news. That group of individuals, 93% first dose, first dose vaccinated, 91% second dose. And now 50% third dose and those numbers we expect, given the priority that we have given to our elders in the vaccination process from the beginning, that that group of people, that number will continue to rise in the coming week. I wanted to note as well that the vaccine program for children 5 to 11 is moving forward well as well. We have 134,894 children registered in the program. 113,121 book appointments as of 11 o'clock today. And as of 11 o'clock today, 33,186 vaccines have been administered to children 5 to 11. So that is starting and it's going and I want to thank all of those involved in our vaccination programs. First dose, second dose, booster dose, dose for children 5 to 11 who are just doing an exceptional job of getting the vaccine out there who has gone to get vaccinated. It is a critical way. And as we've seen in the numbers, a critical way that we can deal together with the COVID-19 pandemic, keeping ourselves safe, our communities safe, and address the outcome of transmission and hospitalization in the pandemic. I want to just report on where we are in our acute care system today. The vaccination program is just to express our appreciation to pharmacists across BC. BC Pharmacy Association community pharmacists. As of yesterday, 1,150,244 influenza vaccines have been administered in BC. The vast majority of those have been administered in community pharmacy. For the first time last year majority, this year the vast majority of those influenza vaccines have been administered in BC. And community pharmacies are now significantly involved in our COVID-19 program. 214 pharmacies already onboarded into the program. 300 will be added between December 8th to 15th. And of course, more as I said, reaching the 1,000 mark in January. And they are playing a critical role. And I want to just say to everybody, if you get the opportunity to please express your appreciation and your support for this important role in this process, understand that these are exceptional times. And of course, community pharmacists have always sought to play an important role and they are. And that when you are working and maybe from time to time waiting for your community pharmacists, please show them all of the generosity and respect we show every healthcare worker. They are doing an exceptional job for all of us. And I want to just say to everybody in BC, there are 2,353 surge beds across the province. And the census as of today across the acute care system is 9,330, which means that even though the relative number of COVID-19 cases is in decline, our hospitals are extremely busy. In critical care, there are 510 base beds, 218 surge beds. And as of today, there are 476 people in critical care in BC. And regarding critical care patients transferred out of northern health and to other regions of the province, there have been 150 transferred to date, 117 of those patients are confirmed to have COVID-19. And of course, the vast majority of those are unvaccinated. And the message from all of that really is to support our healthcare system. It is important to get vaccinated. And finally, our weekly surgical renewal update. Health authorities reported 5,814 people in critical care in BC. Between November 7th and November 13th, we know that there is a statutory holiday for a member and stay in that week. And well, surgeries, of course, are continuing at a very significant level across the province. Roughly near where they are in previous years. There are some postponements across BC and there have been this week, November 28th to December 4th and there have been some postponements that we all know. So 219 non-urgent scheduled surgeries postponed this week, 100 in Fraser Health, 21 in Vancouver Coastal Health, 10 in Vancouver Island Health, 88 in Incarrier Health. No surgeries were postponed in the provincial health services authority or in northern health. It is important to note of the 100 postponements in Fraser Health, 85 were due to severe flooding and landslides impacting the province. Cumulatively from September 5th to December 4th, there have been 3,670 surgical postponements. And as our commitment all along, every one of those patients will get the surgery they need. Our commitment stands and the work that we continue to do across our health care system demonstrates that commitment. Two things matter right now. The first is that while we take some positivity drop, we absolutely cannot in this time drop our guard when it comes to COVID-19. And while all of the discussion of the Omicron variant is important and the work being done on that question here in British Columbia nationally and across the world is significant, we need to stay focused also on the here and now. And what is here in BC right now is the Delta variant. It is the Delta variant that seizes upon the unvaccinated to live. It is the Delta variant that is causing patients with COVID-19 to be transported hundreds of miles away from their families for care. And it is the Delta variant that affects our hospital, has an impact on our surgeries, and of course an impact and exhausts our health care teams. So if we haven't been vaccinated, we need to get vaccinated. If we have children age 5 to 11, we need to protect them by making sure they get vaccinated on the vaccinated website. Or by calling 1-833-838-2323. If you are eligible for a booster and get an invitation, we all of us need to get that booster. And of course we need to wash our hands and wear our masks and follow public health measures. And if we are thinking of having people over our home or going over to someone's home, we need to be vaccinated as well. That is part of what we do out of respect for one another in a pandemic. And that is part of what we do out of respect for one another in a pandemic. That is our now and with that, we are happy to take your questions. Thank you, Minister. As a reminder to the reporters on the phone line, please press star 1 to enter the queue. You are limited to one question and one follow-up. First question today is from David Mulco at CTV. In terms of the new Omicron cases, what can you tell us about the new Omicron cases that have been hospitalized, what regions and any cases that were caught by mandatory tests on arrival at airports? A lot of questions there. I'm sorry about that. Good questions. And so far they have all been mild cases or asymptomatic cases. Yes, some have been caught on both random screening and the mandatory screening at the hospital or at the airport. The initial case was one of the ones that was put in the border. And the first one was the one that was put in the border. And the second one was the one that was put in the border. So it was a person who was followed up on and tested again. So all of them have been mild. Nobody has been hospitalized. There has been no deaths. And they have been picked up in a variety of ways. And we will continue to see that. And so far we have had a lot of people who have been tested in Nigeria and Egypt where added and Malawi. And I'm not sure exactly what that number is, but it's somewhere around 300 or 400 people who had to come in prior to the on arrival testing. And now we are following up on people with the on arrival testing. David, do you have a follow-up? I do. Dr. Henry, last year about this time, you answered the question that we are not going to today, but I did ask what you wanted for Christmas and you answered, quote, for this to be over, end quote, and then you said for everyone to stay home, quote, so that we can get through to next year. So here we are a year later. We have got effective vaccines. We have got an enviable vaccination rate. And we have a new variant. So people wondering if they should gather together, if they should travel. I think the minister is thankful you are not asking me to sing because it is not my strength singing. But you know, what do I want this year? I think all of us want this. I think this year we have come through a lot. And I talked a little bit about that today. But we have seen so much positive in each other, whether it is dealing with this pandemic, which has underlined everything for this last little period of time. It seems endless. But look at everything else that has happened here in the province. We have had heat domes. We have had atmospheric rivers. Who had even heard of those things a few years ago? We have been, and I am just, again, amazed and grateful for the altruism that we have seen. People show each other through these hard times. So what I really want for Christmas is us to continue to work together. To continue that. To change this. To combat this unrelenting uncertainty with relentless kindness. And just to remember as we get frustrated and anxious and depressed in the darkness over this next little while, that we will get through this. And that it is being kind to each other that helps. It is recognizing that we have this common suffering and I am going on a bit, but this is important. Where I come from and I have said this before, we say common suffering builds strong bonds and we have a bond here in this province, in this country. And that is what is going to get us through this next piece. So let's remember to be kind to each other. To have all of those things that we know make a difference. Keeping our close friends and our family close. And yes, we need to go and visit our family who may have been affected by this pandemic and we need to be patient with each other as we go through this period of time too. Next question is from Rob Schott, check news. Doctor Henry, just on booster doses with half of seniors over 70 now having got their third booster dose, do you now restart the clock for a fourth booster dose for them in six months from now, is that your expectation that we are on a booster dose schedule that BC will plan for actively months in advance? Let me make that a qualified no. We don't yet know. But looking at the way this virus has mutated and changed over time, what we need to do is focus on immunizing other parts of the world. It is where this virus transmits rapidly amongst large numbers of people that these unusual mutations or mixing and assortments can come up. And it is because that we have low levels of protection of immunity through vaccination in many parts of the world that we all have to continue to be on our guard. This virus is going to be with us. That is clear. But if we can get protection through immunization to more people around the world, so vaccine equity is the other important part of this globally. And when we do that globally, the risk of having another mutation that is different, that escapes viruses or spreads more quickly, is what we need to do dramatically. So that is what our focus needs to be. So we don't yet know if there is going to be a need for another booster dose at all. What is the optimal program? It may be that for the future, getting a primary series at zero and six months gives you good long lasting protection. It may mean that we get a booster dose every two or three or five years. So those are questions that we will still be seeing evidence, and it's been great that we are seeing this from around the world, that increased interval between dose one and dose two gives longer lasting protection. And we are now starting to see that if you increase the interval between dose two and a booster dose, that it is probably going to give us longer lasting immune response as well. So we may not need a booster, that this booster may be enough to get us through next respiratory season or longer. But at the moment, we are planning for everybody getting a dose three over the next few months. Do you have a follow-up? Sure. For Minister Dix, a question from a colleague, on Monday, your government opened the urgent and primary care center in a squimalt at its permanent location, but it still doesn't have enough doctors to actually accept patients to the primary care side, a problem that is impacting some of your other centers as well. So why isn't it working to recruit family doctors and what are you doing differently now, if anything, in terms of an approach to attract them to these clinics? Well, what I can tell you is the urgent and primary care centers have been at God's end during the pandemic. They have been open. They have taken increasing numbers of patients. I can give you the specific numbers in terms of the number of people who have been hired both into UBCCs and into primary care centers, but it has been significant. Of course, there are challenges in hiring and staffing out. We have increased the number of family doctors in the last year in BC above the increase in population in the past three years. In fact, we have obviously dramatically increased the number of nurse practitioners as well. They have increased well above population. In fact, we have led the country and we have also led a number of registered nurses, all of which are important urgent and primary care centers. So I think the urgent and primary care center is in Esquimals going to be a big success as they have been across the province. There are challenges here in the capital regional district for two sets of reasons. One, we have the situation isn't static. Our existing core of doctors sees quite a few retirements, but I think UBCC is one of the biggest challenges. I know it is. Just as the one in Langford is, just as those in Victoria is, but not just those, the new nurse practitioner, the primary care networks, the investment in the primary care clinic, and so on. All of it is significant. One of the big challenges in primary care right now, and we have to face it, one of the reasons why UBCC has been important is that a lot of people over a long time have got their care virtually. That has big advantages in some ways. It has advantages sometimes for patients and they don't have to book as much time off for themselves or for their children to get appointments. It has advantages for doctors and of course, obviously, at adventuring the pandemic, we need to also as much as we can, working with the doctors of BC and nurse practitioners, restore in-person and have been fundamentally successful in BC. We wouldn't have, we didn't do them with a pandemic in mind, of course. We didn't start with them. They are 26. In fact, we are opening one in Cranbrook tomorrow on Wednesday, but they have been central to ensuring and give people primary care during the very challenging period that has been the pandemic for primary care. I want to thank everyone involved in the pandemic, not just doctors. It's doctors, nurse practitioners, nurses and pharmacists and mental health and addiction workers and so many more who are part of our health care teams. This is what we have to do. I'm very confident that the one in BC is going to be a big success. Next question is from Richard Sussman, Global News. Doctor Henry, I know it's a small sample size with just five Omicron cases, but with three of those people vaccinated, are you worried about the effectiveness of the vaccine against the variant? Can you explain to people, I know this is federal jurisdiction, but how are there unvaccinated people traveling into Canada potentially carrying Omicron? Are you worried that the border checks are not working properly and that people unvaccinated are being able to travel here and potentially bringing with them the virus? Yes, it is too small a sample size to make any indication at all about things like vaccination and obviously we are talking across the country and sharing information on cases as we are finding them. That is really the point we are at globally right now, how far has this virus, the strain of the virus spread? We are looking at it here in BC obviously through our whole genome sequencing program and across the country. Like many people, you don't have to be vaccinated at least at the period of time we were talking about, you didn't have to be vaccinated to go to some countries. That has of course changed as of the end of November when vaccination became a requirement to get on flights here in Canada. So Canadians who go places and return, they need to be tested, there is a testing and quarantine program and the unvaccinated people were part of that testing and quarantine program. And we are tested again when we had concerns about the omicron arising. So it is a challenge. I think we all want efficient travel. We all know there is reasons why people need to travel internationally and there is a variety of reasons why people do that. Clearly, clearly people should be vaccinated before they travel. And many countries in the world won't let people in unless they are able to travel to Canada. And we need to have a robust system for being able to test people on arrival and ensuring that that is done efficiently. And we are working with the federal government to try and ramp up that program too. Follow up, Richard? I do for colleagues here. And Dr. Henry, the Vancouver police department has made a decision not to mandate vaccine amongst their staff. Other police departments and first of all, we have a lot of mandate vaccine. Does that concern you at all? And there has also been a growing concern around rapid testing. We have talked about this many times before, but we are seeing other jurisdictions, even in Canada, strongly encouraging and making rapid tests accessible. Is there any chance that a rapid test will be more widely accessible before Christmas for people here in BC to buy it at a pharmacy or to enter some other gathering? So our program is focused on where we can use rapid tests to help address transmission and the public program here. So it is for people who have symptoms. And more and more we are learning across the country that using rapid tests for asymptomatic testing, particularly vaccinated people, has a very, very low yield. And so we are looking at what is the benefit of that. And there is a challenge in actually accessing a lot of the rapid tests. Yes, we have some that are useful in certain situations and we have been using them in a whole variety of situations that we have talked about before, whether it is businesses, whether it is investigating outbreaks and other things. So it is still unclear whether, and we are looking at whether it makes sense to have rapid tests available for people and we have been talking about whether we would have them for purchase for people. I think my focus is on where they make a difference in terms of a parent assessing whether a child should go into school today. We have been using them in more remote communities where access to PCR testing can be a challenge. People have symptoms and it helps us rapidly assess whether we have a COVID outbreak going on in different regions. And it is important that when we use these tests that they are available for people. So it is an evolving issue. And yes, there has been different pilot tests in different situations across the country around rapid testing. So not an easy answer to that one. Thank you for taking my question. This is for Dr. Henry and perhaps Minister Dix. I am hearing from parents about their COVID-19 vaccine bookings canceled because the government mistakenly booked them at pharmacies. Can you tell me how this happened and how many bookings are getting canceled because of this mix-up? I think there was a small number that I have heard about. We know that as we have talked about pharmacies are starting to come on board for booster doses and the booster dose is a different formulation. So the 5-11 formulation, the vaccine provided to our clinics across communities, some of the communities, the whole of community approach will have both the pediatric and adult vaccines and we have many that are specifically for children. So I know there was a small number that had mistakenly been booked into a pharmacy clinic and we have been addressing that with the call centre and with the online booking program so that it doesn't allow you to book a booster dose there because they don't have the pediatric vaccine in pharmacies and it is not our intention to have pediatric vaccines in pharmacies in the near future. The pharmacies are working with us to really support the big roll out of the booster doses that will be coming due in the coming months. Do you want to add anything? Do you have a follow-up, Stefan? I do. I'm also hearing from parents that the distance to get their kids vaccinated is unfair, especially for those without a car. Can you explain why the pediatric COVID-19 vaccine is only being offered at larger clinics and maybe an update on its possible widespread roll out at schools as well? So each community is being our public health teams on the ground and each community are determining where the best place for these vaccination clinics are for children and people that may mean a bit of a distance, but they are not only large clinics, small clinics, multiple clinics in different areas at different times. So we are trying to address the needs in every specific community and I know in some communities already there are school-based immunization programs, particularly in some communities where it can be a challenge for parents to be off and where we have heard that is a need. So we are trying to address all schools in BC because that is not the clinic type that we have heard that parents want and they are not the most effective. We did some of those for the 12-17 and most children and parents want it to have a separate clinic where they could come together. So there are some communities where that is happening and really what we are trying to do is tailor the pediatric clinics to the needs of the province and there has been some challenges, particularly in the last couple of weeks with the road closures, with snow closures, with a few other things. And getting vaccine to many different places has been a challenge. It has to be transported under very strict cold conditions. So there are all of these operational issues and we are trying to meet the needs of parents and communities around the province. So it will be a variety and it will be a variety of things. Next question is from Lizzie Eustaf, City News. Questions that we are wondering, did you mention that the testing, the wastewater, what are you looking for when you are doing that now? Do you expect to see all the clients show up? Is that what you are looking for when you are checking it? We look for a variety of things. It helps us understand if we are missing a lot of cases. We have large filtration plants, so Vancouver and there is a couple in the Fraser Valley area, the Surrey area as well. So what we are showing is that it actually moves the positivity we are getting goes up and down very similar to the test positivity rates that we are seeing. So it helps us understand if we are missing a lot in the community. And then a subset of it will do whole genome sequencing of the strains that are found in the wastewater. That is a very tricky process. The whole process, I am learning this myself, the whole process of how we do whole genome sequencing and how you get the sample. It is not a simple thing to do it in wastewater, let's just say. And our team at the VCC DC lab and Natalie Pristajaki, who is one of the scientists who has been working with the VCC DC website, they have done an amazing process of developing a process that allows us to accurately test wastewater. So that is something we have been following. And I know we have put some of the information up, but I will get a report to put up on the VCC DC website. Because I do think it is really fascinating stuff that helps us understand if we are missing things. And when you have a number of different systems for surveillance and they are all aligning, that gives us confidence that we know what is going on. Lisa, do you have a follow-up? Yes, heading into the holiday, I heard Minister Dick saying that Delta, Delta, Delta is a concern, but of course Omicron is getting all the headlines. But heading into the holidays, people are concerned about not going to see more restrictions heading to these holidays or is it going to be just keep it as small as you can? You know what, I don't intend to put on more restrictions. We have got the bases in place right now. We have got very high levels of immunization and it has been so great to see in some of those communities where immunization rates were low that as we got up above and it makes a huge difference, even a small percentage increase of protection in many communities and we are seeing that now in the north and in other places. So we have come down in the interior enough that we have now taken off those additional measures that were in place in the interior and it is aligned with the province. So what we have in place, wearing masks in those important indoor places, the indoor settings, in mitigating the risk, it doesn't get rid of it entirely but in those indoor settings, whether it is a hockey game or a theater or music concert, restaurants, it makes a difference that everybody in there is vaccinated that reduces the risk dramatically and we know that it reduces the risk of people having severe enough illness that they are going to end up in hospital. So staying away if you are not feeling sick, keeping groups small over this period of time as we are still having transmission across the province, wearing masks in those important indoor settings and that is one of the reasons why we added the religious services to this, knowing that that is an important part of celebrations over the next few weeks. So there was no mandate for mask wearing, it is important in those settings as well as more people come together. So the vaccine mandates that we are seeing in workplaces, particularly in healthcare, are also making a difference. Cheryl Jean, CK PG. Cheryl, are you there? Hi, go ahead. Hello. Go ahead. Okay. So Dr. Henry, I'm looking at the latest data from Northern Health dated December 1st and it shows that about 90% despite protests, about 90% of Prince George's residents are vaccinated. The problem appears to be the peace country, the Northeast, where a vaccination rate is around 50. So it begs the question, has the question being asked around here is why Prince George is under a health restriction when we are not part of the problem? I don't want to call people problems in any part of it. It makes a difference that it's up to 90% in Prince George and it's just got there quite quickly. And it makes a difference in every community where vaccination has increased. The restrictions that are in place across the North, which are slightly above what we're seeing, reflect the fact that we see community transmission take off in many different places and it reflects the stress on the health care system across the North as well. So it is a combination of measures that are designed to take us out of those woods yet and we need to be cautious and we need to be respectful of each other through this period of time so that we don't see it take off again in some of those communities. I don't know, Minister, if you want to talk about where we've seen some of the positive change. I think we have done well in Prince George because Prince George is an important center for all of the North. If you look at the Prince George service areas, two of them are rural and three of them are urban around Prince George, they have varying degrees of vaccination level. You're right that Prince George city central and Prince George Southwest, they're relatively high vaccination rates but I would say just in a general sense, across the North, over 12, you see that first dose immunization is quite a bit up, 82.9% compared to where it was, over five numbers yet because we're just getting started there. Those numbers are available as well. I do want to highlight because you mentioned the piece is a really exceptional effort. We're closing in or closed in on 80% in the Fort St. John area, for example, which is significant compared to where we were and reflects the extraordinary effort there. But we've got work to do and not just in the peace river but in the overall rate across northern health. And when northern health, when public health and northern health makes the decisions about restrictions, they're reflecting test positivity, which is about 12% in northern health and in the rest of BC, not counting northern health under 3%, they look at hospitalizations well. In the last week we have continued to move patients out of critical care in northern health and they look at immunization rates overall. So I think we're doing better. I'm very, very impressed about the effort, for example, in Fort St. John but also the effort in other communities, such as Kitimat, on the northwest side. The extraordinary efforts made in Nishka to make and to increase vaccination rates. So we have a very much higher variation of vaccination rates between community health service areas and then north and lower overall rate and we need to continue to raise them, including in Prince George and the region around Prince George. So what that tells you is that we're going to continue to work in that region to support our health care workers, to support our communities because when we talk about 119 people who have been flown south away from their families in critical care, all of them needing vaccines around them, and most of them unvaccinated, I think collectively we can do better and I think leaders across the north, regardless of their community or political party, have been a big part in making things better in the last few weeks, talk about 12% test positivity, you'll know that it was 20 at one point, so that's in the right direction but it's still four times higher than the provincial average. So if the numbers don't improve around in the region by genuineness and current order expires, is there an expectation it'll just be a perpetual order? No, you know, our whole aim from the very beginning of this was to do the least restrictive means possible to ensure that we were trying to find that balance of keeping the virus suppressed, protecting people from severe illness and death, protecting our health care system and allowing society to function as much as possible. So that's what our aim will continue to be and I talk with the chief medical officer and the team up in the north on a daily basis and we'll be doing reassessing things as we go and trying to do what we can to make sure that we are having the least restrictive means possible and right now we also know that every time we make a change it causes a lot of concern for people and we have a lot of uncertainty and I talked about that a little bit today with introduction of new variants and other things. So what we have in place now is to stay the course. We're on a downward trajectory across the province because of what people have been doing and that has been vaccinated, it means wearing masks, it means keeping groups small, it's been respecting each other and that's how we're going to get through this next little while and I want to get out of the order business as soon as we possibly can. We have time for one more question today. Thank you. Minister Dix, you talked early on in the briefing about the incident in Prince George but you didn't explain why these people were only warned and not fine. What's the point if they're not going to be fine and if you could also give us your thoughts on BPD not making vaccinations mandatory, Dr Henry didn't get to it. I think one thing that we have learned of course is that it is at the discretion of the public safety officers about how to deal with situations and so that's one option, there are other tools that they can use as well. In terms of the Vancouver Police Department, that is their responsibility as an employer to have a safe workplace and if they have the information that there's other ways to do that as opposed to requiring a mandate, it may be that they have an understanding of the vaccination status of their teams, they have other ways to do that as well. I would like to comment as with every employer, they have to do that assessment. I think we have set some really good examples with the public service agency and others in supporting people and understanding that immunization is the best way. It's the most important single tool that we have but it's not the only tool and there are many other things that we need to do to keep each other safe. I think the R-C-N-P responded promptly and made it clear to people what the law was and obviously it's up to them and others who enforce public health orders and other acts of the legislature, the law of course and other regulations in the province to use their judgment in these matters but I can say that bothering people with vaccine clinics especially, bothering parents with their children, bothering children is not acceptable and I know everyone agrees with that. With respect to vaccine management, make one point about the relative success of those in our health care system, those are the mandates that are in place by public health order and both in long-term care, we have seen the positive impact of them and booster shots in our community outbreaks on November 1 in long-term care assisted living and an independent living 2 in long-term care today, 1 in assisted living in Prince George at Laurier House and that demonstrates their value. It is employers such as the public service here across BC, the public services put its own mandate in place and 98% of public servants are vaccinated which is good news and I know the vast majority I mean the vast majority of police officers given where they live, especially where in health authorities, Vancouver Coastal Health with extremely high levels of vaccination well over 90% for those over 18 and both health authorities are vaccinated and up to their employer and to work through what the appropriate way is to make sure that workplace is safe. We see the vaccine mandates in order by provincial health to be very, very effective. Bell, do you have a follow-up? I do and this is for Minister Dix who is going to switch up a little bit here. It is quite a disturbing story that has been unfolding over the last few days out of BC women's hospital and that a person worked there from June 2020 to last June as a nurse but this person wasn't a nurse had no credentials or anything and since then this woman Bridget Clareau has been arrested and charged. Dozens, possibly hundreds of women are getting letters from PHSA saying oh, yeah, you were in the hospital during this time and they are looking for answers. They are not getting any answers. What do you say to these people? Well, as you will note, there is, there have been charges late so those issues will be dealt with in court. There is obviously a very significant review by the provincial health services authority as to how this happened and the kinds of letters you are talking about are appropriate actions in those reviews, obviously, it was completely unacceptable that the person could work under those circumstances and people at the PHSA who take their job and especially on that site at BC women and children take their job extremely seriously are obviously dealing with that, reviewing the circumstances comprehensively and there will be obviously a report out on that but I think it is at absolutely the obligation of the PHSA to inform people that this has occurred so that they know because not everyone would necessarily see it or see themselves affected in that way so that is appropriate as is a comprehensive review by the PHSA which is happening and of course the legal process is going on as it should. Thanks very much. We will see you next time.