 good afternoon everyone before I begin I'd like to acknowledge that we're gathered on the land of the Lekwungen speaking people of the Songhees and the Esquimalt First Nations my name's Adrian Dix I'm BC's Minister of Health my right is Dr. Bonnie Henry BC's Provincial Health Officer we're here to provide an update on the health care professionals vaccination reporting in October 2021 Dr. Henry created a new order that requires all professional health colleges to provide personal information about their registrants to the Ministry of Health this order impacts 18 colleges we've made the commitment to share the aggregate vaccination rates by professions and this is why we're here today the goal of sharing this data is to make sure members of the public have the general vaccination information they need to help them make informed decisions as they seek treatment or services from a regulated health professional data that we're reporting on today are for 17 of the 18 colleges about 94% overall have been vaccinated or are medically exempt so on a note on the 17 or 18 side we're not reporting data from the College of Nurses and midwives today but you do have very significant information we know that the vast majority and I mean the vast majority of nurses work in the public health care system and the vast majority of those of those nurses have been vaccinated to the tune of 99% so when those numbers are introduced finally into these numbers we'll see them go up not down the nurses are extremely well vaccinated in BC for those of you keeping track keeping track of these things the highest level of vaccination is the College of Dietitians followed by the College of Physicians and Surgeons in BC at 98% it's expected as I say the data for all things including nurses will be available in in the coming weeks and just remind everyone that nurses represent about 46% of all those in health professional colleges so they're about the rest of them are about 67,000 the nurses are about 63,000 that's why it's taking just a little bit longer I want to say two things just finally and then I'm going to hand it over to Dr. Henry the first is that about just under 80,000 78,362 people in BC have received their fourth dose of COVID-19 vaccine that the priority in the month of April was long-term care and those who are clinically vulnerable who had received in effect their first or their third vaccinations soonest over this month of May we're going to see a very high number of those over 70 reach 182 days and then be eligible for their fourth dose dose vaccination we're going to have a week next week in fact when 75,000 people over 70 reach that level and they'll be all be invited to be vaccinated and as you know there are hundreds of locations across BC and the hundreds particularly in community pharmacy some from health authorities and community pharmacy and we encourage everyone I'm got your first dose get your first dose and happily I'm happy to say about a thousand people have received their first dose of Novavax since it's become available and more are coming every day and got your second dose get your second dose if you haven't got your third dose get your third dose that's more than a million people invited who haven't got the third dose yet and of course for those over 70 those who are clinically vulnerable for those who are a long-term care or supporting people in long-term care that's that's vital as well so with that it's my honor to introduce Dr. Bonnie Henry to share a few words thank you very much it's been a while thank you as you know we've been on a long journey around this around the vaccination and we have safe and effective vaccines that have really changed the game for us as you know in October we issued an order around hospital and community health care and other services COVID-19 vaccination status and that meant that people can be reassured that in our public health care system across the board from hospitals to community to long-term care settings and public health settings everybody who they receive services from is vaccinated and protected and these orders have helped protect our health care system by ensuring that we have that high level of coverage in these essential health care settings and I just want to express my gratitude to my colleagues across the board for stepping up we also recognize the important role of health care providers not covered under that order and that's why we put in a place this information primarily firstly an information status and prevention measures order that applies to regulated health professionals so BC as in many other as every other province in Canada has a regulated health professionals act that creates what we call a college and I'm expressing this because I've had some people explain to me that they're confused about what this is about so the colleges so the College of Physicians and Surgeons for example is the body that's responsible for licensing and establishing standards of practice for physicians and surgeons in the province and the same happens for the other 18 colleges that we have in British Columbia and they have an important role of as I said establishing these standards of practice ensuring that people who are licensed to practice as a regulated health professional meet the standards for licensing and their primary role is protection of the public and this is what a profession is is having a self-regulating body with the focus on protecting the public so I've been working at my office have been working with each of the colleges to first understand the vaccination status of all of the registrants so all of us who are registered and licensed to practice and then to develop the standards so that we can ensure people can make their own informed decisions about whether to receive in-person services from a regulated health professional so not surprising to me much like other British Columbia residents there is a very high degree of COVID-19 vaccination coverage amongst all regulated health professionals in British Columbia among practicing regulated health professionals 93.9% of completed the two dose at least two dose vaccine series or have a medical exemption from my office as of April 25th so as the minister indicated we have not yet got the final numbers from the College of Nurses and midwives and this is because there are so many registrants and that is a process and I've mentioned this before that it was a lot more challenging than we initially thought in terms of being able to link people and then determine and have the colleges reach out to each of the registrants for whom they did not yet have information on vaccination status so the aggregated data that we're putting out today likely underestimates a little bit vaccination coverage mostly because as we mentioned the College of Nurses and midwives have had some challenges in getting the status and there also is we have a column where people are either known to be non-vaccinated or for whom we don't yet have information and as you are probably aware there's new registrants new people coming in to practice in different parts of our health system in the every year and every month and so it takes some time for those to be updated. But we do know as was mentioned the College of Dietitians so people who work in our dietary world across the board and the College of Physicians and Surgeons are the highest rates at 98% and the College of Occupational Therapies is close behind at 97% and we've put out a list so people can see and this will help you understand that the levels of immunization are very high in most of the registered health professionals. Practicing registrants who are least likely to be reported as fully vaccinated are the College of Naturopathic Physicians, the College of Chiropractors and the College of Traditional Chinese Medicine Practitioners and Acupuncturists and there's some variation between each of the regulated health professionals amongst those colleges but I will say that I am very proud that all of these are very high rates of immunization and I think we can be reassured that across the board regulated health professionals understand the value of vaccination in protecting both themselves, the people they work with and the people we care for. We will continue my office to work with each of the colleges to ensure that we have standards in place so that people will be able to make informed decisions as they seek treatment from individual practitioners across BC. So because we have this very high rate of protection from vaccination it has meant that we have weathered this Omicron storm over the last few months without overwhelming strain on our health care system that has been seen in some other jurisdictions but it has not been easy in any way and I cannot imagine where we would be if we had not stepped up across this province to thank everyone who did their bit by getting vaccinated. This has allowed us to remove restrictions and get back to more of those important essential social and other activities that we love and to come together again but we know that hospitalization and infection rates from the data that we put out they've leveled off somewhat but we are still in this pandemic and we know there are still strains on the health care system and as we come together more frequently with more people the virus has more opportunity to spread and we are seeing that I don't think there's anybody that I know certainly not in this room I don't believe who hasn't known somebody who has had most likely Omicron in the last few months. We also know that the protection from two doses of vaccines or from recent infection does wane over time and particularly for milder infections it is it is still a very strong protection that we are seeing against hospitalization and severe disease but now is more important than ever to get that booster dose and I encourage everyone who has not yet received that dose to get it now it is not too late if you've had a Omicron infection in January February you're now at a point where you need to get that extra boost as well. We continue to see circulation of BA.2 and particularly the strain that is even more infectious the BA.2.12 we see that in certain areas of the province more than others and we are also seeing some other variants like the BA.4 and .5 which are seen in other jurisdictions as well. What we know now in reality is that three doses of a primary series of vaccine is needed to protect against Omicron and yes it does increase our protection against infection even mild infection and it also boosts that protection of against severe disease and protects you from some of the long-term complications of COVID-19 that we are seeing even young people with milder illness can experience. I also would encourage everyone who is 70 or older First Nation Métis and Inuit Peoples in British Columbia 55 years of age and older and people with immune compromising conditions so our CEV groups to get their second booster or fourth shot. We know that also makes a difference right now. We need to be aware that the SARS-CoV-2 virus is still circulating around the world and I don't need to say that. This virus is pernicious and it's changeable so while the level of immunity that we have from recent infection and from the high rates of vaccination we have here and the fact that we're entering the spring and summer season where we know there's a bit of seasonality to this virus spread means we will likely have some reprieve in the next few months but we need to plan for what's coming and particularly I'm concerned and working with my team to look at what are the the possible scenarios that we may face given our situation our our demographics and our immunity levels here when we get into the next respiratory season in the fall we will need to manage influenza we're starting to see a bit of it now but influenza will come back in the fall now that we're traveling more now that we're connecting more and we'll have on top of that the usual things that we see like RSV and also COVID this virus is going to be with us for some time we do not yet know if all of us will need another dose of vaccine come the fall or protection from the three doses we'll carry most of us through and only some people will need another dose those are the the things that we are planning for for the future we're watching closely and we're planning for how that will happen now we have come through this latest challenge because people in BC have continued to take those measures to protect themselves their families and their communities our weekly surveillance reports gives you the sense of what I call our COVID climate you know where we are facing what are the trends that we're seeing right now over time and then every day we need to monitor the weather in our own context that means asking ourselves am I up to date on my vaccinations how am I feeling today if I'm not feeling well I can use the rapid tests that are available and I encourage people to pick those up they can help but it also is about taking that that that responsibility to say if I'm not feeling well what am I doing who am I going to be with and maybe I need to postpone a visit to an elderly relative until I'm feeling better or if there's people in my close family or social circle who I know have COVID then we need to take a step back from some of the riskier activities if I'm going to be in an indoor place with a lot of people for that I don't know for a longer period of time then bring a mask and wear a mask that will protect you and it helps protect others we are transitioning through this emergency phase of the pandemic but we still need to be vigilant and we still need to be aware of the things that will we make a difference both for us personally and for those around us we're not through it yet but we do we are making a difference and we need to continue to support each other as we have throughout this very long storm with compassion and with kindness thank you we're happy to take questions thanks very much to media on the phone line please press star one to get in the queue if you're not already there we are going to go to questions in the room first if you are comfortable in the room with lowering your mask while you ask a question it's easier for us to hear that way we're going to start with Richard Zisman vaccine questions on both ends of the spectrum in Quebec they have opened up fort doses for all adults now why is British Columbia not doing that in terms of the oldest British Colombians are you concerned about the uptake so far in fort doses and on the flip end is there any update from Ottawa on vaccine for zero to five year olds and and whether we may be getting any news at some point that they are eligible for vaccine yeah so there is a little bit of news I'll start with the second one and it's it's not zero we do know that the developing immune system probably doesn't respond to vaccination and and has some protection from from your mother or your up to about six months so the we do know Moderna has put in to Health Canada submitted data for six months to five years of age so that is the next one that we're likely to see Health Canada has just started looking at those data and it often takes several weeks to months it has not been approved for used anywhere in the in the world yet but it's good to know that that's coming the Pfizer version is as you know the you may recall the FDA had asked for submission early on in the fall of or in late winter but it turned out that the formulation that was being used for the six months to five year olds because was was not giving a strong and immune response with the two doses so they have added a third dose and they are not yet at the point where they've submitted data for for the outcomes of that yet it may be by late spring early summer they may have that so it is potential that will have vaccination for younger kids as probably maybe even as early as late summer so that's something to look for in terms of why we've put the cut off at 70 we looked at a lot of the data of who was getting infected who was having waning immunity over time and they also the program that we have around clinically extremely vulnerable which is different most other provinces have not identified that group of people and we look at our hospitalization data so who is it that is vaccinated with three doses that is ending up having more severe illness and it is people with severe clinically immune compromising conditions so people with solid organ transplants for example hematologic malignancies and so they need an extra boost an extra dose and we've also seen that there really is very good protection from three doses for most people up to age actually really up to age 80 but definitely up to age 70 and we see a little bit of an increase in hospitalizations over age 70 people who've had three doses and it bumps up again over age 80 so those are the people who got immunized first so their immunity is going down more quickly and as we get older our immune system fades away a little bit more quickly so that's where we're targeting this fourth dose and we need to find that balance of whether you need it and whether how long the protection will last and so for our data here in BC from the program that we've had with the intervals we've used it really is those groups of people who are most at risk and where they need that short-term protection so what we're seeing from other countries is that that fourth dose that second booster does give a boost up in protection against infection and also stimulates a stronger protection for more severe illness and and deaths but it also wanes again over time so what we want to do for most people who still have really good strong protection from their third dose and again i'll say if you haven't got that third dose go get it now that protection is good enough to get us through omicron and very very highly protective still for people staying out of hospital and preventing severe illness i think Dr Henry did a good job on sub questions two through six there but um i just i would just just say just on the first one i think you asked about how it's going in terms of take up i mean principally the focus has been on long-term care and on the first the first group of people who are clinically vulnerable people who have immune challenges i think in the latter group we've actually had quite a high take up and we'll report on that soon in terms of long-term care we're going through systematically as we did in october of 2021 the long-term care homes i would say overall the take up is slightly lower for fourth doses and for third but the real question will come in the coming weeks and we want to really encourage people who are over 70 or who are invited for their fourth dose to get it and all the other people because the big vaccination task is still all the people who haven't got their third doses yet we want to really encourage people to do that and also to say to others that Novavax is available and people who were considering that it's available you can call 1-833-838-2323 and and connect then the BC Pharmacy Association they'll be in touch for an appointment for Novavax so that's where we are now and we'll know more after these big bolus sort of big groups of people who are who are seeing who are going to be invited in the next two or three weeks we'll have a better sense of those over 70 probably on or around June 1st Explain why more than 600,000 doses of vaccine have had to be thrown out and why not then fast-track and I know it's sort of separate but could you prioritize groups like pregnant women for fourth doses to try to get more people vaccinated and then also for minister Dix I want to get a sense separate on the regulated colleges what sort of tools will be at people's disposal to understand who's vaccinating who isn't if they go to an office so in terms of wastage there's a there's a whole bunch of factors that go into that and actually our percent of vaccines that have been wasted are very low which is great as you know very early on when supply was an issue we were very focused on that a small percentage of the the 600,000 or so doses that have been have been expired they came to us with an end date that was relatively short and some of them have expired most of that we tried to give back through covax although we've also been able to make donations canada has donated quite a lot financially to covax so we're very aware of those issues but the the reality right now is that we have sufficient vaccine and when we have more providers so once it's out in in the community in pharmacies and the uptake is slow one-on-one that means that you may have wastage they have been trying very hard to to book people in at a time where you can use the whole vial but it is more important for us to make sure that people get their dose and don't get turned down for a dose then to preserve every dose in the vial as it was so critical very early on so I think we're very mindful we're very mindful of the wastage and we're being very careful about it the vast majority of it is now because there's not enough people to get the vaccines and there's several doses per vial that may be lost through pharmacies for example in terms of the regulated health professionals and I'll ask that and pregnant women see when I talked last time about you know age so we are not seeing breakthrough in pregnant women who have their three doses or pregnant people so we do again encourage people to get that first booster dose the third dose that is making a tremendous difference in prevention of transmission of infection and and there was a recent report out of Israel that sewed as much as 85 percent in the short term so that protects you from getting sick and it absolutely protects you from getting really sick so anybody who's pregnant needs to get their their third dose there's no need though as far as we can tell in terms of breakthrough infections etc for an additional booster dose at this point in terms of the regulated health professionals we are working at with each college about how to build that into the professional standards about how to notify somebody and I the the overriding interest is patient safety and making it safe for people to ask those questions so there are several ways that it could be it's for in-person services that we receive from a health care provider and it may be things like when you called a book an appointment you're asked if you have a preference to see a vaccinated or unvaccinated or makes a difference to you for those clinics where that's an issue so we are trying to work out those details in a way that protects privacy but also gives agency to people to make those decisions because it may be different depending on my risk and depending on what's happening in in the community so if we see rates go up in a community and I'm somebody who's more vulnerable then I may opt not to see somebody for an in-person treatment or postpone that if there's a time when there's a lot of circulation of virus on the other hand if I've just received a booster dose and I'm not particularly vulnerable it may not be as a decision that I'm I may not I may choose not to postpone a visit for example Katie D'Rosa Vancouver son can you give the percentage figure for the naturopathic practitioners of chinese medicine yes uh so the college of chiropractors 78.1 percent college of naturopathic physicians of bridge columbia 69.2 percent and the college of traditional chinese medicine practitioners and acupuncturists was 79 percent can you speak to why do you think it's so low and what can you do to boost that yeah so this is you know part of this I know in my discussions with the registers of the colleges are you know some people have been reluctant or slow to respond to the colleges need for this information so it is probably an underestimate as well we know that some regulated health professionals have views about the vaccination and we have only recently had alternatives to the mRNA vaccines available for some people and that's an important choice for some practitioners so this will change over time and I hope that seeing this and seeing that the vast majority in every regulated health professional will be reassuring to people and will help people um have that discussion with each other about the importance to the profession I would say and um all of the detailed numbers will be shared with the enterprise release and in addition to that will provide the list of the list of the number of registrants so you have a sense of the size of these health professional colleges I think be valuable I say this so the group of people that will be I think um most unhappy with those results are the vast majority of people in those three colleges who are vaccinated will be the naturopathic physicians who have first volunteer became part of our vaccination programs for example in Vancouver coastal health and in Fraser health and all the people who work in that sector they'll be disappointed with that because um all of if you look at the 18 health professional colleges and nurses will be well north of 95 percent when those numbers are released they are now in our numbers for the health care system all of the health professional colleges except those three are in the 90 percent range and I think those are are very good results and I think those numbers will be higher there and the vast majority of people in those three professions are vaccinated and I think it's that group of people which will may have more concerns with some of their colleagues who have for whatever reason chosen not to be vaccinated and uh but that's the reality we're facing the public can see that now and um and you know all of these professions have robust debates within them I'm sure and I'm sure this will be a subject of discussion amongst all of those as we seek to raise vaccination rates amongst every group in society thank you we're going to go to the phone now and first question is from Justine Hunter thank you um Dr. Henry do you believe that the public should know whether an individual practitioner is vaccinated or not it sounds like privacy has come a button in the way of that level of disclosure yeah so what we are working through is how to make it so that it's not uh a personal disclosure personal information in a way that protects um the practitioner but the overriding public interest is patient safety and that is our overriding interest so it has to be done in a way that doesn't put a person who has concerns about receiving certain services in person um and wants to make that informed decision themselves doesn't put them at a disadvantage and I say that in a in a way um we one of the um programs that we've talked about a lot is it's okay to ask your healthcare provider if they clean their hands well I know that many people including when I was supporting my grandmother in law when she was in hospital she would never ask because she was afraid that it would somehow be uh held against her or that she didn't have she was afraid to ask those questions so we don't want to put people in those positions particularly people who are feeling very vulnerable so I am working with the colleges and we all have the same goal to make sure that people are comfortable receiving those services and feel safe to do it so we're working through the details of what that will look like but it will be a process that will do its best to protect the privacy of individual practitioners but give people the information they need to make an informed decision Justine do you have a follow-up I do thanks Dr. Henry I just from reading your work over the years I think you've been a real advocate for vaccination of medical practitioners and I'm just trying to get a sense of whether your objective here is to ensure that an individual can find out whether a practitioner that they want to see is vaccinated or not or whether you believe that the privacy rights of those practitioners is a higher value like everything nothing is simple on this and and yes there's I've done a lot of work on things like blood-borne pathogens in health care workers infected with blood-borne viruses and the risk to the health setting so and it there is ethical principles around protection of privacy that are very very important and there's principles around patient safety that are that trump everything so it is finding that balance and I don't know there are ways that we can do that we've done it for you know surgeons who are infected with HIV for example people who have hepatitis so we have models that we can use and we're just working through how to do that. Next question is from Lisa Yuzda. Hello Dr Henry and this is I'm going to get a bit personal but I know that there's a lot of people that want to know as you said like we all know someone who's had COVID and we're wondering have you made it through so far without it or have you had it and what was your experience? No I I've managed to clean my hands enough I guess and wear masks in the right places but now I have not yet but I I do know that I've been around people that have and you know I think we see the results of vaccination and how protective it is but we also know that you know people who have a lot of contacts with many different people I will say in the last few weeks I have done more things it was slightly terrifying at first but going out to I was able to go to the opera for the the here in in Victoria a couple of weeks ago and you know it was just I think for me personally and I know for many people that I hear about missing those things that gave us joy in life and we went through a period of time when it was so hard and we couldn't get together with people and we couldn't hear live music in a theater with others and that is so important for we're we're social creatures and we need that connectedness so I think again we've always tried to find that balance of the negative consequences of the measures that we have in place and being able to do the best that we can to protect people through this and I know it's been we're all on our own path in this and some people are more or less anxious to get there but I think we're in a reasonable place right now and I just encourage people to continue to be kind to each other and to remember those moments of joy that have gotten us through this past two and a half years. Lisa do you have a follow-up? You said earlier you know that we are still in this pandemic but often you know you go out to stores or to the hockey game or things like that and it really doesn't look like it anymore. I'm wondering do you think that in general we're doing okay and still responding in an appropriate way and that we'll be able to bounce into a different place if we need to in the fall or do you have concerns? You know I'm always concerned but yeah I think the fact that we have vaccinations has led us to this place and we only have to look at places like Hong Kong and Shanghai to see what can happen if you don't have that level of protection that these vaccines have given us they are a magic bullet. They're not perfect and so that's why we all need to to do that day-to-day assessment of where we are but we've done this before we used to do this if I'm not feeling good you know don't go to school today or don't go to work today stay away from that big gathering if I'm not feeling well we need to be even more cautious about that because we know this virus is still out there and thankfully in most people now because we have this level of protection from vaccination they're not getting severe severe illness but some people are still getting long COVID for example including children and we've seen that be a problem so we need to be extra cautious we need to to take those measures that we know help and you know check ourselves every day how am I feeling today maybe I need to stay away or do this remotely and just be respectful of that as we go through this next period of time I think we're going to be in a period of relative ease for the next little while but we all have to pay attention to to what might happen in the fall and if we look at data around the world I mean it's it's shocking to think but there's close to a million people now who have died in the United States at least recorded and probably more and if we look around Canada you know we have not had that level of of of devastation and tragedy but we've had a we've had enough so we do need to be cautious as we go through this and we need to be prepared that we're going to see a surge in the fall and there are things that we'll have to go back to to remember about how we can do that I hope and I expect that we'll never have to put in orders that require people to do those things like we did when we didn't know what was going on over the last two and a half years but we will rely on each other to take those measures when we start to see things going to increase in transmission again you know I I would say Lisa that we're in a very challenging period for the health care system it should be said though that we have similar levels of people off sick and a lot of us and the principal difference between now and other times was COVID-19 as we did in January which people recall was at the height of the Omnicron variant of concern I think you can draw two conclusions from that is that it's very challenging when you've got compared to the normal time this week we had between 17 and 18,000 people who missed at least one day doesn't mean they're off sick all day but at least miss one day as a result of that across the health care system and that's a significant number of people now there are always because it's a huge health care system a huge number of employees a lot of people off sick but this presents challenges for everyone else and I think as well you're seeing because of what's happening in society a return to health care as well in a dramatic way just at this time so I think people have to keep in mind that it's happening the second thing I'd say though is some extraordinary things are happening in spite of that consider that and consider that we had one of our most most recent reporting period the most significant number of surgeries that we've ever had in the BC health care system in spite of that it shows how dedicated how hard people are working on producing the best possible outcomes but this is a this is a challenging time because the pandemic is still here it's still having effects those effects are different but they continue to challenge our health care system and health care professionals and health care workers everywhere next question is from a rob Monroe hi Dr Henry thank you for this I just wonder in the the numbers for the colleges is there any breakdown for by health region I know the interior health region is about five percent below the rest of the provincial average in terms of greater vaccination so is there that kind of difference here as well the colleges no we have not broken it down the colleges are are a provincial level entity so I'm afraid there's no no breakdown by by regions at all do you have a follow-up Rob you'd also mentioned about the the BA 2.12 and it's coming up in certain regions of the province and again concern the interior sometimes has led the way in some of these things and is that a problem here you know what there there has been an increase in the 2.12 and I I'm just trying to remember the latest whole genome sequencing you know our those pictorials we have with the different colors it is on the VCCDC website and there has been slight variations in different areas of the province of which strain we're seeing and yes we are seeing some of the BA 1.12 in in the interior and I believe the island was the other area where we saw the most but I can check on that for you next question is from Rob Buffham oh hi thanks for taking my question my first question is on behalf of a colleague and it's directed I think primarily to minister Dix but if Dr Henry wanted to weigh in would be great too it relates to the the rally with nurses on the lawn going on right now in front of the legislature who are expressing their concern that the healthcare system is buckling under pressure and they're upset about staffing issues working conditions and patient care in light of what's going on with the healthcare crisis in the province what would you say to those nurses throughout their minister Dix and you know and they're expressing their concerns and I will turn this to minister Dix just to say that that I can absolutely empathize I think across the board in our healthcare system it has been a long long road it's a long road and it's one we're still on the the COVID-19 public health emergency was declared really we started dealing with it in healthcare at the beginning of 2020 the public health emergency that is the overdose public health emergency what is from 2016 and continues on as all of you know that enormous cost to people in our communities and so these are real challenges in the healthcare system now on the issue of nurses we've seen since 2017 because we were low in Canada prior to that as everyone knows dramatically low we've seen the fastest increase of any province and registered nurses we've seen a doubling in the number of nurse practitioners we've seen a very large increase in the number of licensed practical nurses of registered psychiatric nurses you see that in the pure numbers of the nursing colleges as well and and all of those things are true and we've added now 602 new training spaces for nurses in all those categories of nurses which is significant we have twice as many nurse practitioners practicing as we did in 2017 and that's a real achievement of the system but I would say now let's give you an example about nurses say in the interior region you're asking about that in Kamloops for example where they've gone through two years of COVID-19 and the overdose public health emergency and the heat dome and the wildfires which saw people moving and moving back across the whole region and the floods consequences of that for nurses working at Royal Inland Hospital one of our and who a team of health professionals and healthcare workers have done exceptional things under circumstances no one has seen and even within the healthcare system are extraordinary so I think nurses have been through and all health professionals and all healthcare workers have been through an enormous amount and that's why we're taking the actions we're taking specific action not rhetoric specific actions that means 6600 more people hired in our age cap program in our long-term care program you'll recall the 7000 that were promised in august of 2020 the program is not over yet that means the leveling up of wages for healthcare workers that means the repatriation of healthcare workers who were being paid poverty wages in the acute care system could work 25 years in healthcare not even have a pension that's changing and all the recruitment efforts for doctors and health sciences professionals the efforts on ambulance paramedics because we've seen an increase of 26 percent in ambulance calls in four years and you can only meet that especially for purple and red calls with more people and still it has been immensely difficult and today not some other day but today it's extremely challenging with a number of people largely due to COVID-19 off sick and the challenges of the healthcare system of people in many cases returning the healthcare system it's a difficult time and our nurses are doing incredible work and I am with them why I was with them at the vigil last night why I'm in regular work consultation with them why on the some of the proposals I mentioned we're working with them to see that they're implemented and why importantly in health human resources we got to take steps to make sure we retain those nurses we have experienced nurses we have and so I would say to them that I have that I have heard their message now and not just now during the height of the delta variant in the early days of the pandemic when nurses didn't just serve as outstanding health professionals they are but sometimes and often as the only family people had when circumstances in both long-term care and acute care had provided less access those are moments in all of these public health emergencies that no one involved will forget no one involved will be unchanged by and the what we can do now is to respond and and continue to build together a better healthcare system for the future. Do you have a follow-up question Rob? I do thanks for that my question is we've talked about the fact that we are still in what's been called a pandemic I've heard people describe it as we're still in the sixth wave I don't know if you want to weigh in on that Dr. Henry but I'm most curious to know about you know this idea of motivating more people to get a booster shot as well as having a higher rate of vaccination for kids because BC does trail behind other provinces in that regard do you think part of the the challenge now is that so many people as we've talked about know someone who's had COVID recently and it's been relatively mild compared to what it would have been earlier or what people expect I think part of it's that I I'm not sure the wave terminology I've never been a fan of it but I'm not sure it's particularly helpful you know we're going to see it come and go over time but and yes we saw from the national advisory committee on immunization that we do get a boost in immunity from infection and and that combination of being vaccinated and then having particularly Omicron even a mild infection that does give you a boost but it's short relatively short lived so now's the time if you were had an infection in January or February it's time to get that booster dose now and I know many people had put it off because they had had a recent infection and the national advisory committee says you know three months as long as three months to put off getting that extra dose and that gives you the boost on the boost instead of just having them too close together so if you have had a recent infection now it's time to get your booster it's going to help maintain that protection and maintain protection as we go into the next phase of whatever comes at us next so it is really important same with children I know there was a lot of young people who had infections over the last couple of months that doesn't mean you don't need the vaccine the two of them work together it gives you better protection in the long run and we are starting to see you know young children from other jurisdictions in the world where even mild infections can lead again in younger people to long-lasting complications from COVID-19 so it is important to get immunized to get protected and now's the time to do that appointments are available in pharmacies around the province I know it's easy right now there's lots of availability so I encourage people to go out in and get that extra protection. Our next question is from Karen Larson CBC. Oh hi there thank you very much can you hear me? Go ahead okay thank you my question is have you detected any cases of childhood hepatitis in BC and are you seeing any links with COVID? So yes this is one of those things that we've been watching along with our colleagues across the country we have a case definition and it is a reportable condition in British Columbia I put a notice out to all physicians about that last week to remind them that this is a new phenomenon we still don't yet understand it is mostly causing illness we're up to about 200 reported cases worldwide in younger children most of them under the age of five there has been a stronger association not with SARS-CoV-2 or COVID infection but with an adenovirus infection particularly adenovirus 41 we have had one case under investigation here in British Columbia but they turned out not to be related to this so currently we do not have anybody who meets the probable or confirmed case definition here in BC but we are watching and we're working with our pediatric colleagues yeah so this is still a bit of a mystery globally there's a lot of looking into it we have a very detailed what we call case report form if you're interested it's on the VCCDC website to help us get a better understanding of each individual case and what might be the link there is some speculation that it could be related to co-infections either with SARS-CoV-2 or with some other infection or something that we just don't know yet so that is a really intriguing investigation and we're monitoring for it here but no we have not seen any cases here in BC yet. Karen, do you have a follow-up? I was hoping to go ahead and answer in French if it's all possible if it's not I'll ask another question that maybe I could get an answer in French for if we can make this work. Sure, ask your second question and maybe you can answer both. Okay great so in French I'm sorry I'm just scrolling through our list here you Dr. Henry you seem to indicate earlier that changes to visitation rules in long-term care might not be immediate can you give people who really want to get in to see their loved ones a bit of a timeline on when they can expect all facilities to come into compliance with the updated rules? My understanding is that those are in effect now I don't know that any facilities are not in compliance so there are no limitations there still is a requirement for testing and for visitors to be fully vaccinated we know that there still is transmission happening in long-term care homes and as we know it can be devastating when it gets into care homes thankfully and with the high levels of vaccination and the variants that we're seeing right now even in care homes we're mostly seeing milder infections but those are still important protections that we have in place still. Thank you very much and we'll see you see you soon. Thanks everyone that's all the time we have.