 Good afternoon, my name is Adrian Dix, I'm BC's Minister of Health, my writer is Dr Bonnie Henry, BC's provincial health officer. So our COVID-19 briefing for Friday, January the 28th. As you'll be aware, two years ago was the date of our first briefing and indeed we're the first case of COVID-19 in British Columbia and it's certainly been a long two years. This is, as I understand it, the 276th briefing today. We're honored to be here on the territory of the Kuangun-speaking people of the Songhees and the Esquimalt First Nations. And with that, it's my honor to introduce Dr Bonnie Henry. Thank you very much and good afternoon. We are here today in a very different place than two years ago. And we wanted to take the opportunity to walk through quickly, some of what we have been through. Remembering where we have been and what we have come through can help us put where we are today in a perspective and can help us remember a lot of what we have learned and experienced together. I will start by saying we've all made sacrifices and experienced loss in some way, but it has not been equal across this province. I also want to acknowledge that our COVID journey has not been in isolation and we also have many other things that we have been doing. We also have many other things that have affected us across this province. And from my perspective as well, the ongoing public health emergency of the toxic drug crisis that has been profoundly affected by COVID-19 and by the measures that we have put in place across society, it is not possible to cover everything today. But we have experienced and we have been able to cover everything that we have experienced and we have weathered this storm together. And I do want to acknowledge that particularly the toxic drug crisis is one that we need to bear in mind through all of this. So in this two years of working together, two years ago today, as Minister Dix indicated, we stood before you to announce our first case of COVID-19 and there was a lot we didn't know. That was the start of our pandemic and since that time, every single one of us in BC and around the world have been impacted. And I think the thing that we realize very early on is that we are connected. We are connected to the people in our community that we may not have recognized, whether that's the person working in our grocery store, the person working with our workers, our pharmacists, our early childhood educators, our teachers, and we are connected globally. And what that tells us is what we have learned is that what happens in places like recently South Africa, what happens in places like India, Iran affect us. And that continues to be the case. We have also seen and will show that our collective efforts, your efforts have saved countless lives and have made a difference. So today, we have over half of our eligible children, 5 to 11, have received their first dose of COVID-19 vaccine. 92.6% of people across British Columbia have received at least one dose of vaccine. And 90% have received their second dose as well. We now have 977 people and we haven't seen the numbers from today in hospital with a COVID positive test. And how did we get there? If we think through these last two years, we really have gone through five different periods or waves as we have been referring to them. The first really solidified our understanding and was a lot of unknowns. But from the very beginning, we had a number of goals that we kept to through this whole time. A pandemic response requires extraordinary efforts to control it because of the potential impacts. And a new pathogen and the things that we need to understand to manage it is something that we have experienced here and globally. Early on, we set our goals for this pandemic and those remain today. And that is to reduce morbidity and mortality, so sickness and death as much as possible. To protect our health care system because we know if the health care system gets overwhelmed, then people who have other issues as well are not able to get the care they need. And that has impacts on our health individually and as a community. And very importantly, to minimize societal disruption. Because we know that that also has impacts on our health, both our mental health, our physical health, particularly over time. So as the slides I'm showing you today will show, we have stayed true to these goals as we have learned and changed and adapted and adapted again. And we need to continue to adapt. If we look at this slide that we have seen many times, the cumulative case rates, there has been no part of our province that has not been affected by this pandemic. In some rates, some places have had the impact at different times. And we have seen that in the waves that we have been through as well. When we look at our daily cases by age, we see as well that not all age groups are impacted the same. Through every single wave that we have experienced, people who are in the 19 to 59 year age group, so that is people who have children, are working, are part of a much more connected, are the ones who are most affected by this virus that we have seen, but it is not the same impact across the board, and particularly since we have had vaccination. From the very beginning, we know that those people who are most likely to end up in hospital, to have severe illness or to die from COVID-19, have been people who are older. Age has across the board been the number one most important risk factor for having address effects from this virus, and we have seen that in hospitalizations, we have seen that in the tragic outbreaks that we have had in long-term care, and nobody has suffered more than our seniors and elders. And we need to pause and remember the impacts across families and across communities in British Columbia, where we have lost so many, particularly of our seniors and elders. Through this, however, we have all worked together to make a difference, and it's meant using different tools at different times, depending on what we were faced with. At the very beginning, we took a lot of measures, public health measures, government measures. We stood together by staying apart. We learned all about the importance of distancing and hand washing and staying away if we're ill. And things like the measures that we needed to do to connect with others in our community, even if it was remotely. And going outside, the importance of risk and where things were higher risk, inside versus outside, we learned about the things that we could do to protect those in long-term care, but we also learned about the intense impact it had on communities and on families when people were isolated. One of the things that we have done and we have put incredible importance on is working together with our First Nations Health Authority and First Nations communities across British Columbia, but all Indigenous peoples. Métis and Inuit peoples, Indigenous people living in community and living away from home. And this recognizes that pandemics throughout history have disproportionately negatively affected Indigenous peoples. And I am reminded again and again that Elder Pauline Waterfalls' words to us about how we have shown through these differential impacts of pandemics through history, the strength and resilience of First Nations. And we saw that again repeatedly in this past two years. And the importance of self-determination in allowing Indigenous peoples and First Nations to protect their communities. We learned that different tools are needed and we need to recognize that different tools are needed at different times. And this is reflected in our testing strategy, which has changed multiple times. At the very beginning when we had a brand-new test that was challenging to scale up, where there was difficulties in getting the reagents that were needed, we recognized our global dependence on certain supply chains, particularly from China. Not only for testing, but for also things like PPE, which became part of our lexicon early on in this. And when we had limited amounts of tests, particularly the more accurate PCR tests, when we had limited testing available, we needed to focus on those people who are more likely to have this virus so that we could isolate, find out where it was spreading, take measures to prevent transmission. After our first wave, we focused on expanding our capacity to do PCR testing. And we changed our strategy as we moved into our second wave that happened in the fall and winter of 2020. And then again into our third waves and fourth waves. So when we started to see the variants of concern, like alpha and gamma, and then of course delta. And what we needed to do was find anybody who had symptoms. So that was our message to people was we knew now that those tools that we had, like case management, contact tracing, were effective for those strains of the virus because we had time to find people. So if we could find people when they had mild symptoms, earliest onset of symptoms, or even asymptomatic if they had been in contact with somebody who was a case, we were able to control and manage the spread through the active use of case and contact tracing. And that really helped us get through both the second third and the delta wave, where that became more and more important. As things changed again recently in December of 2021, we had to change our strategy again. There are so many, the intensity and the spread of Omicron meant that we needed to change our approach to testing. It was not possible to continue with trying to test everybody. Our capacity was over-reached. So that meant we had to go back to making sure that we had those accurate PCR tests available for those people who needed them most. And we focused again, symptom based testing still, but on targeted populations. And that's where we are right now. This is the picture again of the same progress that we've made through genome sequencing. And we started very early on with genome, whole genome sequencing in British Columbia and some projects that we had been working on for quite a long time around the use of whole genome sequencing and helping us understand the trajectory of outbreaks. And what it showed us early on was that we had a lot of introductions from a conference, a dental conference that was held from Washington state, from Europe. We could pinpoint using this whole genome sequencing where we were seeing cases come in. In March and April we started to see alpha and gamma and that's the purple and orange in this. Really competing with each other. And we're one of the few jurisdictions that actually had two different types of these variants in different areas of the province. And then of course that was replaced over time with Delta across British Columbia. And more recently, very rapidly Delta has been replaced by Omicron. This is the first time in fact that we have been able to actually follow the genetic changes and mutations of a virus in real time. So to go through this really quickly, much was unknown in our first wave. And much was unknown not just here but around the world. And we took extraordinary actions because of the intensity of what we were being faced with and the many unknowns that we had. And we had a lot of questions. Would it continue to spread? Would it become a virus that spreads in the community? Would it still be a possibility of control? And I think many of us around the world thought there was still a strong possibility of being able to control this virus up until the summer. And once we got to the summer of 2020 and this virus was still circulating in large amounts, particularly in some parts of the world, again it reminded us of our global connectedness and the realization that we were going to have to manage this, that there was no way we were going to be able to push it back into nature like we did with SARS-CoV-1, for example. And we put up a few of the things that happened during this time where we started to use provincial health to require people to take specific, quite extraordinary measures as ways to try and deal with the unknowns and the spread of this virus. And it worked. We did a lot in British Columbia to flatten the curve. And in the face of a lot of disbelief and anxiety and fear and unknowns. Once we got through the summer, there was a lot of concern and questions that were still there. We knew a lot more, but we didn't know everything. We had concerns that as we went into our normal respiratory season in BC and in Canada that we would see a resurgence and of course that is what happened. But what we also knew was the intense negative impacts of some of those extraordinary measures that we had taken. And so we refocused and we prioritized some of the most important activities in our community, particularly making sure children were in school, particularly supporting childcare and early childhood educators. And we made that transition to supporting workplaces to develop specific plans that met the needs of their workplaces so our COVID safety plans became an important tool that we had during this phase to keep things open as much as we could. We also came to understand more about layers of protection in different settings, depending on the risk in those settings. And finally, of course, one of the most important and wonderful days that we had was the arrival of safe and effective vaccines. On December 9th was when the first vaccine was approved for use in Canada and our first vaccine was given on December 15th of 2020. And that was a very positive and optimistic day. And I can't say how many times I've seen the happy faces of people getting their vaccine, the relief, the optimism that that brought with it. Even as we were moving through what became our nether wave in the spring of 2021, so we know we had our mass vaccination clinics, the positive energy that we knew we were making a difference in reducing the risk particularly to those who are most effective based on age, our seniors and elders who we prioritized across the province. People who were clinically extremely vulnerable, who had additional conditions like immune compromising conditions that made them more at risk of severe disease. We also had issues with supply and we go back and think about the challenges where we knew this virus was increasing again with these new variants of concern as well as our supply constraints meant that we couldn't vaccinate as many people as we wanted to as quickly as possible. And we took some very measured and thoughtful decisions around things like extending the interval between dose one and dose two so that we could have a higher level of protection sooner. And that also made a difference. At this time, we were able to provide testing for symptomatic people. We had vaccines at our disposal and that is what got us through this wave. Once we head into the summer again with our vaccine success, there was a lot of optimism. Certainly I felt it that with these effective vaccines we would reach a level of immunity that could help us control and manage this virus in a way that we hadn't been able to up until then. Could this be our last wave? Again, we were reminded of our global connectedness where we had the rapid emergence of yet another variant of concern, the delta variant. And the pattern again of this virus meant that that level of immunity we had with the vaccine program that we had so far was not enough to prevent this strain of the virus from transmitting. And it was causing more serious infections, more hospitalizations, more need for ICU care, particularly in people who had not yet had that protection from vaccines. Again, we went back to the tools that were working for people. We had testing available for people around the province, making sure we had our case contact management teams ramped up and working the high risk settings, increasing our vaccination of people. And we were very successful with that. We also, as we were challenged with delta, starting initially in regional areas. So through the delta wave particularly in the lower mainland we weren't seeing the outbreaks that we were seeing in other parts of the province. And we know it was a challenge primarily in the interior and our northern health region. And then at the end of November we had our first 5 to 11 childhood vaccines. And now those children are coming up for their dose two. The vaccination program has been immense and tremendous and we've had such participation. We've had vaccination rates that are hardly imaginable. And to be able to have over 90% of our population agree on the importance of this type of a measure, not just to protect ourselves, but recognizing that what we do made a difference. It made a difference for our families and our communities too. And the wonderful images that we have of young people getting protected as well and we need to continue to focus on those. Unfortunately we got hit again as we were weathering that wave of delta. Omicron came out of again the global connectedness that we have. It was first detected globally or reported on globally from South Africa in late November. And by the middle of December it had been detected and found all over the world and it had spread rapidly. So we needed to adapt again and use the right tools for the job that we were faced with now which was an intensity and the spread that was very different from what we had seen even with delta. And given this speed and intensity we had to reset the strategies and respond differently. Each of these waves has had their unique challenges and our response has adapted to that. We have made extraordinary societal efforts and these efforts have saved countless lives. If we look at how we have weathered these waves here in British Columbia we are managing to prevent people from getting sick. And we have saved lives even as it has stretched our health care system. And we have saved lives. There has been loss and there has been much more people affected in some areas and some communities than others. And particularly as I said our seniors and elders. So what is it that we can take from this? There have been five waves that we have been able to overcome. We are in this and we are coming through it but because the virus has changed we need it to reset our control strategies. Contact tracing is not something that works with this degree of spread. And it is not possible to test everyone so we need to focus our testing on those people where we need it and that are working. We have done the right thing. People have made sacrifices. We got vaccinated. You supported your family, your neighbors, your community. And right now the actions we need to take are clear to us. We need to get boosted. That helps us now. That helps us for our longer term protection. We need to get our children vaccinated to protect them and make sure we continue to participate in the activities that are so important for their growth and development and health. We need to stay home when we are sick. We need to wear masks. We need to keep our groups small right now until we get through this wave too. And we can look ahead to a time when we have enough immunity and we have enough control that we can start to open up again. We need to get the extraordinary measures away. As we move through this phase the extraordinary measures will change and we are looking now towards the middle of February and family day when we can start to get back to doing some more things again. This is about recognizing that we have been on an incredibly arduous and long journey and no, I didn't think we would be on this phase with all of the solidarity that we have to accept. And so much has happened in those last two years but we have the tools and the resources and the wherewithal to help us deal with whatever is going to lie ahead. We know that I lost my train of thought here. We know that COVID-19 will be with us for some time. It's not done with us yet. We know that we will be able to get through this. We know that the virus will surely emerge. Immunity will wane whether that's from infection or from vaccination. And we know that there's a seasonality and next fall we will bring the increased risk of transmission again. And we need to prepare for that. But we do know that we can get through this and we will reach a point of societal efforts. And we can rely on each other to do those individual and collective things that make a difference. This last two years I have not been alone in this journey we have not been alone. There have been incredible group of people who have been around us and helping us make these decisions and I want to thank all of them for the work that they have done and continue to do each and every day. In particular I want to recognize my public health colleagues across the province the team at the BCCDC the PHO office and thank you to all of the healthcare workers everywhere who have not stopped who have stepped up and provided care for everyone every day for this last very long period of time. And I will also say today one of my dear friends and colleagues is retiring and I want to give my thanks and gratitude to Dr Richard Stanwick here in Vancouver Island and of course thank you to everybody in British Columbia in your own unique way every person in this province has been part of the team that has stepped up and done our part we followed public health guidance we flattened the curves and that has saved lives you have been kind and calm and compassionate with each other we need it safer for everybody every day so while we must continue to persevere in this phase of our journey we need to acknowledge the challenges and loss let's find hope in knowing that our collective action has made a difference and will continue to make a difference and I will turn it over to Minister Dix Thank you very much Dr Henry and I wanted to start by just expressing my thanks to all of our healthcare teams across the province from Dr Henry and her teams in public health people working in acute care and home support and long term care in our pharmacies people who are working in the community the extraordinary teams that are working to support people through the public health emergency that is the overdose crisis was declared in 2016 and continues and has been exacerbated by the COVID-19 public health emergency I think our teams have been exceptional and I am honored to work alongside them as we deal with these two public health emergencies and all the other challenges facing our healthcare system since the first wave of COVID and all the way through there have been moments when a shift was needed when a difference had to be made and all along, fundamentally the difference were all of those healthcare teams and all of us we made the difference that matters each of us, all of us every single time and that difference is all around each of us we see it in mass worn, physical distancing kept COVID sense used, health orders respected health guidance embraced we see it in vaccinations developed and then received by us and by our children in boosters offered and accepted in all the work we do to make the difference that is required this is BC, we fight COVID and all that it tries to take we fight to make things better safer to ensure our resilience in the durability of all that we count on our work is not done in this moment in our pandemic a time of great challenge for patients waiting for their surgeries a challenge for all we count on for our public healthcare a time of great challenge on many fronts we must perform our job with the same dedication and drive we have demonstrated since the start with that I just want to note especially with respect to vaccinations I want to encourage people to book their vaccines today when invited the remain just as we noted on Tuesday 48,000 people 70 plus who have received their invite but have not yet booked a booster it's urgent that this group of people that these folks get vaccinated as they are more likely to be hospitalized if they acquire COVID-19 there are 670,000 as of yesterday people who have been invited for their boosters and have not yet booked that's people 18 plus we strongly encourage them to book into our clinics or pharmacies today yesterday 31,000 people did so 31,581% online 19% over the phone but there were as of yesterday 600,000 appointments open across the province we encourage people to fill those appointments and in addition we encourage parents of children 5 to 11 to register and book the vaccine for their children today we have passed the 50% mark in terms of vaccines administered to children 5 to 11 55% of children 5 to 11 are vaccinated or booked at the moment but we strongly encourage parents to get children in this age group vaccinated with their first dose and now with 27,000 invites to people who have had their vaccine after the 8 week interval their second dose as well and you see those numbers in the thousand starting this week this is critical this is what we can do now to contribute to both our collective effort but also to contribute to our own safety in these times our safety from being hospitalized our safety from severe outcomes our support for one another and making ourselves and our community safer I strongly encourage you to book your vaccine today the get vaccinated website or 1-833-838-23 call in and book your appointment or call in we have blazed our own path a path that is marked by consideration for others by generosity and by compassion by tolerance, by hard work by relentless work by focused work these are the qualities that matter two years ago, they matter today and they will matter no matter what the pandemic and the future bring our way because our work is not done yesterday there were 9,231 patients patients in patients across our systems we have as you know 9,229 base beds and 2,353 surge beds in our system it is a significant challenge and that's why it's so important that we all stay involved in supporting public health guidance public health orders and getting vaccinated in terms of critical care there are 510 critical care beds there are 18 surge beds yesterday there were 474 people in critical care in the last couple of days an increasing number of unvaccinated people unvaccinated against COVID-19 who are dealing with COVID-19 in critical care units all over BC and I'd say finally that what got us today to where we are today and the work that we've done today over the last two years and we're feeling this will get us to tomorrow and beyond and it's not just in stopping the spread of COVID but through our essential work required to renew, rebuild and add new strength and resilience to our health care system the skilled and caring people who deliver it and the key and essential parts of it that matter so much to each of us and to all of us from mental health and addictions care to primary care from neonatal and maternity care to surgical renewal to palliative care all of the things we do in community and all of the things we need to do together to address the social determinants of health for the ministry of health and for me this work will like our surgical renewal action start with a clear assessment of the challenges then a clear path to address them each of them and because sometimes plans fall through we will make the achievement of those plans a commitment a commitment to patients and care for them and then as we have done with our surgical renewal commitment we will fulfill those commitments as well this is an effort that will be led in British Columbia by our premier whose commitment to ensuring that at all levels of government we work together to deliver the health care that people in Canada need and deserve will be there the work that the premier is leading with respect to a renewal the Canada health transfer is critical to that because when we focus on that work it's focusing on patients and people and their health care needs that's important not the jurisdictional needs of governments and all of the debate that goes on but focusing on people that's what we will do in all of these areas of health care as we continue to deal with the COVID-19 pandemic we will ensure a BC health care system that is renewed rebuilt and strengthened after two years of enormous challenges with the pandemic and other challenges facing our system and our society the kinds of things that we have seen in the last two years including moving hundreds indeed combined thousands of people in long-term care having to move them because of wildfire and flood we need to do that because the public health care system has again as it always does demonstrated its value to all of us and we must demonstrate our belief in its value to support and invest and supporting a new generation of health care workers in short our work is not done not with the pandemic and not with the public health emergency that's the overdose crisis and not with our need to invest and support our health care system and with that it's my honor to take it's our honor to take your questions a reminder to reporters on the line please press star one to enter the queue you'll be limited to one question and one follow-up it comes from Gordon Hoekstra Vancouver Sun good afternoon thanks for taking my question just wondering if you could have found a little bit more on what you mean by things could change or be even a different place by family day on February 21st does that mean lifting restrictions or are you talking about just bending the curve more and hospitalizations being down I'm talking about all of those things you know we are making our way through this overcron wave different yet again and there are measures that we put in place in December to address some of those higher risk settings and to give us time to understand Omicron more so yes we are seeing the peak I hope in our hospitals right now there is a strain on our hospitals we don't expect to see the census drop for some time but we're also at a point where much in the community people have a level of immunity because we've stepped up for booster doses so yes the orders the most recent orders are due for review on February 16th and before February 16th on February 15th we'll be talking about those and if we are continuing on this trajectory then yes I do hope that we will be able to lift some of those restrictions back to those needed connections that we have as you know most of the restrictions right now are on social gatherings and social connections and looking at family day is a time to start getting back to not opening things up completely because we know and we've seen that around the world that when you do things precipitously you can get a rebound that can be really hard on people so hard on because we start to see more transmission again so what we will do and we've been working with the different sectors who are affected about plans for a gradual reopening and coming back together and I see family day as one of those next steps Gordon do you have a follow up I do I mentioned I think both yourself Mr. Dix mentioned about encouraging people whether it's children 5 to 11 to get a vaccine or on the booster side is there anything that the province can do in terms of initiatives or whatever to try and move that forward I see that BC is behind some provinces on both of those fronts yes so we are on the booster dose front we are actually in a pretty good place but you are right we have been doing a number of initiatives for children particularly 5 to 11 we have been working with Children's Hospital and there was a number of webinars and other things yesterday working with family docs about how we can make it part of their role and involve them more in providing vaccinations for young children I think that's a really important thing in certain communities we are reaching out through schools to give opportunities for younger children and all school aged children so there is a whole variety of things that we are doing on that in terms of boosters we have seen that infection spreads rapidly amongst that highly connected younger age group I will also say that the 18 to 29 age group is the one that has after 80 plus where we have 90% in the very high 90s of people getting their booster doses that young people are stepping up and getting vaccinated and there is a huge difference in post secondary institutions in workplaces and other places and I need to encourage all of you to get your booster it's not only for now these booster doses we now know especially after that 6 month interval and there is a study that was published I read it yesterday it came out in the last few days that really supports at least 5 to 6 month interval the second dose and the booster dose again gives longer lasting protection so that's going to help us with whatever comes next so we don't have to have some of the measures in place again that we've had to see in the last few weeks and months so yes everybody step up get your booster dose it's good for you it's good for getting us out of this pandemic and getting us out of this wave and it's going to be important for us to get us out of this pandemic so that's what we're going to do next week we'll start with the first question Maria Weissgarber CTV Hi there I just wanted to ask following up the announcement last week about the 200,000 rapid tests that were going to be sent out for educational workers in the K-12 sector checking around with some districts today in Metro Vancouver and anecdotally have heard for more rapid tests for the school community beyond this initial amount The answer to the second question is yes absolutely as they're coming in what we would like to see is right now the target is supporting staff and teachers and staff in those settings to make sure if they have symptoms that they have an option of getting tested to understand what's happening but yeah once we get a larger supply and I've said this for several months what we would like to be able to do is provide them to parents so that you can make those decisions for your child if they have symptoms on any given day and that's part of the plan in terms of rollout I know that they've gone out to each of the school districts and I don't know you have more information on that on the operations and logistics Yes they have gone out in their hundreds of thousands to give you an update on where we are as of January 27th BC has received 7,528,000 rapid tests we've deployed 5,737,000 of those that leaves a current inventory of 1.79 1,597,000 of which we've received over the last few days so those are received and processed and moved out as you know about 556,000 of that inventory aren't suitable for deployment for take away use and just to give you a sense of where we are this week this week we'll be delivering over 1,666,000 test kits including on those on hand and expected new test kits arrivals as follows 351,000 to COVID-19 test sites 250,000 to replenish supply at acute care centers 260,000 to support the testing of visitors and symptomatic staff in long-term care and symptomatic staff in assisted living 130,000 to support rural and indigenous communities 300,000 additional tests to support K-12 education 375,000 to support business and organizations as part of the point of care testing process and over 250,000 rapid tests are in the process of being delivered to the childcare sector as you know and I think I laid out on Tuesday we are expecting today in the middle of February about 10 and a half million rapid tests that's a reduction in what we expected but still a considerable amount and as those tests come they'll be distributed to key priority areas and K-12 education is clearly one of them Maria do you have a follow-up? Thank you, yes also relating to part of the announcement last week along with the rapid test for schools it was mentioned that there would be additional funding to support further upgrades and improvements for ventilation in K-12 schools that would be made available soon in addition to the investments that have already been made so what is happening with that new money that's expected for those types of upgrades? I'm afraid you're going to have to refer that to the Ministry of Education obviously there are people who know all the details of those funding announcements I know that they're working very hard on that and that there's been an initiative and every school has been assessed but I can't give you the details of that specific announcement Next question goes to Richard Zussman Global News Dr Henry with NASA's changing guidance today around boosters for 12 to 17 year olds where is the province at with offering that age group the boosters and to the larger issue today you know as we plan towards family day and easing those restrictions what do you say to the most vulnerable who won't be able to keep up in terms of their risk will still very much exist as many people are just moving on? Yeah you know it is all about balance and that is why we still have things in place and why we reinforce as I've mentioned we reinforce the importance that each of us does around reducing risk in our own family for ourselves, for our family, our community so as each of us gets vaccinated it makes a difference in the amount of virus that's circulating in our community and that in itself protects those who are most vulnerable and yes, people who have these innate vulnerabilities whether it's because of the immune system of age and underlying illnesses we all need to take additional measures to protect them and they need to continue to take additional measures to avoid some of the higher risk settings until the virus is able to at a low enough level so it is going to be different for each of us based on our risk of the activities that will be able or want to partake in and the measures that we use as we have less and less hopefully of this virus circulating so it really is titrating our own risk with the measures that we know work and the situations that we're going to be in so right now the important thing is that all of us need to continue to take these active measures whether it's vaccination and masking and keeping our groups small because that's how we are dampening down the amount of virus that's transmitting to everyone. In terms of the NACI statement for 12 to 17 that is something that we've been discussing and we're expecting so we've been discussing with our BC Immunization Committee and looking at what this means for our program here and we have another meeting with as I mentioned today that we have a large team that we work together on these issues you know think through what is the best way to approach this from BC's perspective and we'll be coming out with our plan starting sometime next week so next Tuesday we'll be able to talk to it in more detail so we're also looking at the information that NACI use to make those decisions as well as what other jurisdictions are doing around the world so there's lots of pros and cons and I'll be talking more about that. Richard do you have a follow up? This week Dr. Henry we saw some of the highest days of COVID related deaths who is still dying here are these cases linked to long term care and you know is enough being done to prevent these deaths from happening and for Minister Dix unrelated to COVID there's been another clinic closed in Victoria in terms of family doctor support what is the province doing to address the shortage of family doctors and to support you know hundreds if not more people who no longer have a connection to the primary care system. The people who die from COVID and with COVID has always been part of the tragedy of this pandemic it is something that we've been watching in a way that we don't for many other illnesses so yes about 40% of the people who've died in this month have been related to outbreaks in long term care most of the people who are dying outside of those outbreaks are older people with underlying illnesses a high proportion of them are people who don't have the protection from vaccination some have had younger people die as well some of that are people who were infected with Delta we know that it caused more severe illness and it's people who have been in hospital for some time for example and some of it is the fact that this virus even in its form that it is now the Omicron strain does cause severe illness in some people so most of the younger people that we've had at least this week are people in their 40s who've died from COVID we've had younger people as well and younger tend to be people who are not yet vaccinated and don't have that protection and many have other underlying causes as we know but age is the number one most important risk factor in about 40% of people are people in long term care and we have talked a little bit about such high rates of vaccination in residents and in staff and high rates of booster doses we're seeing very mild illness but we count everybody who has a positive COVID test and dies within 30 days of that test as being we've always recognized that COVID could play a role in those people's deaths unfortunately so obviously there are significant challenges facing especially in some parts of the problems our primary care system one of the key challenges is that fundamentally the system that has been in place for the support and funding of private primary care is not best suited to the current times and that's why we've been undertaking a transformation well before COVID in fact since 2017 of our primary care system focusing on team based care so you've seen the development of more than two dozen urgent primary care centers but also dozens of primary care networks which support our existing primary care systems not to the side of our existing systems including here on the south island creation of new community health centers the addition of additional supports for first nations led primary care initiatives as well so you see that in a move to team based care allowing a variety of health care professionals to work to the full extent of their skills we've also seen compared to other jurisdictions in Canada an increase in family practice doctors relative to other jurisdictions but there are significant challenges our existing system is based on when a clinic closes and that's happened and this is particularly an issue in the south island it's a great worry for people particularly people with chronic diseases who are older who need health care services and that's why we're doing a lot of work right now we're on the south island with local divisions of family practice to address these problems because it's not just creating new services which do support us and have been invaluable during the COVID-19 pandemic and building out team based care but it's also important to stabilize systems so that work is being done with local doctors now I want to emphasize that our core initiative in performing primary care are primary care networks which come from local divisions of family practice so this involves working with doctors who have not succeeded in doing this in almost 50 communities across BC in community health service areas across BC where proposals from local divisions of family practice from local nurse practitioners come forward and those proposals are supported and funded and as a result more than 800 new staff have been added to support primary care across the province which is a significant achievement there is more to do closely with family practice doctors to address the present situation present some of the challenges that COVID-19 has brought here and that's true across BC as well so that's the work that's happening now there is a significant initiative in place clearly more needs to be done and we're acting on that as I noted in my initial remarks for the next question we go to Xiaozhu, Globe and Mail Hi Dr. Harry, the definition of an outbreak in long-term care homes appears to have changed can you tell how our long-term care homes deciding when an outbreak is declared and what's the stretch hold VCH told us outbreaks continue to be declared by a medical health officer if there is a higher than expected level of transmission what does that higher than expected level mean could you please specify that yeah so yes and I've said this several times it is the medical health officer in the local situation that works and assesses the situation in every long-term care home that has always been the case and the declaration of an outbreak is at the discretion of the medical health officer based on the unique situation in every home so you will remember that very early on in this we used our outbreak guidelines and they're available we've had them for a long time in long-term care guidelines that were based on things like influenza and we found that early on in dealing with COVID that it was sometimes causing especially early on causing mild disease in many people so we lowered the threshold for making sure that we were being very sensitive and detecting every single case with Omicron it's changed again and it's changed in several ways one of them is that we're seeing in the highly vaccinated population that we have now in care homes that it's not causing the same amount of illness so we've gone back again to looking at and the definition of an outbreak this is something we use in epidemiology all the time it is a number above expected so it depends on what expected is and with what we're seeing transmission in the community it's around seeing a clinical illness that is severe enough to cause medical concern for a resident so we are seeing a lot of staff in particular this is what we're seeing across the board that staff are infected they're infected in the community they have mild illness many of them are off for a period of time so the level of exposures that we're seeing is different the severity of illness we're seeing is different in long-term care so I've said this before and we'll be coming out with the published guidelines but we are working through what this means in terms of consistency in declaring outbreaks across the province but we are still managing every single facility and it's not based on a specific number it's based on the clinical situation in each facility shall we have a follow up yes I do thanks so because the definition is shifting so is it the same across all health authorities and also because the restriction are being relaxed in the general public how long do you expect care homes to have to severely restrict visitors yes so we have changed the visitors so that we recognize the impact that has had on long-term care homes so that they can continue to have visitation and that's one of the things that's different about managing outbreaks now compared to over the last few years and partly that's making sure that everybody does have a visitor if they want one and particularly to support them when we have so much transmission right now that's not causing severe illness so those things have changed and yes the guidance is consistent it's all based on the clinical judgment that we are doing consistently across the province and we're catching up with the documentation of that and we'll have that out for people soon but it is important what we are doing now is balancing what we're seeing on the ground in terms of clinical illness with the restrictions that we had in place quite extreme restrictions and recognizing that that also has health impacts for residents in care homes so finding that balance based on the situation in each care home Next question goes to Justin Wong, Singtao Daily Yes, hi Yes, thank you for Dr. Harry and Dr. Des for being with us these two years so I want to ask about to the gay persons or the LGBT person in Vancouver because they think that there will be difficult to get the service for him or other organization because the COVID-19 they think about the government they focus on the COVID-19 but they will get any service for the organization how to think about this issue Yes, so I'm not sure exactly in terms of what services we're thinking about I do know that it is an area that obviously we have seen that this pandemic along with many other things differentially affects certain communities and the LGBTQ community is one of them where yes, it can be very challenging to deal with some of the issues that we're seeing in accessing health services I will say that we have focus on many of the services that are needed and the BCCDC some of my colleagues working with the programs at BCCDC have been focused on that I'm not I don't know particularly what the concern is I'd be happy to talk with you offline to understand what exactly we're looking at here Justin, do you have a follow-up? Yes, because they are very difficult to get HIV broadcast and HPV vaccine, they have to ask for the public's house or their family's daughter as many years ago they are very easy to get in the community organization for example the HMHIM yes, so now they are very difficult to get the service for example the PIEP I actually had not heard that because I know I obviously know him very well and some of the Center for Excellence in HIV and AIDS and the work that has been done through our community through the clinics at BCCDC so I'm happy to take that back and discuss with our colleagues about where the issues are I had not heard that that was an issue so obviously really important services to make sure that people with HIV get what they need and don't have disruptions in their access to medications and treatments so thank you for bringing that up Yes, I expect shortly to do an update with Dr. Montanier in the Center for Excellence for HIV AIDS in BCC but I think it's fair to say that we continue to lead the way and having seen the update and we will be reporting out on programs such as the PREP program which have been exceedingly successful led by Dr. Montanier and their teams so it would be interesting to hear and be able to respond to issues you may have at that time or that you can expect an update on that in detail very soon and I think it's fair to say given the quality of the work being done there that it will be a very positive update and show what we're doing in British Columbia and I think what we need to do around the world as well to deal with HIV AIDS We have time for one more question Just to say you took me a little bit by surprise with that question but we have been working very closely with our group in terms of identifying people who may be more at risk and we've prioritized for many people in that community to be able to receive their vaccines sooner as well recognizing particularly people who are living with HIV that that can be a risk factor for more severe illness We have time for one more question we'll go to Belle Peary, CBC Peary at the start of your comments today you said looking back helps to put things into perspective so two years into the pandemic what is there that you and Minister Dick's wish that British Columbia had done differently you know what are your regrets and in English and French please I'm not sure I'm at the point where regrets are what we need more about looking at how we adapted as we did and recognizing that change is difficult and it's hard and you know it's easy to look back and say oh well that was obvious it was coming but when you're looking forward and you don't know how high the wave is going or when it's going to start or when it's going to decrease it is a very different perspective and I was trying to remind us all that there are many things that were unknowns that we now take for granted in some ways and that we were very focused on specific tools that served us well through much but now as we're changing or as we're seeing a new virus that has changed a new strain of the virus that has changed those old tools that served us well are not working anymore and we need to find new tools and new strategies that there is hope that this movement through this phase of it is going to push us to that point where we no longer need to take those extraordinary public health measures and societal measures to be able to live with this virus and manage it effectively in the future I think if I regret anything sorry it's really that my challenges in being able to communicate when we've had major changes and to communicate why we need it to change things in a way that was accessible to everybody and that continues to be the challenge and one of the things of doing this today was to try and put some perspective around the language that we've learned and how we've moved ahead with it and reassuring people that we have learned a lot and I guess if I could do anything over it would be to be clearer in some of those communications particularly at those most stressful times when things are changing I think what I'd say Bella's were right and still in the middle of this in this moment of the COVID-19 pandemic and still working hard to both support people we have 977 people in hospital yesterday it will be about the same today just slightly higher and so this is a moment where we're right in the middle of supporting our health care systems and supporting one another I think what I would say is that there's always an assessment after the fact but I think what I find so impressive about Dr. Henry and her approach and her whole teams approach but to continue to learn every day and adapt every day and because when the pandemic came and COVID-19 came on the scene there was enormous things we didn't know and decisions were based on less knowledge and now they're based on more knowledge but this is a team of public health leaders who has never stuck who always looks at the evidence looks at the facts never worries about whether changing will reflect on the past decisions but change when it's necessary to protect people I'm really proud of our public health teams and healthcare for their willingness to do that and I think that's been reflected in the general public which has been overwhelmingly responsive a lot of our focus is people because the vast majority of people have been doing exactly what they've been asked to do the vast majority of people of course vaccinated there's a tendency to focus a lot on those who aren't or those who are not following and I'd say to everyone this is true for all of us is that it's not too late to join it's not too late today is the best day if you haven't been vaccinated to get vaccinated and the assessments and the reflections well we're right in the middle of this right now and the Omicron a wave of the COVID-19 pandemic has had relative to other jurisdictions some success but there's also been real losses and rather than focus on my regrets I think of all the families who have lost people from COVID-19 all the people affected by COVID-19's impact on the overdose public health emergencies the healthcare workers who worked so hard the grocery workers and other essential service workers I look at them in the sense of pride and support of course an understanding of what so many people have lost in the last two years and that sense of shared grief also drives us forward at this point I would say in French that we are now always the pandemic continues to exist and at least 80 people were hospitalized with COVID-19 and about 9231 people were hospitalized for all the medical problems the medical problems in British Columbia we are now working below with all our hearts and all the talents of the public health team and the teams in the health sector in the British Columbia I am proud of the people of the British Columbia but we have to continue the effort because it is an important moment and the most important day is today and then tomorrow to be vaccinated and to follow the public health advice Bell do you have a follow-up I do yes please with half of the 5-11 year old children still not vaccinated we are seeing some pushback from parents and teachers on the announcement earlier this week that youth sports tournaments will come back early next week so should we expect to see an increase in transmission and if so are you okay with that I was expecting the numbers to go up. Why not? And in English and French, please. Just to apropos of your last question, I was thinking of Maya Angelou who says, you know, do the best with what you know and this is a poor paraphrase, do the best with what you know and when you know better, do better. And I think that's always been our mantra with my team about trying to adapt to what we know as we go. I was actually taken by surprise by that. We know that for some children that activities in sports and dance and other things is a really important part of the growth in development. And as you know, we have prioritized youth sports and activities for that very reason. I think as adults we can give up a season of having our old timers hockey tournament, but as children those can be really important events for them. So we have prioritized them. We have measures in place and we worked with VIA Sport to make sure that those are told or out there with all of the leagues, we have worked together a lot through this pandemic. We meet regularly with the multiple sports leagues, especially for children and youth. And so, yes, I do expect that that they will be followed, that we have those guidance in place. It involves making sure that the adults in those settings are vaccinated and doing the right things. So I don't expect there to be a large increase in cases. I do know that some of the school tournaments that the school system and teachers and the school districts are working together on whether those are viable now or not, and that's more because of what we are seeing, that there are strains on our schools across the province because of staffing off with illness particularly and we've seen some functional closures. So that is up to the school system to try and determine what's the best way to manage school-based sports and competitions. But I don't expect to see an increase in transmission related to youth sports. So I think that everybody will follow the guidelines that we've put in place to try and do our best to minimize any risk. And just to say, youth of course represents those 15, 16, 17, and 18. If you look at the data that we look at every day, 17 and 18 year olds and 16 year olds have some of the highest levels of vaccination of any age cohort in the province. I think it's important, especially in sports where it's possible. I think it's important to have considerations in school sports that Dr. Henry has spoken about that. We return to that with everyone following the COVID safety plans that need to be in place for those events to be successful. So I want to acknowledge that a lot of people, people involved in sports in BC and a lot of people who sort of graduate from sports systems whether it be 12 year olds for little leagues or 16, 17 or 18 year olds or 18 year olds. The coming up would be the high school basketball tournaments in BC. These are important moments in their lives. And some people have lost those moments in the last couple of years. So it's important that we act safely and follow public health guidance. But it's also important that these events take place if they can be done safely. So that's the direction that public health is given here. I think that the majority of people in the age of 16 and 18 are the most vaccinated in the province. We will continue to increase the effective vaccines among the children, 5 or 11. And it will continue. And I think the decision is founded on the need to follow the protection plans, the public health advice in the development of these tournaments and to follow them sequenced. I think we can have celebration of sports that are tournaments especially in this time of the year. And also to protect people as much as possible against COVID-19. So that's why Dr Henry and his team of public health and public health in the province can make this decision. Thank you very much.