 Good morning, everyone. I'm Adrian Dix, I'm BC's Minister of Health. To my left is Dr Bonnie Henry, BC's provincial health officer. And to my right, Dr Penny Ballum, executive lead of immunized BC vaccine operations. I want to thank both of them for joining us today. I want to begin the event by recognizing and acknowledging the history, customs, and culture of the first nations. We are grateful to be doing this presentation today on our lands. It's an honor to live and work here. As we enter the holiday season, we also know right now that we are in the height of the influenza season. And as people gather and spend more time together, the influenza virus has more opportunities to spread. This means that we are expecting and preparing for more influenza cases. And so part of our intention today is to ensure that the prevention that's involved in vaccination is again understood by everybody. But this is the time, particularly for children, to be vaccinated against influenza to get your flu shot. And here to give us an update on influenza is Dr Bonnie Henry. Thank you. And good morning. And as Minister Dix has said, we are here today to give an update on what we are seeing in our country. And we know that all parents and guardians are aware and know that they can still get children protected, particularly against influenza. As we know from our last briefings, we have seen a number of mostly viruses causing a lot of people to be ill this year. We have had a lot of common cold viruses like adenovirus and one in particular, D68, which did cause some severe illness in children. And we also saw a rise in respiratory sencissial virus or RSV and our data shows that that is also leveling off. And COVID-19 remained steady and particularly affecting older adults, reminding us of the importance still of booster doses with the bivalent vaccine that we know gives greater protection against COVID-19. In our last briefing, we had started to see the dramatic impact of influenza, particularly influenza A, that is increasing and it continues to increase. In September and in November, we reiterated the importance of protecting children, in particular, six months and older from influenza. And we have not seen much influenza in the past two years, primarily because of the restrictions in travel. We know that influenza spreads around the globe and it moves with the globe. And we had been watching what was happening in the southern hemisphere, particularly Australia and New Zealand. And as we talked about in September and November, they saw an early increase in influenza, particularly influenza A, in their winter season. And we were concerned that we would see the same thing here. And that, indeed, has come to pass. We have seen a dramatic increase in influenza in the past two years. And it is a significant increase in influenza. Influenza has started early and it is mainly influenza A, H3N2, that is causing illness that we are seeing around the province now. And we know from previous experience with influenza that H3N2 does tend to cause more severe illness across the board, particularly in young children and in older people. And there are more children now who because of the lack of circulation of influenza that we have seen. So more of them are getting sick now. We see that reflected in absenteeism in our schools where people are keeping children home when they are sick. And this past week we have heard from pediatrician colleagues in particular from EC Children's Hospital and from hospitals around the province that they are starting to see and hear more about severe cases of influenza and in some cases complications from COVID-19. We know much more than COVID influenza can cause more severe illness in children especially young children and it can lead to secondary bacterial infections with things like streptococcus or pneumococcus that can cause very severe pneumonia. So that is the concern that we have right now. Normal influenza seasons before COVID we would see this type of move through our population. Usually about six to eight weeks we would have peaks and they would change over time. And in Canada we would have about 2,500 to 3,000 people who were affected and died from influenza and about somewhere between 15,000 to 20,000 people who were hospitalized across the country. So that is the before times. So what we are seeing now is more typical from a usual influenza season before COVID but it is happening earlier. And as I said it does take about six to eight weeks to move through the population. We still have time to blunt the impact of this transmission by getting people vaccinated. I cannot stress enough the importance of influenza immunization right now this year in particular as the best protection we have against infection and severe illness from influenza and particularly for children who we are seeing being effective right now. Influenza vaccines are available for free for everyone over six months of age in British Columbia and we have enhanced vaccines for seniors over age 65. Just to remind people most at risk of severe illness or these complications from influenza are children under the age of five and I will say that there are nasal spray vaccines for children two to 17 years of age if they have concerns about needles. Older children and adults with chronic conditions like lung disease or heart disease pregnant people at all stages in pregnancy the vaccine protects both you and your child and gives protection to the baby for the first few months of life where there is no vaccine available so very important if you are pregnant or you are delivering or you have during the influenza season that the vaccine makes a difference for both of you and of course seniors over the age of 65. Now is also the time to plan for the holidays and we are going to make it and we are making it even easier and more convenient for people to get their flu shots and their COVID vaccines too if you do for those and I will be turning it over to Dr. Ballant to talk a bit more about that in a minute. But I do want to talk a little bit about the upcoming holiday season. Now is the time to plan so that you can have a safe and joyful holiday together with families and loved ones something we have missed for this past two years but we are not out of the woods completely yet so we need to be extra sure we continue to protect ourselves our families and our communities as we go into this important holiday season and that means number one get your vaccines and ensure children are protected too both for influenza and for COVID staying home or away from others especially if you have a fever fever is a pretty good sign that you have something that is infectious to others and that is an important sign that you need to stay home and rest and recover and take extra care around infants because we know they are susceptible to more severe illness and so we need to protect them when we are in respiratory season. Clean your hands regularly practicing respiratory etiquette which means covering your cough and exposing of it wearing a mask if you have mild symptoms and you are not sure if you are incubating something or if children are sick for example in your house and you go to work those are times when wearing a mask is a prevention measure is important and we should think about postponing visits to people who may be more at risk if you are not feeling 100% we also encourage people to wear a mask if you want that extra protection and if you are in a crowded indoor setting with people you don't know. I think it is also really important for us to remember what we have been through in the last two years and make it okay in your holiday plans for people not to come or to be able to participate remotely or outside if they or someone in the family is not feeling well even if they are ones that are supposed to bring the turkey make it okay we have found many ways to be able to safely be together outdoors if we need to and we need to remember those ways as we go into this holiday season we need to remember to be patient and flexible this year as we transition to more normal celebrations like we used to have because we still have COVID-19 and also influenza here now I also want to talk a minute to faith leaders and I am so appreciative of the way that faith leaders have supported communities across this province through these last few years and I want to encourage you again to find ways to celebrate these most important days that are coming up that people can participate safely having the ability to broadcast for example or to participate remotely for those who feel sick or for people who feel at risk and aren't comfortable yet in being in those settings with others the many ways faith leaders have been supporting their congregations through these difficult years those are things that we need to do again to get us through this year and to be able to celebrate together as I said typical influenza season lasts about eight weeks so it is not too late to make a difference now we can blunt this curve prevent the spread to family to loved ones by vaccination now before the holidays so that we can have safe and joyful gatherings and activities together and as I said it is making it much easier for parents to add this into their day during this busy time and I will now turn it over to Dr. Ballum to give you some details. Good morning and thanks so much Minister Dix and Dr. Henry it is always a privilege to be here to just give our public some basic information about how they can access an influenza vaccine and particularly today I just want to share with you how we are trying to make it easier for parents who are currently one of the busiest times of the year to get their kids vaccinated we have had a very strong enthusiastic response to the influenza campaign we have vaccinated over 1.5 million people which is much above last year and I believe getting to a record in the province we have used about 70% of our vaccine and we have had more in the wings coming in to make sure that everybody has a chance to who wishes to get vaccinated and generally with the high-risk groups that Dr. Henry has identified we are doing well over 50% of seniors over 65 have been vaccinated we do track people with chronic illness so that we can prioritize them 40-45% of them have come in and gotten influenza vaccine and really our concern as Dr. Henry has said is children particularly those who are 6 months to 4 years who are in the highest risk group they are the most vulnerable and amongst those children we have only 20% have been vaccinated for those 5-11 20% have been vaccinated and for our teens only 15% so I think our call out today is to all children and youth and particularly the small ones to make that extra effort on behalf of their parents to get them vaccinated now I think the public are very familiar with the get vaccinated system it's a remarkable way that they can be notified of when a vaccine is due and they can go in and book themselves or their children a vaccine in one of many options that is convenient for them to date though we only have about 50,000 of the most vulnerable children 6 months to 4 years who are actually registered in the get vaccinated system and one of the steps that we are taking today is that we are going to take information that is in the provincial registry and use that to send a notification through get vaccinated to parents we know that some of those notifications won't reach them because the telephone number we have is possibly a landline in the age group of children of 6 months to 4 years are very savvy most of them operate off mobile phones and so we are hoping that the majority of these notifications will go out and reach them and we will encourage them to get their children registered then we can send them an invitation link and they can book an appointment in many of the health authority clinics that are around the province waiting for them to come in and they can send their children in to get vaccinated there are lots of options available for parents to bring their children and youth in to get vaccinated we have about 2,000 family doctors who have received influenza vaccine through the health authorities and who are able to provide vaccination so parents can phone their family doctor's office and see if there is vaccine available and bring their children in to get vaccinated there are health authority clinics that do not have vaccine and these clinics are specifically set up to welcome children to make them comfortable a few extra touches some of them are able to put decorations on little Christmas trees there are balloons and we generally try and make those children's clinics a very safe and comfortable place for children especially the little ones to feel okay and for infants and toddlers for children 5 to 11 they can receive their vaccine at a pharmacy as well and there are about 250 pharmacies across the province who are welcoming children in that age group 5 to 11 and providing vaccine but actually any pharmacy is legally able to provide vaccine to children 5 to 11 so generally as you can see we have a lot of access around the province we have about 140 health authority clinics that are designed just for children and there are thousands of appointments available on the get vaccinated system at the end of this week we would like to sort of have a blitz as I called it a vax of fluoza to welcome kids there is a special effort that is being planned by the health authorities by our pharmacy colleagues and we hope by our family physicians to really make an extra effort if you get Friday, Saturday and Sunday at a vaccine you are ready for 2 weeks away when your immune system has responded and you are moving into your holiday season with your family so December 9th, 10th and 11th a special effort lots of walk-in availability for families to bring their kids in there is a lot of effort being made to make sure that we are in convenient places and that we are able to welcome families we encourage families to book an appointment if they can through get vaccinated as I told you a few minutes ago we are going to send out notifications to families who do not have their children in that system to encourage them to do that so just a little note on what you need to get your child registered and get vaccinated BC you need your child's full name their PHN number their date of birth and the postal code where they live that is all you need and you can get your child registered and within a few hours you will receive an invite to actually book them in to one of the many clinics around the province and if they are a little bit older to a pharmacy where they can get a vaccination so I am going to close there just to say we have ample vaccine most vaccines in the influenza category can be used for children as Dr Henry mentioned we have some flu mist still available and that is for children who have a problem with a needle you can ask for that at the clinic but generally there is vaccine there is a lot of information on the government website on the health authority website and on BC CDC's website for information about influenza vaccine for where you can get it we want to make it very, very easy for people to feel like they have access to what do they do and where do they go and the provincial call centre is always available to answer pretty much any question and book your child in if you can't get to it using the internet or online we are here to help you and support you and what we know is the busiest time of year for you and your family please reach out to your local health authority the provincial call centre to your local doctor and help make it happen to protect your children thank you so much Mr. Dix thank you Dr Henry and obviously vaccination is one of our best tools to combating influenza combating COVID-19 and I encourage everybody to consider booking a flu vaccine appointment soon as Dr. Balm has said this is going to be a record year for flu vaccination and well that record has been going on by our healthcare teams extraordinary teams of pharmacists community pharmacists of health authority clinics of family doctors all that is going on we also have done more than 1.5 million people to get their COVID-19 booster shot and we need people to continue to do that and adults continue to do that as Dr. Balm has said 55% of people 11 out of every 20 of seniors over 65 have got their flu vaccine however that number can be higher and importantly it should be higher as we go towards the holiday season so we continue to encourage everyone in BC to get their flu shot to get their COVID-19 by valent vaccine and there are opportunities available to do that everywhere in BC the focus today is of course on children 21% between six months and five years have received their flu shot about 20% of those five to 11 received their flu shot about 15% 12 to 17 particularly in the first two categories so I strongly encourage all parents to get their children vaccinated against influenza this year getting vaccinated of course also helps reduce the load on our healthcare workers and our healthcare system we have been working tirelessly to keep British Columbians healthy in difficult times for every healthcare worker every healthcare professional for all the work they are doing their work is of course not easy especially during the colder months and the ongoing commitment of healthcare teams to the people of BC is deeply appreciated I know by me and by everybody else our hospitals are ready and continue to be ready for the surge of patients that comes with respiratory illness season and we will get through this season together we will increase in emergency room visits particularly in the provincial health services authority we are talking about BC children and the Fraser health authority over the last month we have gone roughly in terms of emergency room visits if you take September and October and compared to November through December 2 we have gone from about 6,700 emergency room visits a day to between 6,800 and 6,900 and that is increase reflects those increases especially at BC children and in the Fraser health authority in addition we continue to be taking measures to support our healthcare system and especially to support our emergency rooms where we are seeing significant and ongoing pressure on the healthcare system but the way we can all do this we all have control and power as individuals in the community the way we can help the healthcare system to get vaccinated against influenza to get vaccinated against COVID-19 that is something we all have in our hands to do but more important than that especially when it involves children it is an opportunity to protect them against influenza and its impact on them to protect them against COVID-19 and its impact on them we can all do what we need to do to be ready as well we need to get vaccinated we need to wear a mask if we have mild symptoms we need to stay home if we are sick we need to wash our hands frequently we need to keep doing what we know and keep doing what we know works and with that we are happy to take your questions and I will invite Dr Henry back to the podium . Thank you to all our speakers as a reminder for media on the phone please press star 1 to enter the queue that is star 1 to ask a question for media in the room and please make sure to provide your full name and outlet we are going to start in the room today so please go ahead . Good morning, syndrome with CTV a lot here to go through so let me try this it sounds like after years of COVID that perhaps the flu is now your number one concern is that the case and also was there in discussion about the push for kids to limit how many adults get the flu shot and instead just give them straight to kids so that do you know what I mean by that just because there may not be enough is there enough for everybody that you may have had a discussion that perhaps we should only give them to children . The first answer to the first question is we have been watching and we were concerned that we would see an early influenza season and that it would come at the same time as the last two years and that is indeed what we are seeing we did see quite a lot of RSV but not as much as some other parts of the country but right now for children what is making most children sick what we are seeing the greatest proportion of is influenza and influenza A and it is an influenza A H3N2 so that is one that does cause more severe illness historically across the board so the answer about whether we would reserve a flu vaccine for children only we believe we have enough and we certainly have enough for children right now in the province and we see that influenza causes more severe illness in older people as well so unfortunately older people have the double whammy of being very severely affected by COVID and also by influenza and particularly influenza H3N2 so we do need to make sure that it is available for people at high risk whether they are children with underlying conditions or adults with underlying conditions or older adults so we do have enough for everybody across the board that is really important what we are seeing that is different in children and why we are focusing on that today is we do know that children have mostly milder illness with COVID relative to adults but that is not the case for influenza so it is really important this year more than most other years that we protect children as best we can . As we are very sad news of course I am sure you heard of Richmond it looks like a six-year-old girl Danielle passed away from complications through the flu I am sure you have heard of this and I am sure just your reaction to that if you could Dr Henry. We do know that there have been a number of children around the province who have had influenza and we actually know the details of this person in particular but yes we have had a number of children who have had more severe illness and one of the things that we see with influenza that we don't see with COVID for example in children is having secondary bacterial infections that cause pneumonia sometimes meningitis so very severe infections that have sometimes very tragic outcomes so yeah that is something that we are very proud of but it is always heartbreaking to hear about severe illness in young children and that is why it is so, so important to do the best we can to protect them and that is where vaccine comes in. Our next question will be going to the phones Richard Dussman Global News please go ahead. Dr Henry you have encouraged people before to go get vaccinated and the rates among children are still low so what is the whole question that will be different this time around in terms of increasing rates and is there any consideration being given to requirements around vaccination within the school system and what tools do those in the school system have if kids come in sick my understanding is there is not a lot of power a teacher has if a student comes in and is sick to ask them to go home. So I think it is not a surprise I don't think to parents around the province that kids are getting sick with respiratory illnesses right now and we are seeing that in absenteeism in schools where people are keeping children home which is good but I want people to be aware that we can still make a difference we are still early on in this trajectory of influenza we are starting to see the impact of a large number of children who have been exposed to influenza for a few years and a small proportion of them are getting severely ill so now is the time to really make a difference get the vaccine now especially we know that there is going to be activities during the holidays we are going to want to spend time with family and friends and that is a situation where we can spread the virus even more so really important now is the time to get this done we are making it easier we will have walk-in days at clinics this coming weekend and that gives you the time to protect children as best we can as we are going into this really important time Richard, did you have a follow-up? Why not create requirements? I know that vaccine requirements are controversial they have caused problems in the past but why not put a requirement in we did it when adults were getting very sick and there seems to be more of reluctance now for various different reasons are we doing as much now to protect children as we did to protect older adults at the height of COVID? That is a really interesting question influenza is something that we have been living with for many, many years and seasons tend to fluctuate the vaccine is available most children do have mild illness especially school-aged children are mostly have mild illness from influenza as well but we know they can amplify it and spread it in their families and in communities so it is partly where do we see influenza having the most severe effects and of course the most severe effects that are in younger children who aren't in school we do have promotion for children for influenza vaccine but we haven't made them requirement in any situations with the exception of the long-standing vaccine and mask policy that we had in healthcare settings so we focus on mandates if you will in those settings where they are going to have the most impact and where it makes the most difference and that is why we still have mask mandates in all of our healthcare settings where we still have vaccination mandates for COVID and the requirement for influenza vaccination in healthcare settings because those are the settings where the most vulnerable people may be exposed we generally have not had vaccination requirements for children for a whole variety of things that can spread in schools what we do have is the reporting requirement that came into place in 2018 where we have reporting of vaccination status of children in schools influenza is not part of that because it is a vaccine that changes every year and that we need to update every year with the changing influenza virus so it is a balancing where these have the most impact and where they have the most benefit and mandates are always sort of the last resort I don't know if you want to speak to that or not. Just to say Richard you recall in 2019 when we dealt with I think at the time 29 cases of the measles in BC given that we had largely eradicated the measles that was a significant issue what we did at that time was what we are doing today which is dramatically significantly improving access to children who need to do especially to protect their children things that was so important in that time was the number of children 16, 17 and 18 who chose to get immunized against measles at that time right now the situation is that roughly 21% of those six months to four years and 364 days who are eligible are vaccinated against influenza at this time and as you know the numbers on COVID-19 are also in the same range or lower and so I think what we are saying to people today is take advantage especially in this pre-holidays season you can still have an impact to protect your children as individuals which is the most important thing but also to protect the community we found this to be effective in spite of the small number of people who hadn't been vaccinated against measles and we found that a lot of them were 16, 17, 18 year olds who were making that decision for themselves at that time so I think that's the effective way of dealing on the issue of vaccination we do have course vaccine requirements in our healthcare system we do have mass requirements in our healthcare system but this is an opportunity for everyone and I think Dr Henry has said it well that this is an opportunity right now to positively affect the health of our children and to protect the health of our children for the whole community most importantly for your child. Our next question we are going to von Palmer please go ahead. For Henry thank you for doing this as always. The COVID-19 operations review that was released Friday by the government reported on what it characterizes an erosion of trust in public health measures and expressed a concern that it could translate to advice on public health measures. Do you think that may be a factor in why so many parents have so far not got their children vaccinated for either the flu or COVID? It's an interesting question. I think part of it is that we've been talking about this for a long time and until it becomes very real there's sometimes a challenge in fitting it into a busy day and especially parents of young children they have a lot going on and a lot going on right now and that's why we need to make it as easy as possible for parents to do what they need to do with children and I hear that from parents all the time that oh yeah we're going to get the kids vaccinated we just had this going on and that going on in school and it's busy and so what we're doing today is saying it's really important what we're seeing is children are being affected we know that in the holidays we're going to get the kids vaccinated again and it's important for us to do that we need to do that this year so the best thing we can do now is make it easy for you to drop into a clinic anywhere in the province bring your children you can get your vaccine too and we'll get it all done so we can have the safest holidays possible. Did you have a follow-up? Yes please. The operations review also recommended well in one of their findings the provincial health officer or office conduct a review of public health measures during COVID-19 to determine which ones worked best is that a review that you would be open to doing and if so when would it likely be conducted? I think it is something that we're not only open to doing but are doing not just us but across the country we're talking with my colleagues and globally it's very, very challenging though just to put this on the table to tease apart because many of these things came in together and I talked about that a little bit on our last call when we had a lot of COVID and many, many people were vulnerable we needed to put in layers of protections because we didn't have vaccination for example and it was causing severe illness across the board so those layers of protections that we could put in it's very difficult to tease out was one better than the other or was it the combination of them and then as the immunity went up and as cases went down we no longer needed to have the multiple different barriers so yes we absolutely are committed to trying to understand which combinations as best we can worked best in which situations I think one of the things that I took out of that report and that I've been thinking a lot about myself and my colleagues over the past two and a half years almost three years now is the fact that things changed a lot during this last three years it's a long period of time the virus changed our immunity changed and immunity is complex the things that we were doing changed what was happening globally changed and every time there's a change trying to adjust to it and trying to find the best effective means of doing things was a challenge that we had so things like the testing protocols changed for a variety of reasons and part of that was people have to get become we have to become comfortable with changing tactics as the situation changes but that's always that's not always easy and we get into a pattern we understand certain things and it becomes challenging when things change and we no longer know what to do causes a lot of concern for people so I think we as a community and public health and myself in particular need to learn how to talk more about change and communicate why we're doing things and why the changes are and help people with that anxiety that comes with things changing over time so certainly something that I'm very interested in and how do we do that and how do we help build up trust again for our next question we're going to Justin Hunter global mail please go ahead I heard the health minister say that hospitals in BC are ready for the surge we had a story over the weekend that shows hospitalizations of children with the flu have skyrocketed across the country 223 children admitted in 12 hospitals with the flu can you tell me what the situation in BC is and how would you describe the state of capacity right now for pediatric ER? A couple of things I think your story in global mail showed that major restrictions have it worse than us but it's a significant situation here in BC in a general sense we're seeing an increase in emergency room visits at BC children so everyone can see that we're seeing an increase in respiratory illness season in terms of pediatric and neonatal ICU it's been relatively stable in November and December against September and October overall we're seeing approximately 200 people more a day in terms of our daily census in hospitals across BC and the important thing to remember though is that while BC children is very important and significant in terms of the state of interest really it's affecting every hospital in BC we tend to have a lower level of occupancy at BC children than we do at hospitals that take all patients and that's certainly the case right now so yes I think if you look at what we've seen for example in interior health in terms of emergency room visits against a typical November they're significantly higher for respiratory illness from about 300 to about 1,000 in interior health and that's what we're seeing and that's what we're responding to so that means we're taking a series of actions in emergency rooms particularly at BC children as you know the opening up of triage and BC children and if you'd like just to list off what we've done since those announcements we've done the November 16th briefing at Victoria General Hospital we now have pediatricians providing care in the ER BC children has activated their emergency department satellite clinic and we would expect that clinic to still be in place right through tentatively through to March 31st 2023 or until the surge abates effective next week Surrey Memorial will have a process to redirect some patients from the ED to emergency room physicians at the Surrey urgent and primary care center children and youth in White Rock South Surrey have opened we've opened a pediatric access to rapid care clinic at Peace Arch Hospital which has a positive impact there and there's a series of actions that of course were put in place before including the opening up of long-term care beds 187 of them in order to move from acute care to long-term care and those beds are continuing to open so those are the steps we're taking to prepare our healthcare system but I think the key message from us today is that there's another way we can all do that and that's increase our rate of vaccination against influenza and just note in terms of the question I think that Vaughn asked earlier one of the differences we've seen is 2020 and 2021 we had relatively mild influenza season and that is a significant effect on people getting flu shots so there may well be children who as a result of that haven't got flu shots in previous years well they need to get them this year influenza has come back as it was in a number of years prior to COVID-19 and so that's a real change and so continue to give that message we're going to have a record number of people getting flu shots this year but a record number is not what we're looking for we're looking for as many people as possible and if it's your child, your loved one your grandmother, your grandparent whoever it is that's vulnerable we need everyone or as many people as possible to get immunized both against COVID-19 of course but especially right now against influenza . Justine did you have a follow-up? Thank you you did list off a whole bunch of things that BC has done and I'm wondering if there can you explain why we haven't got the message out we knew that there was a flu season that was coming early there was a new system put in place through the get vaccinated program I guess I'm wondering what's going to change this weekend to get parents to get their kids in and why weren't we doing that accessibility piece perhaps earlier? Well we have we're just making the point of it now again I talked about this in September we talked about it in November pediatricians across the province have been reaching out to children in their practice to get the message out this is just reiterating that yes we do need to and to try and talk again about the fact that there are walk-in clinics drop in walk-in weekend next weekend and making sure that we're adjusting the clinic schedule so that parents are aware that they can do this and making special efforts over the next little while and it partly is where we are in the influenza season and it's partly because we're heading up to the holiday season so I want to get that message out to people that we can still do things that will make a difference and make it better for us and our loved ones and our families in the coming holidays . Thank you. Next question. I'm wondering why if this is so urgent right now, why not just drop the get vaccinated part entirely and just let people walk in wherever they want to get this vaccine and I'm also wondering if you can talk about the efficacy of this vaccine and how great of protection do you get from it? Influenza vaccines change every year depending on the strains we expect to see circulating and this year so far we've been seeing across this country and the US as well primarily influenza A H3N2 as I mentioned and so far the lab tests are telling us that it's a very good match to what's in the vaccine. So the vaccines that we have this year they have two strains of influenza A so an H3 and an H1 strain and H1N1 strain and they have both strains of the virus as well. So unfortunately we can't tell the vaccine efficacy until enough people have been vaccinated and we've seen enough cases in both vaccinated and unvaccinated people so it's one of those things that we can look at retrospectively but all the indications so far are that there's a very good match with the vaccine so we know that when there's a good match we can get 50 to 70% protection against infection and against illness with influenza so it's not that we're saying that it just started today we've been saying this for the last few months we just want to reiterate to people that it's not too late the vaccine is still available get vaccinated is the easiest way to do it but we know that there are challenges particularly parents with young children there's lots going on so we have increased the availability for younger children reminding people that it's going to be available especially in the next coming days. Thanks Dr. Henry and maybe I could just add a couple of points you know the get vaccinated system has been highly, highly appreciated by the public they really like that they can book an appointment and we've had an enormous amount of feedback after the initial sort of change where people said oh I used to walk in and now you want me to make an appointment and I think at the very beginning of the campaign it was a little bit shaky as people got used to the notion that they could actually get a notification and book a vaccine but generally it's been really well received and it just provides the clarity and certainty for people that they know where they can get it they don't have to phone around to different places they can go on this one system on a specific basis so it's been really successful and I think in part accounts for the very high uptake we've had the difficulty that we have with children especially the small children is that they're not in the system and we haven't been able to notify their parents and so we've done some work with the government and with the data set and the PIR in the provincial registry for vaccination and we're going to work backwards from there to send notifications out and that's, as I said, going to start today and there's about 150,000 children who aren't in that system that once they're in we can invite them and their parents then can make an appointment or we will welcome them if they walk in you know generally staffing up for the uncertainty if everyone decides to walk in and some people book it for everyone, for staff and for people who end up queuing to get into a clinic if there are a lot of droppings so this smooths it out but as Dr Henry has said we want to make the next few days and particularly next weekend Friday, Saturday, Sunday a time when we're really putting a massive effort on to allow people to walk in make an appointment get into our clinics and call their doctor's offices visit pharmacies if they're old enough to get a vaccine in pharmacies and get the job done and get them protected for the Christmas or the holiday season thanks. Lisa did you have a follow-up? I'm just wondering a couple things I'm going to throw in here like do we know how many kids are absent from school, how great that is and why not do you know I'm 20% seems incredibly low for 5 to 11 year olds, 15% for teenagers why not just do a couple of vaccinations within school but I know there's a lot of workforce for it but if it's that urgent why not use that we just had the HPV wanted our kids school and it was incredibly efficient and in some places around the province they are doing school-based clinics for the most part though especially for the younger children we've heard from families that's not their preferred place to have children immunized although we do often use schools after hours because they're familiar places for parents with young children to bring them in so it is trying to find the right place in the right setting and in some smaller communities the vaccination clinics are often in schools or associated with schools but all of the clinics around the province now are also providing COVID and influenza vaccination so you can get them both at the same time in terms of absenteeism that is something that the superintendents and the individual schools report on regularly and have a good sense of and yes we have seen increased absenteeism the biggest concern that we have of course is that schools are able to function safely and for most part that has been we've been managing around the province and I think it's a reflection as well of lots of children getting mostly milder illness thankfully but also that people are doing the right thing in keeping children home and I know it's a stressful thing sometimes when lots of kids are sick but we are expecting to see this particularly this year when we haven't seen RSV for a while we haven't seen influenza for a few years that is going to be and that we still have COVID here so this is going to be transition year I believe and then hopefully by the time we get to next respiratory season we will be in a better place for our next question Jane Scribnick, black press please go ahead Thank you for taking my question I want to confirm one thing with you Minister Dix you mentioned 300 to 1,000 cases of respiratory illness among kids in interior health can you confirm what time period was that over and do you have similar numbers for the rest of the other health authorities? We can get you that those numbers are from Dr. Fenton in interior health they reflect the situation there so that's an increase in visits to emergency departments from November to November for respiratory conditions so that's the specific statistic we're talking about and Dr. Fenton talked about that in some media discussions over the past weekend and Jane did you have a follow-up? I'm also just wondering how far along into the six to eight week influenza season we are right now so we look at the data that we started to see quite a dramatic increase about two weeks ago so I would say we're in the sort of two to three week phase of it it tends to last two to three or two months or so so it's not too late to make a difference and we've seen it level off a little bit in older teens but definitely increasing still in the younger children so not surprising this is what we saw in Australia and New Zealand as well that we had a very steep peak what we hope and why we're talking again today is we can blunt that peak and we can prevent that ongoing transmission to older adults as we come together over the holiday season which is often when we see our influenza peaking before this pandemic what we saw was our peak of our season tended to be in January after the holidays when people were mixing and there was more spread so we want to prevent that this year and we have the opportunity to do that so we take some action today that will make a difference. Our next question is for Rob Monroe in phone news please go ahead. Hi, I just want to clarify if I heard Minister Dix correctly saying those interior numbers were from November of last year to November of this year which means we're not really comparing apples and oranges but why the interior would possibly be worse off than other places? It's not necessarily worse off this is a province wide circumstance and the response of BC Children's is typically more weighted to Metro Vancouver although obviously BC Children's takes patients from throughout the province all this is is a regular reporting that is done through Interior Health that talks about that Dr Fenton talked about this weekend with respect to Interior Health but I think what we're seeing is amongst children is a more significant influenza season by a very significant margin and that reflects that the presentation at emergency departments reflects that but look, I mean you want to take a step back to where we were in 2021 through in Interior Health August, September, October, November in Northern Health August, September, October, November with the Delta variant of concern of COVID-19 in that period we flew people in the hundreds who were from ICU so these were every case serious down to Southern British Columbia hospitals in order to support them with care that's what occurred in that time and we had a very challenging time as you recall and throughout that period there was deferrals for example of non-urgent scheduled surgeries so we've been going through this for two and a half years what makes this qualitatively different is influenza which is significantly higher which has been higher in every jurisdiction in the country and is higher here in BC so that's what we're seeing but I don't think it's particularly more significant in Interior Health and everywhere else it's a challenge everywhere in BC and that's why everywhere in BC it's important that people get vaccinated. Rob, did you have a follow-up? Yes, I just want to keep this in perspective I think we have 21% of the youngest children being vaccinated this year we can't compare that to last year the year before because of COVID how does that 21% compare to say 2018, 2019 the more historically typical flu season that we've had? The short answer is we don't really know for a variety of reasons and as you said influenza vaccination we didn't record it in the same way that we're doing it this year so with the get vaccinated system and recording of influenza immunizations into our provincial immunization registry we have a much better idea of who's getting vaccinated and their age, their risk, etc. so it's very difficult to compare we hadn't been recording influenza vaccinations in the same way prior to having this system but we have now in place so we do know from surveys that were done in 2018, 2019 that we would have up to 30% of children vaccinated but it varied depending on the year and depending on the severity of influenza and that was always an estimate so we have a better estimate this year the one area it doesn't include is people who were vaccinated at their physicians offices because we don't yet have a direct link to put those immunizations into our immunization registry and we'll be working on that because it is really helpful for all of us to know what rates we have of vaccination but also so that we can get our own vaccination records once we're into the immunization registry. Our next question is for Ashley Joana, Canadian press please go ahead. You mentioned going into the provincial registry to reach out to the families of kids who aren't getting vaccinated can you talk to me a little bit about what that's actually going to look like are people getting text messages are they actually getting phone calls from another human who can answer their questions about the vaccine like what will that actually look like for these parents who aren't part of the system? Thanks so much really great question. The get vaccinated system will use mostly the phone number the information that we have in the registry for people who have never registered and get vaccinated is usually an address and a phone number very occasionally you may have an email if there's an email and or a phone number we will send a text message and if there is an email address we'll send an email so we're using all the information that the get vaccinated system can leverage to actually try and reach these parents and as I said a bit earlier we know that we won't get everybody and that's part of the reason why we have a pretty significant communication campaign going on a lot of social media from the government and from the health authorities the pharmacy association urging people to get vaccinated telling them how to do that as well as there's a lot of activity around the influenza season to let people know but this is a much more direct and targeted response to parents of the very smallest children six months to four years who as Dr. Henry has said are the most vulnerable along with our seniors for the impact of influenza so text or email if we have that available Ashley did you have a follow-up? I do yeah thanks so over the weekend a code orange was declared at the Children's Hospital I'm hoping you can talk a bit about why that was called and how close we are to that happening again the code orange was called at 6.35 a.m. and cancelled at 7.03 a.m. it was enacted based on the information at the time but it was cancelled when it was determined that the code did not need to be enacted but it was required so people are managing as you can imagine have been managing the health care system on a routine basis in that case someone triggered the code orange with the best information more information came in and it was cancelled I think 28 minutes later our next question is for Moira White please go ahead hi thanks for taking my question Dr. Henry you mentioned earlier that you want to use mandates at the last resort where they will have the most impact and benefit can you talk to me about why masks in schools aren't on the table for you right now given that children are being the most impacted as you said? Yeah and you know masking is one of the measures that is needed in certain situations and I talked about that a little bit in answer to von Palmer's question you know it was one of the layers that was absolutely needed at a period of time where we had a lot of transmission of COVID and in the context where we had a number of other measures in place reduced capacity limits increased ventilation which is still an issue making sure that we had the ability to work remotely or to have remote teaching needed etc so there was a whole bunch of activity restrictions travel restrictions that were in place and now we are in a very different situation there are a number of different viruses that are out there circulating that are transmitted between children in many different settings and having only a mask mandate and only in schools is very unlikely to have any difference and effect on the trajectory of the viruses that are circulating in our community so a mandate is a rather heavy-handed measure that we do as a last resort when it is something that is absolutely needed everywhere all the time and right now we are in a place where we have measures that can help mitigate the effects and we can prevent transmission of some of these viruses through vaccination and that is why that is so important and there are other measures that we all need to take on an ongoing basis we have talked about those measures that we do have and we need that extra piece of protection for ourselves depending on the situation we are in but it is not at a place where we would require that as a sole measure as a mandate across the board we do have mask mandates in the settings where it is most important that we have that additional layer of protection and that is in our health care settings right now. I do and perhaps this is also for Dr. Valen why are we not vaccinating kids in schools right now? We have seen in other provinces have really good uptake on COVID vaccines and other vaccine courses in schools and it seems like there is quite a bit of urgency to fund the way that you said so why aren't we going into schools? I will start and I can turn it over as we talked about before. The highest risk age group for children are the children 6 months to 5 years of age who are eligible for vaccination and of course they are not in schools. There is important vaccination programs that are run in schools and in some parts of the province where it makes sense schools are a place where people can get vaccinated for COVID and influenza as well but we know and we have heard from parents that they prefer to have it done at their family doctor's office or in a public health clinic that is established for children so they can bring all of their children regardless of the age and have immunization be provided to the family together. We have time for one more question. Our final question goes to Mira Bains CBC, please go ahead. Hi, I would like the answers in English and French for my French colleagues. This one has already been answered in the last few minutes. I will go ahead and answer hopefully from Minister Dix. The question is why not bring mandatory flu vaccines in schools and also as part of that why not vaccinate children in schools? We have talked about the vaccination clinics in schools. The other thing I would say is we with all of these viruses we tend to spread them to the people we have most contact with. They spread in families, social connections, social groups. Schools in and of themselves are not the only setting where we are seeing transmission. It is unclear if we would even affect the trajectory of what we are seeing in terms of spread unless we had all of those other settings where we didn't have people in contact where we had other measures in place. That is what we have seen over the last two years. We have seen a lot of social activities. We don't have those sports activities. We don't have people gathering and traveling. We can stop transmission of respiratory viruses. But we also know that that has a tremendous effect, particularly on children on their emotional health, their physical health, their well-being. We have to balance risk and the measures that we have that can help prevent transmission that don't interfere with all of those connections and activities that especially children need, but we all need in our communities. So it is trying to find the right balance, as I have said for several years now, of looking at the whole picture, not just focusing on reducing transmission of a virus, but all of the things that we can do to protect ourselves when we are in groups together, but recognizing that those things we do, whether it's getting together with family and friends, and whether it's participating in sports events and tournaments and other things, those are also important for us in terms of our growth and well-being as a society. I think it's important for us to make our children immunized. It's 21% right now that have been vaccinated against the flu in the British Columbia between six months and five years. It's about the same thing, 20% between five years and 12 years. So it's important and essential now to take this opportunity to protect your children against the flu and also against the COVID-19. Why not a program of mandatory vaccination? Now we are primarily at 21%. So there is a lot of progress that we can do from now on. And I think we have to do it. It's important. We have other vaccination programs like other diseases and for a long time we don't have a mandatory vaccination system except in the health system against the COVID-19. But it's absolutely important for those who work in the health system and for the children who are more vulnerable and for people of third age who are more vulnerable to receive the vaccine. And it's for those of us who have taken this conference, but also this campaign and these changes that will make the vaccination of the children easier. This one in French and English too, if possible. This is Serge and young patients admitted to hospital. He is now in the hospital and he is now in the hospital. He is now in the hospital. And I am with the search group where are all of our local patients admitted to hospitals. What's the split or breakdown in respiratory illnesses between flu RfV and Kovid around the province? H. We just talked about that. But there is also, of course, we continue to have people in our hospitals of all ages who are there or who have tested positive for COVID-19. It's about 360 actually. And then there are those who need it and who are there for the most part of our pre-occupation actually. Not for everyone, but for the children. It's the vaccination and the effect of the flu in our hospital system and in our emergency services. We see this elsewhere. A little bit everywhere in the country and more severe in other regions than in our country. But I think that this represents the nest and demands why we are talking about the importance of it. We are talking about the importance of vaccination for the children. And I think I got most of that. Maybe not all of it. But I just say there are a couple of things that we look at to help us understand what is causing infection across the province. We do report that on the new respiratory dashboard on the BCCDC website and you can look at it by health authority. One of the key things that we look at is the number of what we call lab-based surveillance. So when somebody gets a test and we have done this for years during respiratory season if they get a test for respiratory illness whether it is in the emergency department, in the physician's office that all goes to the lab and we do what is called a multiplex test in the lab. So if there is somebody concerned about COVID, concerned about influenza, we have a test that allows us a PCR test that looks for influenza A, influenza B, RSV and now we have added COVID to that. So that is what we call a multiplex test. So one of our key ways of understanding what is causing illness or respiratory illness around the province is looking at that multiplex test and by age group and seeing what viruses come back positive. So that is on the dashboard and we also have a system where we have been looking at the lab at Children's Hospital for many years and you can go back to the old influenza flu bulletins and see the data there and we have now added COVID to that. So if somebody gets a test when they are in Children's Hospital or in the emergency Children's Hospital and it goes to the lab they automatically do those five tests for those five viruses. And that is what helps us understand what proportion of different viruses are circulating. And both of those lab based surveillance so it is not individuals it is based on the first test that people have. And that lab based surveillance is what tells us that we are seeing a lot of influenza. That we are seeing RSV had peaked and was leveling off and that COVID was very young very low in children. And we are also broken down by age we see that COVID is much more common in older people either hospitalized or people being tested with the PCR test. So that is one of the main ways to tell which viruses are circulating in which parts of the province and that is based on lab testing. We also have other pieces of surveillance and it is all a bit of a puzzle so we can say who is getting admitted to hospital what age group what are they being admitted with. We have what we call the sentinel physician or sentinel provider surveillance network, SPSN that we have had for many years and now we have added COVID to that and we have added a lot of information about how many people are visiting community providers with respiratory symptoms and we can tell where it is happening in different parts of the province. So there are a bunch of different pieces that we put together to help us understand what is happening across the province and in different areas of the province. And all of those are on the respiratory dashboard on the BCCDC website. That is all the questions we have for you.