 Good afternoon, my name is Adrian Dix, I'm BC's Minister of Health, to my right is Dr. Bonnie Henry, BC's Provincial Health Officer. We're here today to talk about long-term care and seniors assisted living and visitor restrictions that have been in place in different forms since March of 2020. Everyone will recall and knows who lives in long-term care, who has family members or friends in long-term care. The challenge of the COVID-19 pandemic for everyone in long-term care. We're honoured today, Dr. Henry and I, to speak about this on the territories of the Musqueam, of the Squamish and of the Slewa Tooth First Nations. Today in the regular report you would have received on COVID-19 cases in BC, you'll note that there are no longer any outbreaks in long-term care homes in BC as of today. There's a care home in Dawson Creek, the Rotary Care Home in Dawson Creek that had an outbreak declared over just in the last couple of days. As I say, since March of 2020 there have been restrictions in long-term care, you will remember that on June 30th 2020 changes were made to allow visits in long-term care, social visits in long-term care. And then again on March the 21st further changes were made that significantly expanded the number of visits in long-term care at that time. They were done because of the significant success of immunization in reducing transmission in long-term care that occurred at that time. And we're happy to announce today a series of changes. I'm going to just briefly detail them and then Dr. Henry will go into them in greater detail. The first significant change is that visitors will no longer need to schedule or book in advance to visit loved ones. And the limit on the number of visitors for each resident will be removed. Fully immunized visitors can visit with residents without a mask. Larger facility-wide social events or gatherings are safe to be held again in long-term care and assisted living. Indoor gatherings may include residents and staff across units of a facility. Well outdoor gatherings may include family and friends. In addition to the changes in long-term care and seniors assisted living, adult day programs for seniors and in facility respite can fully resume, providing additional health and well-being benefits for seniors and caregivers in the community. Those programs are essential to seniors programs in BC and seniors care. They of course have been interrupted in the course of the pandemic and those changes are significant. We also want to note that there will be new requirements that these changes will come into force on July the 19th. This will give both care providers, long-term care workers and ourselves a chance to work through all of the details. So we're fully prepared for these changes. These changes are coming and they are going to make I think an important difference for everyone who lives in long-term care and especially and as well their families and their friends. It will be able to allow within significant with continuing restriction, some continuing restrictions for the safety of people in long-term care but true, even spontaneous, unscheduled visits in long-term care that will allow I think a return to a sense of normalcy and social activity in long-term care. I would note that there will be other changes brought into effect that Dr. Henry will speak about. They involve in some cases provincial health orders that long-term care and assisted living workers will be required to report vaccination status to their employer. Workers that are not fully vaccinated will be required to wear a mask at work and be tested for COVID-19 using regular rapid tests. Volunteers and personal services providers entering long-term care settings must be fully vaccinated. Masks will be required for visitors who are not fully vaccinated. Masks will not be required for visitors who are fully vaccinated except when travelling through common areas of a care home. In other words, when arrives, when goes and visits and when the visit occurs when both the resident and the visitor are fully vaccinated can be done without masks. And each site will continue to maintain a sign-in list for contact tracing purposes and actively promote adherence to all infection prevention control protocols. It's just been a long time coming and everybody, I think, as I say, associated with long-term care understands the consequences, the necessary consequences, but the consequences of restriction and visitation in long-term care. We have, of course, made two significant sets of changes before last June and again in March but today's changes will allow, I believe, some return to normalcy while continuing to have safety in long-term care and assisted living. And the changes to resume adult day programs, the changes to resume in facility respite will make a real difference for seniors everywhere. I am very, want to acknowledge the exceptional work done by everybody in the long-term care sector of people who provide personal care to people who have gone above and beyond the call of duty throughout the COVID-19 pandemic. This is an important day. It reflects the progress we're making. Today, as you'll know, more than 79% of adults, more than 78%, 78.4% of all those over 12 have received their first dose of a COVID-19 vaccine. And, well, significantly over 40%, 44%, I believe, of those over 18, 42% of, should I say 42% of those over 18 and 40% of those over 12 have received their second dose of a COVID-19 vaccine. Numbers that will be significantly higher when we arrive at July 19th to these new changes. So the circumstances are in place. Again, no long-term care outbreaks. We have significant decline in test positivity for COVID-19 and reducing cases. And in the long-term care sector overwhelmingly, staff and residents have received both doses of a COVID-19 vaccine. In other words, it's time for a change and it will make an enormous difference. I say it at a personal level. Like many of you, I have loved family in long-term care. And as for everyone involved in the system, this will make, I think, a significant difference in bringing life back to normal after a very challenging and long response and limit on visitation in long-term care. It's now my honor to introduce Dr. Bonnie Henry to give more details of these changes. Thank you very much and good afternoon. And I don't need to say that it is an important day for everybody, particularly for seniors and elders living in long-term care and seniors assisted living. And for those who have family and loved ones in care. The past 18 months has been dramatic on all of our lives, but no more so and no more people are more severely impacted than seniors and elders in our long-term care and seniors assisted living. They were the first to suffer severe illness from COVID-19. And you will recall our first deaths were at a long-term care facility here in Vancouver and really was a harbinger of the heartbreak that was to come in many, many places. We acted quickly to reduce risk by putting in outbreak measures that included restricting visitation very severely for the early parts of this pandemic. It was an incredibly difficult decision to make when we know that social connection is so, so important for seniors' health and well-being. But until a vaccine was available, it was a necessary and important step for protecting people in these most vulnerable situations. Later, we prioritized people living and working in long-term care and seniors assisted living for immunization. And our intent was to protect those who were most vulnerable first to try and reduce that devastation that we had seen. And we are now seeing the positive outcomes from this. Today, the vast majority of seniors in care and residents and workers are vaccinated. And we can see that light at the end of the tunnel. Our ongoing vaccine effectiveness in long-term care tells us that the vaccine program that we have is working and continues to work to protect those people who are living in those settings. And that is really good news. And we saw that through this most difficult third wave where we didn't have the degree of outbreaks that we saw even in the few months earlier, particularly in long-term care. And that's the good news. And because of the progress that we've made across the board here in BC and the fact that almost 80% of us across the British Columbia have received their first dose of vaccine, we're now at a place where we can more fully open and get back to visitation once again. So effective July 19th, we through the safe visitation guidelines, residents and loved ones can safely reunite. So what does this mean? Changes in long-term care and seniors assisted living. The guidelines, the changes in the guidelines will mean that visitors will no longer need to schedule or book their visit in advance. And the expectation is that every facility will ensure that there are visiting hours that are available in evenings, at different times of the day, weekends, etc. And they will have people there to ensure that people are screened when they arrive. But each site will continue to maintain a sign-in list so that we do know who has been in a facility if and when we do have outbreaks. There will no longer be a limit on the number of visitors each resident can have. So now small groups of friends or family can gather together for a visit. And if people are visiting from other parts of the province for so long, haven't been able to see their loved ones, they'll be able to do that without having to book ahead. An important change is that we do expect that all visitors recognizing the risk that we continue to have in long-term care will be fully immunized for COVID-19. That means two weeks after the two doses of vaccine. So visitors will be asked to provide proof of immunization when they arrive at a facility and will continue to need to wear a medical mask when they're in common areas. But they'll no longer be required to follow those infection prevention measures when they're in the room with their loved one or in the area with their loved one. And we can expect that these mask-free smiles will make a lot of people very happy. For those who are not fully immunized or who are not willing or able to produce the proof of immunization, the precautions that we have in place now will be continued to make sure that we don't add additional risk in our care homes. As the minister mentioned, another change is that the adult day programs will fully resume. They had been limited in some areas. And so this will provide additional health and well-being benefits for seniors, as well, of course, as for their families. And finally, larger facility-wide social events and gatherings will be able to be started again. Indoor gatherings include residents and staff across all units of a facility, while outdoor gatherings can now include family and friends as well. We know that these changes will be a big sense of joy and relief to many, many people. But we also know that some people will be nervous, perhaps feeling as though we're moving a bit too quickly. We have considered these things very carefully and we will continue to be watching. And we've scheduled these changes to start on July 19th. So we'll have a good sense of what we're seeing in our community and the risk and transmission in areas around British Columbia as we've been monitoring through the next step of our restart. So we are moving these restrictions slowly and carefully as we have for all of our steps in British Columbia. And of course, continue to have the basics of disease prevention in care homes. And this will not change. That means things like not coming in if you're not feeling well yourself, making sure that you're cleaning your hands regularly, making sure that you're taking those general measures to prevent transmission of infection. And visitors will continue to be screened for signs and symptoms of any illness, including COVID-19 before their visits. And we'll be also bringing in some additional protections for people living in facilities. We will be implementing a provincial health officer order that will require facilities to provide public health with names and personal health numbers for all staff, residents and volunteers. So that facility immunization rates can be determined by public health. And this will allow us to focus immunization efforts to support facilities where immunization rates are not as high as they need to be. And to ensure we understand outbreak risks and can work with facilities to take preventive measures. Workers who are not fully vaccinated will be required to adhere to the ongoing infection prevention and control measures that we have now. And that includes wearing masks. As well, they will be asked to, they will be required to be tested for COVID-19 using rapid tests three times a week. Volunteers and personal service providers who generally work in long-term care will need to be fully vaccinated before they'll be able to resume activities in care homes. We are also taking steps to address some of the staffing challenges that we know have been a challenge particularly as we move into the summer here. And the Ministry of Health will be working closely with health authorities, unions and facility operators to work through the details of how we can best identify and enable pools of fully immunized healthcare workers to move between sites to support the need for temporary respite and vacations over the summer months. This will help make sure we have staff we need to provide high quality care for seniors in the coming weeks and months. This again will be done safely and carefully. And we will accommodate this by modifying the rate order that we've had in place for over a year now to make sure that we can maintain the staffing at appropriate levels but to do it in a way that protects the safety of residents. I want to take a moment to thank each and every resident in long-term care to thank all of the workers whether it's the care aides the nurses, the food staff the cleaning staff has been an incredibly challenging time and everybody has pitched in to try and make sure we can best protect people in the most vulnerable of environments in long-term care and it's made a huge difference for everybody who's been immunized that has made a game changer for all of us but particularly for seniors and elders in long-term care and that has brought us to the place where we are now where we can get back to more normal interactions to support the health and wellness of residents and to the families and friends who have missed those important shared moments over this past 18 months the ability to hold your family member your friend close again I hope that this will be a sense of sweet and joy as I expect it will be for many this is an important day there are many many challenges that we still have facing us both with this pandemic and with our health care services and everything that's going on in our province right now but it is important that this step be out there people know that there is light on the horizon and it also reflects to us the importance and the effectiveness of the vaccine programs that we have here and I encourage everyone who has not yet received their vaccine that it is available to you and that step up now anybody can drop in anywhere for your first dose and we're now making tremendous progress in getting people second doses and fully protected as well immunization is what allows us to move through this next phase and to provide additional support and contact with our loved ones in long-term care and seniors assisted living so I want to thank you very much and we'll and we're happy to take questions as a reminder to reporters on the phone please press star one to enter the queue you will be limited to one question and one follow-up please also remember to take your phone off mute you will not be audible until your name is called our first question today is from Penny daftless ctv please go ahead very much I just wanted to start out with a question for a colleague families have concerns about long-term care staff and vaccination why won't vaccinations be mandatory and will families have a choice about whether their loved ones are cared for by unvaccinated staff yes so as we noted and maybe that wasn't quite as obvious as it should have been but we are taking measures to ensure that healthcare workers particularly in long-term care as a start are either immunized or continue to take the infection control precautions that are in place right now as well as additional testing that will be required for any non-vaccinated staff so those are measures that will be coming into place currently everybody all healthcare workers are following the infection control guidance in long-term care and that will be revised over the next few weeks to make allowance for the protection that we know healthcare workers have from immunization so yes it will be a requirement that all healthcare workers all people who work in long-term care are immunized or they will continue to require masking and testing on a routine basis starting in July 19th so that is part of how we managing to protect people in long-term care as well and it's really not practical for people to choose which staff members they have but we make sure that all of these protections are in place to prevent transmission in these settings and I will say as well we know that vaccination is very effective for residents as well so that's important part of making sure that the whole community in a care home is protected did you have a follow-up Penny after BC's last deadly heat wave in 2009 recommendations were made there was a series of reports urging governments and health officials to take action when temperatures that weren't even close to what we saw in last week's heat wave were forecast the BCCBC they had a specific evidence-based set of steps and recommendations to trigger what they call a heat health emergency for greater Vancouver instead a lot of these recommendations and these reports were not implemented and we saw a very atypical heat wave so I just want to know why did you not declare a public health or heat health emergency with a dire forecast for the heat dome and why didn't you do more with the warnings and knowledge from the 2009 death so I'm glad you brought that up because the process that we have in place is based on those reports and Dr. Henderson, Dr. Kozacki the response that we had to this heat wave was based on that report and was based on the processes that we've had in place you'll see as well on the website there is the health response as well as the municipal response those are plans that we have developed across the province and we did actually enact exactly what you're talking about on the Thursday when it became apparent that the heat was going to be arriving we had our initial meeting we had our provincial heat alert response committee meeting on the Friday morning and a heat emergency was declared in every regional health authority that is what triggers all of the different municipal responses as well as health authority responses in different areas and so you will know from that report that this is done by a regional health authority basis and so the decision was made by each regional health authority to declare a heat health emergency and that was done on the Friday so yes these are really important measures that we took and as you will note we have done them a number of times since 2009 but we've not had anywhere near the heat alert response or the heat waves that we had in 2009 and of course this one was even greater than that and of course was not what the usual response that we have based on what happened in 2009 and clearly was not sufficient to reach everybody in this heat wave for sure but we are working and Dr. Henderson and myself working with the coroner service to do the same type of analysis that we did back then to get a better sense of where were the places that people were that were most at risk and they vary across the province most impact as we were indicating from 2009 in the urban heat islands particularly in Vancouver but mostly in the Fraser health region so we'll be looking at each of these deaths with the coroner service we're also looking at the ambulance call records this is ongoing surveillance that we have been doing every year since mid-2000s to try and better understand the impacts of heat in British Columbia and the things that we can do both short-term and long-term to mitigate those and it's everything from the types of building codes we have from the amount of green space in communities and then of course the response which is things like opening cooling centers things like being able to provide water advice to people about how to stay cool in your own environment so these are all things that were done so we can see what we can learn from this past weeks extreme heat wave so that we're better prepared for the rest of this summer but also to look at whether there's specific communities that we need to do additional measures in not just for this summer but for the future as well Our next question is from Marcella Bernardo News 1130 please go ahead Hi Dr Henry and Minister Dix first off thank you for this good news so many families that I've been talking to over the last few months about when they're going to be able to see their loved ones without any restrictions I was hoping to ask you about the single site order and whether or not that is going to remain in effect for the foreseeable future at least to ensure that staff are not mixing from one care home to another So we are going to be modifying the single site order to allow for some limited movement of staff to in a casual pool essentially to be able to provide respite for workers as they go off on vacations and take some time off over this next few months but it will only be allowed to only fully vaccinated healthcare workers will be able to do that and what we're doing is working with facilities and with the health authorities to have groups of facilities so workers won't be in multiple different facilities to provide casual support in facilities where they're stretched or where they're staffing issues so those are all the details we're going to be working out we've been working with the sector over the last little while to try and find the best, safest way to do that so the single site order will remain in effect and we're moving that into long-term policy because there's a number of other reasons including more than just COVID there's a quality of care issue for residents in long-term care but in the short term we are going to be doing a modification of the order so that in a limited basis we can have pools of vaccinated workers that can support a number of facilities Marcella, did you have a follow-up? I did and regarding more about the heatways because we heard the premier say earlier this week that especially for seniors in care homes and other seniors living alone we're going to have to start building so that we have air conditioning automatically included in our site plans and things like that are you hopeful that we are going to be moving towards a model now where all care homes will have air conditioning and we will ensure that building codes include that so that when we deal with climate change we have that available now that's one of the things that came out of 2009 where heatwaves in other parts of the country in BC we're not a province that has experienced routine heatwaves unlike places like Toronto when I worked there for example where heatwaves were a function every year and we had different ways of dealing with them so it is something that is less common here and certainly we've never ever experienced something like what happened this past week we are looking at care homes there's different types of there's data around different types of cooling that can be very effective clearly having air conditioning is the best but having portable air conditioners or coolers cooling units in specific rooms can help mitigate things in the short term and so we absolutely will be looking at that one of the things about care homes is that we don't see when we look at 2009 and we'll be looking in more detail at this past week but we tend to see it's people in the community so between age 65 and 75 in the community and then older people who are more at risk and that is likely because in care homes there is somebody watching you somebody who can tell if you're coming from the heat and we have measures in place in long-term care homes to try and protect residents when we know a heat wave is coming and that's one of the things that happened last week for example providing cool baths for residents making sure that there are some air conditioned places and that people are monitored so we will be looking at all of those things in some detail we also need to look at our environment to mitigate the effects of heat and that means things like planting trees having awnings over windows looking to some of the countries that experience heat on a routine basis for the things that we can do on a community basis but really for the next I know that some of the temperatures are expecting to go up again next week these are the times when we need to look after our neighbours check in on each other all of the things that can help you to recover from heat things like staying hydrated keeping a cool towel in the fridge and wiping yourself down with it at night having a damp towel or cloth or sheet that helps cool you off through the night so there's lots of good information on the VCCDC website on that and we'll be putting out more messages but we need to really understand what are the short-term things that we need to look at particularly community dwelling seniors in housing that is more at risk for heat accumulating but also in our care system as well did you want to add to that? First of all and I think people know this there is with respect to it's called the heat dome or the heat wave that occurred there is a review being undertaken by the coroner it is an independent review it is an independent review it is part of our statute I want to say that every case it is our expectation that every case will be part of that review every person who passed away will be part of that review every person who is loved and what happened to every person matters and that will occur and that is occurring now it is the absolute best kind of independent review because it is statutory it will be led by the coroner and as far as I am concerned every single person matters in that review and actions will be taken based on recommendations in those reviews that is the first thing the second thing is you are quite right Marcella there has been a lack of investment on the capital side in some long-standing long-term care homes and there is a number of issues including multi-bed rooms and including the fact that many of our most significant long-term care facilities date from the 1960's and 1970's and need to be rebuilt replaced, remediated and that process is beginning and will happen obviously that is a longer-term process it is why long-term care was a very singular focus a very significant focus of all the health authorities during the heat wave period and a significant number of actions were taken and some of the long-term solutions include bringing our long-term care homes into the 21st century and that will happen and I think those are important changes that must happen and as Dr Henry has said many of those most affected by the heat wave were not those already connected to the healthcare system although absolutely everyone was affected there are people in long-term care there are people in assisted living or other forms of home support but obviously many people especially those living at home and others were affected by the extraordinary heat indoors during the heat dome and as I say all of that will be significantly reviewed we are not waiting for the review to take some steps that will need to be taken with respect to that but obviously it is significant what happened and requires a significant response Our next question is from Tonya Fletcher CBC Please go ahead Dr Henry in the latest modelling you had alluded to the fact that we will likely see slight rise in cases as we open up more with this next phase we are wondering how many cases of COVID in a care home might trigger the resumption of restrictions at the current level and if that kind of thing is the contingency you have in the works just in case Absolutely and so we are still seeing requirements in place for declaration of either enhanced surveillance or outbreaks in long-term care homes and that will continue sadly we have still seen despite the high levels of immunization we have seen that this virus can cause outbreaks in long-term care thankfully since the immunization in long-term care has gone up dramatically those have mostly been small and relatively contained but we know that with some of the newer variants they can still spread pretty quickly and people are very vulnerable to succumbing and having severe illness from the virus so the outbreak measures are still in place and during an outbreak we suspend visitation so it will go back to the previous restrictions that are in place during an outbreak Tonya did you have a follow-up Yes please and if we could get an answer in French from Minister Dix as well from my colleagues thank you we are looking for clarity about capacity guidelines the current rules for indoor theaters is 50 people or 50% of capacity which ever is greater if a theater has a capacity of 50 seats are they allowed 50 people or 50% and I suppose more to the point if the greater number of the two is full capacity does that not defeat the purpose of these distancing measures in the first place Yes so we are easing back into this next step to full capacity and yes so the minimum is 50 so if your capacity is 60 then you can have 50 people if your capacity is 100 you can have 50 people if your capacity is 300 you can have 50% and it really was we were at 50 prior to going to step 3 but it is increasing the capacity from there and maximizing the amount of space we know that risk goes up with greater numbers of people so that's why we put in the 50% for the larger venues and trying to maximize the space to keep people a part of needed in those venues Yes I think it is a limitation to control the transmission of COVID-19 in this period but it is time we start with this third step of our opening program and I think it is important to be clear if there is a capacity of 50 people we can have 50 people of course if the capacity is 60 or 50 if the capacity is 200 it is 100 people so I think it is clear for everyone we must always be sure to protect people who visit in theaters so we must continue to have these limitations before reaching a bigger capacity later so it is quite simple I think the limitation of at least 50 and the limitation of 50% gives limitations but clear rules for everyone and I think it will work for everyone Our next question is from Nick Johansson Castanet, please go ahead Hi Dr Henry so here in the interior we are seeing cases relative to the rest of the province remain disproportionately high making up 35 to 40 sometimes 5% of the province's cases while we only have about 15% of the population here it has been going on like this rising for a couple months now can you say what you are seeing different here in the interior than some other regions Yes so obviously the proportion is rising the numbers are still staying relatively low and the other thing we look at is the percent positive in testing and that has come down in the interior though it is higher than the very low rates we are seeing in many other parts of the province so the proportion is really because it has come down so much in Vancouver coastal and Fraser health but yes it is concerning it is still small numbers in different focal areas so as you know I was able to spend some time with the team up in Kelowna to get a better understanding of what was happening in the interior and I do feel that they have a strong public health response and that they are managing cases and we know where each of the transmission events is happening so I do expect it will slow down days and weeks as we manage this and as we get immunization rates up so it is clusters primarily in smaller communities where there has been an introduction and some transmission particularly in pockets of unvaccinated people so this is where we are focusing on our ground game as Dr Ballin likes to call it is trying to get vaccine out to people and that is a challenge and I think this is where we are where we have many small communities and of course right now where we have everything from wildfires to smoke as well to contend with and did you have a follow up Nick? Yeah can you speak to where you are seeing greater transmission I know the Central Okanagan was seeing higher than other places at one point and are you seeing any transmission related to Covid-19? Yes I notice that when I was there that things were happening very quickly some has been related to travel yes from other parts of the country in particular and mostly again in people who are not vaccinated and pockets of transmission the Central Okanagan has gone down quite a bit the last I checked and I'm sorry I didn't look at the CHSA level plots today so the last ones I saw there was again a cluster in a couple of smaller communities in the South Okanagan and along the border with Alberta as well I think it was in Vermeer again that there is still some ongoing transmission but I can certainly get to interior health to give you some more of those details Just encourage everyone to get vaccinated I think it's very important not to overstate a single piece of information you recall I think it was at a time of a modeling presentation by Dr Henry there were 11 cases in Grand Forks and given the relative population of Grand Forks that seemed like a lot of cases within a couple of weeks it had gone down to 0 in the area and in fact there was no transmission in that community so what we are seeing last week or so I think the 7 day rolling average is around 3% test positivity in interior health and in the other 4 health 30s is now under 1% of course that wasn't always the case during the pandemic people know that test positivity rates were very high in Fraser and Vancouver Coastal Health so I think the message to everyone in the interior and I think Interior Health has been doing a really good job of this is that there are significant opportunities for first dose immunization everywhere in interior health and it's important to take advantage of that and get immunized it will not just keep you safe not just keep your family safe not just keep your community safe but allow you to do things including travel potentially to other countries so it's time to get first doses and for those of people who are ready to get their second doses have been invited to get your second dose that is a significant way and continuing to raise immunization levels as we have been throughout BC and I think Interior Health has been doing a particularly good job at reaching out to communities that are opportunities every day check out the interior health website about pop-up first dose vaccination clinics that are available to you and get vaccinated Our next question is from Lisa Cordasco Vancouver Sun please go ahead Thank you very much for providing about poverty and others and why is it important to determine the immunization test for those people One of our challenges has one of the many challenges we have is understanding the immunization rates by facility and that's not something that's easy to get because we provide immunization to healthcare workers and to residents in separate ways so what the order will do is require all facilities to provide public health with the names and PHNs of all workers, volunteers and residents and then we can in public health crosslink that with our immunization registry so the one thing we do have is a registry of all vaccines that have been given to everybody in British Columbia so that way we can verify the immunization status of everybody in those facilities and we can do that and create a database by facility and it will take a bit of time to do that in the first instance to get it all together but then we'll be requiring updating as there's turnover of both residents and staff in long-term care homes so what this will give us in public health is that ability to understand at a facility basis exactly who's immunized and who isn't and we will be targeting workers who are not immunized and making sure that they have all of the information that they need to make that informed decision about receiving vaccine or not and if they choose not to be immunized then we'll be ensuring that they continue with additional personal protective measures within the facility when providing care as well as additional testing so we're going to be working it out over the next little while and while we have all of that information on an individual basis being able to understand it at a facility by facility basis will be really important and it is a partnership with us and with public health and each individual facility to make sure that we do everything we can to prevent this virus and make sure that residents and staff are protected and we hope we can help them. Thank you very much. Thank you. You have a follow-up. I'm just wondering if you have a percentage amount of senior care workers who have been fully vaccinated I don't have it off the top of my head so we do have aggregate numbers of the numbers of workers that we have in the 80s, for two doses, it's even higher. It's about in the 80s for two doses. We can get you the exact numbers. But that, in some places, it underscores, though, that there are pockets where it is considerably lower in some facilities. And so we need to know on a facility-by-facility basis the rate of immunization in residents is even higher than that. Two doses in residents is in the 90s. There are very few residents who are not been immunized, and there's good reasons why some of them haven't. But we have that at an aggregate level, and even at a health authority level, but not at a facility level. And so that's what this new order will facilitate. We have time for one more question today, our final question. We'll go to Lucy Jin, Omni News. Please go ahead. Hello, Dr. Henry. As we see, the infection number goes down recently, but we are also seeing the virus, especially the Delta variant is in dominance. Do you think, do you have any concern for force waves coming out of our province? You know, we've been obviously looking at that really closely. The modelers and the team at BCCDC have been working with us on trying to understand where we look. We've been watching what's happening in other countries, looking at the data about who's immunized, where transmission is happening. The UK is a country that we look at quite closely, and we have a good relationship with them, so we can understand some of the details behind some of the numbers there. What we are looking at with our program here in BCC, and really across Canada, is our approach using the mostly mRNA vaccines, having the extended interval that allowed us to get very high rates of immunization, and also across the board. You know, we started earlier than countries like the UK, for example, in immunizing younger people, teenagers and young people. So, and we have very good rates, at least the first doses, and now moving into second dose in that age group. So these are really important things. The other important thing that we've been doing all along is monitoring vaccine effectiveness. So that helps us understand the level of protection in the real world that's happening. And I mentioned this, and why we feel confident in continuing to open up visitation in our long-term care homes, is because that monitoring of how well the vaccine is actually protecting people is still very high, and we're continuing to see that it's good, strong protection. And today being the first day in a long time where we have not had any long-term care outbreaks is a reflection of how well the vaccine is working, as more and more of the population get immunized, and rates of transmission go down. So we're watching all of that. Plus, we're looking at, as I mentioned many times, we're doing whole genome sequencing of every case. So we do have a good understanding of where what strains are circulating. We've had some blips in Delta. We've had still the predominant strains we're seeing are alpha and the P1, gamma. So, and we're continuing with our strong public health follow-up of cases to make sure that we're isolating people that we're not allowing outbreaks and clusters to spread rapidly. So these are all things that put us in good stead. But there are unknowns as we move into the fall. So we'll be continuing to watch. Some of the modeling that we've done here and also across Canada shows that it's unlikely with the level of immunization we have that we'll see a resurgence, a large resurgence in the fall, but it may be pushed out into early in the new year. There are many, many things that we do not yet know. We don't yet know how long this protection is going to last, particularly for people who are seniors and elders who are immune compromised, who are immunized with a shorter interval earlier on. So we'll be watching that very carefully and we'll be planning for if we need to have a booster dose at some time for certain populations, a third dose maybe in the fall. I think it's unlikely from what we're learning that we'll need to have a booster dose for everybody in the fall or even into next year, but that's only from what we're seeing so far. So there's still so much that we don't know. It's really hard to predict. But the things that we're following most closely are that vaccine effectiveness. So that real world protection that we're seeing in even some of the most vulnerable settings. So there's a lot of studies that are coming out about antibody levels and whether the antibody levels are a reflection of protection or not is something we just don't yet know. So we need to do more and more of correlating those antibody levels with actual protection. And these are the things that the team are putting a lot of time and effort into both nationally and we're talking about that this morning with our Canadian Immunity Task Force and some of the work they're doing and with our vaccine effectiveness studies that are happening across the country. And we are in a relatively unique position in Canada, not only because of the age groups and the interval that we've been using, but also because most of our immunization has been with mRNA vaccines and we are doing the mixing and matching of mRNA vaccines with a longer interval. And there's a number of very elegant studies that are going to help us understand whether that gives people better protection, longer lasting protection, and those are the things that we will be talking about when we have more information as we learn more in the coming months. Lucy, did you have a follow-up? Yes, please. Yes, with higher vaccination levels are being uptick in cases and have already slowed down due to the delta virus. So do you think our province should do that too to slow down a little bit? Yes, so again, what we've been looking at are the things that tell us if vaccine is working and what we're not seeing is virus spreading rapidly in the community. So we have some delta virus, it has been introduced in the community, we had an outbreak in long-term care, but the measures that we're taking are working against that virus as well as for the other viruses that were other virus strains that are causing infections and spreading in the province as well. It is in pockets where we have people who are unimmunized and having contact that we're still seeing spread. So those are the things that in public health we're following up on, trying to isolate people, jumping on clusters before they spread, but so far we have not seen that it is affecting the protection that we're getting from immunization. So that's why the message continues to be we all need to be immunized as soon as possible. We've seen a slowing particularly in the younger age groups and when younger people have contact with each other as we're doing as we're moving to step three of the opening up we will see more cases and it's going to be more and more important that all of us be immunized as soon as possible and then getting our second dose as soon as we can. Because we know that that's effective and it's working right now, even a single dose is working at protecting us from having widespread transmission of any of the strains that are circulating in BC right now. Just really briefly in response to I think Lisa Kordasko's question earlier providing to members of the media the aggregate data for immunization and long-term care and assisted living will be providing that to all of you through the health communications department so that will be coming to all of you soon. The numbers referred to by Dr Henry and with that thank you very much for your questions Minister Bukul and we'll see you soon.