 Good afternoon, my name is Adrian Dix and BC Minister of Health. To my right is Dr. Bonnie Henry, BC's provincial health officer. It's one of the say last night with 13,000 people tuned into the virtual town hall in the Vancouver Island health region co-hosted by Mitzi Dean MLA and Sonia Furstenow MLA with CEO Kathy McNeill and medical health officer Dr. Richard Stamwick who received and answered many questions from the public that tonight there'll be a virtual town hall in northern health hosted by MLA's Mike Bernie and Doug Donaldson and with Kathy Ulrich the CEO of Northern Health and Raina Fumerton the medical officer of health medical health officer I should say in northern health and that tomorrow April 23rd in interior health Kathy Katrina Conroy I should say and Norm Lettek MLA's will be hosting a town hall with Dr. Sue Pollock the MHO for interior health and Susan Brown the CEO of interior health we're honored as I say to be here on the territory of the Lekwungen speaking people the Songhees and the Esquimalt First Nation and I'm honored to introduce Dr. Bonnie Henry for today's COVID-19 update. Thank you and thank you for welcome to today's update for April 22nd we have 71 new cases who have tested positive today bringing our total of test positive cases in British Columbia to 1,795 that includes 745 people in the Vancouver coastal health region 747 in the Fraser health region 110 people in the Vancouver Island health authority 153 in the interior health region and 40 in northern health region we have a number of outbreaks as you are aware we have three new outbreaks in long-term care facilities that were announced earlier today by Fraser health all of them in the Fraser health area and as we know we have been putting a lot of attention at detecting any cases in our long-term care sector very early and that's a reflection of the numbers that we're dealing with we have 20 ongoing outbreaks in addition in long-term care assisted living and one which is in an acute care unit in addition four of the long-term care facility outbreaks that were active in Fraser health have been declared over in our other outbreaks we have 77 cases associated with the mission federal correctional facility and the ongoing investigation and support to that facility with Fraser health including the infection prevention and control and outbreak investigation continues there are five inmates who are in hospital currently in addition we have the 28 cases we talked about yesterday that are reflected the outbreak that's ongoing and the investigation that's ongoing into the poultry processing plant in Vancouver coastal in terms of our case status 103 people are currently hospitalized and of those we have 46 people who are currently in critical care or icu nbc we have an additional three deaths to report today bringing our total of people who have died from COVID-19 in British Columbia to 90 they are all people in the long-term care homes and our hearts go out to the families and the caregivers we now have 1079 people who are fully recovered from COVID-19 as we talked about yesterday we continue to experience new community outbreaks in British Columbia and this of course is very very concerning to me and to all of us this tells us that we have more work to do to break the chains of transmission in our communities and to make sure that every individual every business every community every family does what we need to do to break these chains and that's everyone all the time we can't afford to have any weaknesses in our firewall if we are going to be able to to move ahead into our new normal we know people are tired of staying apart from their loved ones we know we are tired from of not being able to do the social connections and events that we are used to doing but to ease restrictions we need to have a decline in both the number of new cases and the numbers of outbreaks and as i've said many times there are things what we can control and there's things that we don't have control over what is happening around us both in the united states and in other provinces in canada and internationally affects us and we know that that is one of the reasons why we have to be so vigilant here in british columbia until we clear this hurdle we can't begin to make changes one of the most important things that we all need to do is to stay home if we're not feeling well and to and with no exception right now we know that many people experience very mild symptoms with this virus and some may think it's just the sniffles or or perhaps even just allergies at this time of year it makes it really hard to tell if you have COVID-19 but you can still transmit it to others even with very mild symptoms so let me be a hundred percent clear right now if you are ill whether you feel it's a cold whether you feel it's allergies whether you are concerned you might have COVID-19 stay home stay away from others and immediately contact us and we can help you get tested if that's appropriate we also expect that employers need to pay attention to this and need to be responsible you must have measures in place to ensure everyone who's working is healthy and can keep a safe distance from each other in the workplace we do not penalize employees for staying home if they are ill during this pandemic we also employers need to understand that an outbreak in your business has effects on all of us it also can have significant financial impact both for the business and for your employees as we've seen with the number of businesses recently an immediate shutdown is required so that we can ensure that we're not passing this on in those situations your own business will only be able to open again once we are confident that it can operate without putting people in danger the employees or the community so as we are planning for what we want to do in the near future in our new normal these sectors and businesses need to think about these we need to address these issues before we can reopen safely we need to have measures in place to keep people safe to avoid further outbreaks if we start having these types of outbreaks and spread in our community we can overwhelm our system and that's what we've been working so hard to avoid for the last few months so we need to have enhanced cleaning both personal hand hygiene as well as in our environment in the workplace being able to keep a safe physical distance and supporting employees and others to stay away if they are ill we need to have a plan for every business that is open and in the event that an outbreak should occur so that we can detect them early we can remove people from the workplace we can connect with public health and ensure that we are isolating people appropriately so they aren't going to be transmitting it to others there's an order providing this guidance for industrial camps and we and for and we've given guidance for those businesses so it's essential businesses that have been open we need everybody to follow these and we need the same from other businesses as we look to opening things up in the coming weeks we need to keep our firewall strong and we have to be 100 committed to all of us doing our way doing our bit to see our way through this storm I want to take a minute before I finish today to just say a word to uh we're aware I think many of us are more aware today about the the details of the senseless tragedy that has folded in Nova Scotia that place that's very dear to me in this time of unparalleled challenge and I just want to say to my Nova Scotia family wherever you are and to my RCMP family know that know that I'm heaving a sigh and a wish for thee and we'll mourn with you from afar so all of us need to do our part and we need to continue to support each other in doing that we need to be calm and to be kind to each other and to be safe thank you very much dr. Henry I know that everyone in British Columbia agrees and has the same feeling for people the people of Nova Scotia today and what they're going through and the the grief the collective grief that people are going through in Nova Scotia I also wanted to start by acknowledging the families of the three people who passed away from COVID-19 in the last 24 hours in BC tour and Fraser Health one in Vancouver coastal health all were in long-term care but all all those families are going through grief right now and not just the grief of of a loved one passing away but the grief of the circumstances we're in when people are all often separated from the ones they love in these very important moments and in families and in communities so our condolences and our thoughts go out to all of them as dr. Henry has said today is a day in terms of the numbers which sometimes people often people analyze after the these press briefings that we have 71 more cases today reflecting the situation in Vancouver at united poultry and part and others and as well the numbers in terms of acute care where we have 103 cases which is I believe the lowest number we've had in the month of April down from a high of 149 and in critical care 46 which is also the lowest amount we've had in in April show the the continuing effort made by the community I think to break the links of transmission of COVID-19 and something that we have to continue to commit to in acute care hospitals today there's about a 62.1 occupancy rate 4222 vacant beds as a report 46 percent of critical care beds are currently occupied and there has been some interest in what's happening in emergency rooms whether people are seeking the care they need again today more than fourth yesterday more than 4,000 people visited emergency rooms across BC which is up from just under 3,000 on April 6th although continue to be down from the normal say March 9th when it was approximately 6,500 visits so that tells you that people are from where we were in April 6th returning and using healthcare services when they need to use them and I think that's an important thing and something that we will continue to encourage often we celebrate people who are working and essential workers I wanted to acknowledge that April's constructions and skills trades month that there's frequently events recognizing people in construction people skills shapes people across across British Columbia and obviously there isn't the public recognition the public celebrations that often accompany this but we know that thousands of construction workers are working on roads and hospitals and other critical infrastructure needed to keep water and electricity flowing that that construction sites and work sector and work sites have made significant adjustments to the way they operate and we wanted to acknowledge them all their contributions both the BC society and to our communities in every part of BC also wanted to offer for the people who live with dementia or who are supporting a level in living with dementia people know about the first link to first link dementia helpline that it's available as a resource this is run by the Alzheimer's Society at BC helpline staff and volunteers can provide support and information very important in these times about resources in the community so and that number is 1-800-936-6033 and just to let people know that that the Alzheimer's Society has extended first link dementia helpline hours that in English that number again is 1-800-936-6033 it's now Monday to Friday 9am to 8pm in Cantonese and Mandarin it's 1-833-674-5007 and that's that is Monday to Friday 9am to 4pm and in Punjabi 1-833-674-5003 and that's Monday to Friday from 9am to 4pm and I wanted to acknowledge the extraordinary ongoing work in this difficult time of the Alzheimer's Society which I think everyone in British Columbia who's ever been associated with the Alzheimer's Society knows that work and will appreciate that in these times that work is even more important there are a lot of questions ongoing questions about surgery and the resumption of surgery I just want to note that from the period March 16th to April 19th the total number of postpone surgical cases in BC was 13,988 the total completed cases because we of course have continued with urgent scheduled and unscheduled surgeries is 11,936 so even though there was a there that we have deferred and cancelled what are called sometimes called non-urgent scheduled surgeries but essentially just scheduled surgeries that are all important as we know there continues to be a lot of activity in terms of surgeries in BC and extraordinary work continuing to be done we've never had this period in surgeries that should be said this need to renew on the scope and to go back potentially to having surgeries again in BC to resuming elective surgeries which we hope to do of course at some point and that's what you know as we proceed with this work our commitment to patients is not wavered that you are not forgotten that you are the center of what we're doing that we have been planning a resumption of surgery which we are continuing to work on ever since the elective surgeries were cancelled that work continues and I want everybody to know who's waiting for surgery that they are in our hearts and in our thoughts and most importantly in the work that's being done across health authorities in BC and finally I think we see the case whether it's Cargill in Alberta whether it's United poultry here in Vancouver whether it's the circumstances of the mission federal institution in mission the significant and ongoing risks posed by COVID-19 to the health of people in British Columbia and what it says to us surely is that we have to continue to do what we need to do to be 100 all in this is particularly important in light of these outbreaks on the question of working sick and just so everyone understands there will be and we are working hard on ideas of how we can move British Columbia forward from this point but what is not going to change what cannot change and which has to happen now is people have to stay home when they're sick and this is going to be part of the new reality during this period of pandemic sometimes I think there's a sense that it's the brave thing to do or the courageous thing to do to play hurt or to work sick well that can no longer be the case and that is the responsibility of both employers and employees that's something we have to continue to work on but we have to especially have that happen now since we've been giving these briefings in January that has been a consistent theme washing hands not touching your face but most importantly staying home when you're sick it's the key part it may be the most important part of being 100 all in and we really need in light of today's numbers and in light of these community outbreaks we really need people to be 100 all in right now and just finally I'm the premier announced today the opening on April 27th of the the original primary care center in James Bay in Victoria and it shows what we're continuing to do we need to continue to expand our public health services across anything about the last few months has told us anything it's how important public health care is to everyone and we're going to continue to make these efforts and as you saw earlier this week in Castlegar in Vernon and Abbotsford those efforts have expanded through urgent and primary care centers and today I was delighted to hear the premier's announcement of the of the opening in Victoria on April the 27th and with that we're happy to take your questions thank you as a reminder to everybody on the phone please press star one to enter the queue uh please also unmute your phones you are not audible until we call your name first question is from Von Paul son go ahead Von hello dr Henry the other day you mentioned this study in California of antibodies which had suggested a more widespread infection rate than had been detected with conventional testing could you discuss a little more the obstacles here in British Columbia to going to antibody testing I know you've expressed said there's some reservations or we haven't found a reliable test yet but I could you discuss what those are and you also the other day provided a good discussion of the significance of the reproduction rate but you didn't say whether we know enough here in British Columbia to know what it might be here so could you address that as well please sure so let's start with the serology testing and and I will note that there's been quite a lot of discussion in the medical community about the study that was done in California particularly because it was done on a sample of people and the sample of people was recruited through a social media site so it was in many people's opinion likely to be a bit biased towards people who had concerns that they might have had infection the other thing that has become really apparent is that the test that they were using is one that has not yet been sufficiently validated and there's a high a relatively high false positive rate so that's one of the concerns the critique as we know we're all trying to learn a lot from the science of what's going on around the world and that means that many papers are getting out into the public before they have what we call peer review so some of the peer concerns about the paper from from california are around how they recruited people and the the validity of the test which speaks to one of the challenges that we have we want to make sure we know how the test works before we use it to make some such types of of studies and we have a number of them planned very similar to what they did in california however using random samples of blood from a different source so from community blood samples that were taken for other reasons and there's a way we can do that so we have a research process set up to do that to help us understand like they were trying to do in california how many people might actually have antibodies in the community so the challenge in california was when they came up with their estimates part of what they looked at was plotting the number of people who had died in that county santa claire county with the estimates of how many people might have actually been infected and it was somewhere around four or five percent so i will note you know that's not enough to have community immunity or herd immunity but it was much higher than the number of people who had actually been tested when the first phase of the outbreak really went through that county so part of the conclusions were from this study which was done on a very small sample they extrapolated that oh it's not really that bad the death rate is only about point two which is closer to what we would see with seasonal influenza so it's unfortunate that that got picked up is one of the conclusions because i don't think that is supported by either by the test because it has a higher rate of false positive or by the information that came out of that study so this is kind of long winded again sorry um anyway in terms of what we are doing here we want to make sure that we have actually validated the test in the population that we know have been affected here in British Columbia so we can understand what is the false positive or the false negative rate from this test with every test that we have it's not a hundred percent either way and it depends on what's most important whether you want to make sure you're catching everybody or if you want to make sure that you're only catching people who have the disease you're looking for which of the which of the parameters you're more um it are more important and that we've seen this challenge around the world with the serology tests that people are using and the the UK purchased 3.5 million of this one type of test and found out that it had an unacceptably high false positive rate and false negative rate so that leaves us all with a dilemma which is to say that the BCCDC is working with the population and actually one of the good news stories perhaps is that we are using we are working with the the Lynn Valley Care Centre with the people who have survived infection there and there's a good proportion of them to ask them to participate in helping validate this test because we know there are people who have tested positive for this for this virus so that work is ongoing I'm hopeful that we'll have a valid test that we can use as we've mentioned before to have a broader understanding of how many people in our community have been infected but also to be able to understand who has antibodies after being affected it also helps us look at some of the contact tracing and understanding of outbreaks in our communities as they happen so we are weeks maybe sometime in the next week to 10 days we should have a much better idea of which tests we can use for which pieces of this and we are part of course of a of a national consortium to look at how we can use seroprevalence to understand the the pandemic across Canada in terms of our not it's a challenging thing because it's one of those parameters so it depends as we've talked about before of how infectious the virus is how long you're infectious to others and how much contact you have with others during your infectious period and this is gets down to our why distancing is so important if you don't have contact with somebody you can't pass this on and that helps reduce our are not so we were probably at two or three early on as we were having increased transmission in our community and that's what we've seen in other places as well in Wuhan it probably which meant that every person who was infected transmitted it to two or three other people we are now down below one but we can only say that looking back so it is a helpful marker to get so we can understand what are the the things that tell us that we're having increased rates of transmission or decreased rates of transmission so the modelers at the BC CDC are working with us on that and actually at UBC and Simon Fraser and we're talking with our clinical colleagues we're looking at how can we use things like hospitalization numbers of people in ICU to help us estimate how we're tracking with the with our reproductive number over time and we'll be presenting some more of that in the coming days probably later next week. Next question is from Bershdi Basu Victoria Bas. Hi Dr Henry thanks for taking my question I was wondering what exactly is the criteria to declare someone recovered from COVID-19 BC can you tell us whether it differs by health region or whether it's changed recently and also are there people in BC who have tested or tested positive or shown symptoms of the virus after they were thought to have recovered? Yeah so we we have criteria we have two different criteria for how we are determining whether somebody's recovered and it is the same across BC but I will address one issue in a minute so initially around the world we were using after symptoms have resolved and you had two negative tests so the the nucleic acid test the that test that we're doing at least 24 hours apart and we are still using that criteria for people who are hospitalized because they have more severe disease or for people who are immune compromised because we know they can shed virus for longer periods of time but we also have a what we call a clinical criteria recognizing as we did at one point where lab testing took some time we've also recognized as we've learned around the world more about this virus that some people can actually shed the virus for periods of time but it's not live virus so they're not going to transmit it to others and there is a couple of papers including one out of Germany that helped us look at that and essentially they were not able to find live virus in after eight days from symptom onset once people's symptoms had resolved so this is for people who have a mild illness so which is a large proportion of the people in bc've tested positive so if you have a mild illness you're at home your fever has resolved your everything except sometimes people have a lingering cough that may go on for a period of time and you're otherwise well you're back to your normal activities and it's 10 days since your onset of symptoms then we consider people able to be out of isolation and recovered so that's the criteria that we're using across the province there was a point when Vancouver Coastal was just using the algorithm for mild disease and they didn't have a physician oversee the some of the reports and it turned out that not everybody after 10 days had had their symptoms resolved so we went back and recalculated that number in the daily follow-up with people so it was so there was a bit of a reckoning that happened last week to make sure that we weren't over including people and there were some people who have mild disease but their symptoms progressed and lasted longer than 10 days so we're still concerned that they might be able to transmit it to others so they aren't considered recovered until their symptoms resolve completely so that's that's kind of the complex criteria we use in terms of whether people have we have had people who early on particularly with people with mild illness we were testing them you know they had to have two tests two negative tests and we found that people would be negative and then positive and then negative and then positive and then sometimes it went on for some time we now know that it's very unlikely that they will shed virus that could infect others and that's been shown again in South Korea recently where they've had upwards of 80 or 90 people who after a period of time tested positive for the virus again but again not having symptoms and it's not clear that they are infectious well it does not appear that they're infectious to others so we're still learning a lot and it's sometimes complex so we have to try and keep on top of all of the different combinations and permutations that happen. Marcella Bernardo news 1130. Hello I wanted to ask again just because I've been inundated with emails from people who are very concerned about this policy involving not letting staff work at more than one facility I've been hearing from people in Camus I've been hearing from people in the Tri-Cities area pretty much all over the province that they're worried that people are still working in facilities that they could be carrying this virus to other places like long-term care homes where their loved ones are. Yeah so as we've said it's quite complex there are some people who are not part of this so for example we know doctors go between facilities they may have patients in different areas we know that there are pharmacists who are in facilities so there's a group of people who are excluded from that they are not however excluded from the need to use appropriate personal protective equipment and to minimize their visits and take all of the precautions that we need them to take and there is a small percentage of people who need to work in both acute care for example and maybe one long-term care home so there there's not it's not a blanket that everybody is at one and so it may be some people not recognizing who are the people who need to go between facilities recognizing that you know they need to do it with all the precautions that we have put in place I will also say and maybe I'll ask minister Dix to address it but it's taken some time to sort out all the combinations again of that affects so many people and it's particularly a challenge to make sure that we have the appropriate nursing staff and care aides that are able to care for people in each facility yeah I mean this principle came out very early on I think in after the outbreak at Lynn Valley and certainly applied very early on at facilities which were affected by outbreak subsequent that there has been a policy direction and then a provincial health order and so it first because Vancouver Coastal Health was affected first it was it proceeded ahead of Fraser Health so you'll see a lot I think very significant progress in Vancouver Coastal Health Island Health had fewer numbers of people working in multiple care homes as is the case with Interior Health although they had some Island Health completed its work I think earlier and Fraser Health which has thousands of people in the circumstances has been ongoing and doing that work so it is happening it's a provincial health order it's a direction and that is going to be the direction from now on it involves thousands of people so I think the task will be completed soon but the order is in place and that's the direction that we've headed in and that we're on and is absolutely necessary in these times and of course the consequence of that is we have to make sure the consequence of that is that care homes have adequate staff to take care of people in care because in general there's 29,000 people in publicly funded care and more obviously who are in a strictly private system or have involved in private care home in some ways in those 29,000 beds there's some health authority owned and operated ones or non-profit ones or for-profit ones but they're all all 29,000 of those beds are public beds and ultimately due to availability people have some choice they make those decisions so we have to ensure that standards are high across the piece and that's what's happening now it's been an extraordinary effort but I think it reflects the extraordinary impact on long-term care of COVID-19 and the necessity to make these changes so it is happening Marcella there may be some people who haven't had it finalized yet but I think it's been an extraordinary effort to date and it's our expectation that it'll be completed soon. Cindy Harnett times colonist. Hi thanks for taking my question if we continue to flatten the curve into May do you foresee any modifications on restrictions of visitors to senior care homes and hospitals and just by way of a clarification or an update what is the policy around visitation of someone dying of COVID-19 in hospital and what is the policy around a first outbreak in a long-term care home like where we to have one on Vancouver Island is it to remove the patient to a designated area or leave them in place. Yeah so in terms of restriction of visitors there are exceptions right now particularly for people in long-term care also in hospital who are at end of life in particular and yes those exceptions we expect to continue I absolutely hope to be able to at least have one family visitor be available be able to go into long-term care to spend time only with their family member there still will be restrictions in place in that they'll have to only go to their family member we I don't see us being able to open up the care homes like we had where there's group events and and families and others come in to to be with people in those our seniors and elders but I do hope we'll be able to open it up to at least have one family member be able to to come and spend time I know how difficult it is not only for the families who are watching but for for our seniors and elders in long-term care particularly to people with dementia and other medical conditions and the same in hospital it has been very much a challenge for people who are dying of COVID-19 because of the the infection prevention and control risk and so I know in intensive care units in hospital they're going to extraordinary lengths to make sure family can be as close as possible recognizing that we have to wear personal protective equipment and make sure that that the staff are protected as well there is no you know with an outbreak it depends it depends on the resident it depends on what room they're in and how well they can be isolated sometimes they're transferred to hospital but it's not automatic it depends on the family's wishes the residents wishes and how well somebody is able to be cared for and isolated within the facility next question is from David Moncoe ctv hey Dr. Henry I just wondered if you could go into a little bit more detail about what we're learning about the outbreak at united poultry you know we heard from the premier earlier talking about how workers were going there six can you give us a sense of how the concept tracing is leading what you're learning about what was in place the facility or what wasn't so that message once again can be driven home to to people watching us yeah so you know this meat processing plant as all of them are are part of the essential services we need in terms of our food chain my understanding from vancouver coastal health who is doing the detailed investigation obviously i get reports from them on how it's working so they had a report of a community person in the community who had been tested for COVID-19 and in the the course of our contact tracing and understanding the case investigation part of what we do with everybody the person identified that others in their workplace were ill so an inspection was done at the workplace vancouver coastal health went there and realized that there were people who had respiratory symptoms who were in the workplace and so arrangements were made for them to be assessed for everybody in the workplace to be assessed and for an inspection to be done to understand you know how close they were together what protocols they had in place for things like hand washing what protocols they had in place for people not coming into work if they were not feeling well whether there was oversight of those and so obviously a number of quite a few others of the people who were on site at the that time the vancouver coastal went on site tested positive and they are now all home the the factory has had to be closed down because of the the amount of illness but also to ensure that appropriate precautions and changes to the workflow could be done to safely protect the workers in that facility so those are things that are ongoing in addition vancouver coastal is doing the investigation and i should say in vancouver and phraser a number of the people who worked in the facility actually live in in the phraser health region and it is our convention of how we investigate these that we we investigate it by a place of residence so phraser health is working with vancouver coastal to ensure that every individual case we find out who their contacts are so if uh who their family contacts are who they may have had other close contact with and those people are being isolated so that uh if and when they develop symptoms they will not be transmitting them to others so it is ongoing this has only been day three uh since the outbreak was detected so there's a lot of work being done right now across the lower mainland to to get a better handle of what's going on shristi gangdev cknw hi dr henry we're just hearing about a case um of someone who was apparently released from um some sort of institution i'm not exactly sure on the details uh but was released from an institution and tested positive for covid-19 and may have been on their way to a halfway house in prince george but then stopped for a visit at a first nation reserve so there's concern about this and i'm just wondering if you're aware of this um of this case and if you have any insight as to how that could have happened there's some ongoing challenges as we've talked about around particularly around our outbreak at the mission correctional facility and we are aware that people inmates have come to the end of their time and have been released from that facility i'm also aware that there's a number of issues in many regions around indigenous people and going home to their communities their home communities and yes we are monitoring this i know that the first nation's health authority has been in touch around the specific issue as well as involved health authorities and we know there's been a number of issues both in phraser health um in vancouver coastal with people um being uh coming there as well as northern health and vancouver island so it is you know it is a challenging thing because we know we've had um we have had uh people cases and outbreaks or i shouldn't say outbreaks because in the community we've had transmission in communities in all regions of bc that have affected indigenous peoples and first nation's peoples and so it is part of our ongoing challenge in managing particularly when we get these outbreaks and you know the mission facility outbreak is the second largest one that we are dealing with right now and it is complex it involves our federal partners correctional services canada it involves a lot of work that phraser health has been doing to try and make sure we have the right infection prevention and control measures in place to protect the inmates and the people who work at the correctional facility and our community and part of it is being notified when people are leaving the facility and making sure we can support them because as with every outbreak with every close contact situation we want we want and will be supporting people to be able to self isolate for that 14 days so that they're not in a position of transmitting it to anyone else we have time for one more question this afternoon for any reporters that didn't get to ask a question there will be a statement released later today for recommendations on protecting families and communities from COVID-19 visit bccdc.ca for non-medical questions about the province's COVID-19 response visit gov.bc.ca forward slash COVID-19 and for a full listing of the provincial health officers orders visit gov.bc.ca forward slash pho guidance last question is from Keith Baldry Global News Hi Dr. Henry you've talked about the second wave of the pandemic in the past and today Robert Redfield the director of the U.S. Center for Disease Control is saying that he fears the second wave is going to be lethal and far more serious in this wave because it's going to coincide with the start of the regular influenza season I'm just wondering what does Canadian public health take on that second wave and what impact is that going to have on any easing of restrictions yeah and I've talked about it as well and we look historically and that the construct that we've been looking at in which he's referred to Dr. Redfield's referring to is what's happened with influenza pandemics where we have a second wave in the respiratory season we don't yet know and I've talked about this as well whether there is a seasonality to this coronavirus but it is very concerning to me and we've talked about this as well that once we have influenza complicating things and the other respiratory viruses that we see it's much more challenging to detect which one is influenza which one is RSV which one is para influenza which one's COVID-19 and we know with COVID-19 it can go be under the surface for quite some time so that's why it is so important for us to do everything we can over the coming weeks we've we've managed to to control this one fairly well right now but we're starting to see community outbreaks and we need to get on those right away and so important for us to try and get this is down to zero as much as we can now and that's where we've been emphasizing how important it is not to be around others if you're sick because come the fall when we start to see other respiratory viruses again it gets much more complicated for us and that's when we're planning we're planning as well for the for the fall when we start to see respiratory viruses and we know that influenza puts people in hospital every year and we know that this is going to put people in hospital as well so yes there is very much a potential of a surge come the fall and that's one of the things that we are working very hard to have in place the surveillance that we need the testing that we need the contact tracing in our communities that we need but we need to do everything we can now to try and stamp it out as much as possible so that we at least have a fighting chance when we're going into the fall that's all the time we have today thank you thank you