2022-04-12 - Affidavit No 1 of B. Emerson

This is the 1* affidavit of
Dr. Brian Emerson

in this case and was made on
11/APR/2022.
No. $210831
Vancouver Registry
IN THE SUPREME COURT OF BRITISH COLUMBIA
BETWEEN
Canadian Society for the Advancement of Science in Public Policy
PLAINTIFF
AND
Her Majesty the Queen in right of the Province of British Columbia and
Dr.
Bonnie Henry in her Capacity as Provincial Health Officer for the Province
of
British Columbia
DEFENDANTS
Brought under the Class Proceedings Act, RSBC 1996, c. 50
AFFIDAVIT
!, Dr. Brian Emerson, of 1515 Blanshard Street, Victoria, in the Provinc

e of
British Columbia, Deputy Provincial Health Officer, AFFIRM THAT:
1. | am the Deputy Provincial Health Officer (“Deputy PHO”) with the Ministry
of Health, and, as such, have personal knowledge of the matters deposed
to
except where such are stated to be based on information and belief, in which
case, | verily believe them to be true.
2. | make this affidavit in support of Her Majesty the Queen in Right

of the
Province of British Columbia (the “Province”) and the Provincial Health
Officer
(“PHO")'s response to the plaintiff's application to have this action certified asa
class proceeding.
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3. | am authorized to give evidence in this proceeding on

behalf of Dr. Bonnie
Henry in her capacity as PHO for the Province of British Columb
ia.
4. In my role as Deputy PHO, | have been closely workin
g with, supporting,
and advising the PHO on many aspects of the COVID-19
response. This has
included regularly participating in meetings with senior Minist
ry of Health and
other Ministry officials, BC Centre for Disease Control
(“BCCDC”) experts, and
senior public health practitioners throughout the provin
ce. As a result, | have
gained detailed knowledge of many aspects of the pandemic.
In particular, | have
been the lead public health official involved in drafting and amend
ing PHO orders
made under the Public Health Act. Attached and marked as Exhibit “A” is a
copy of my curriculum vitae dated October 19, 2021.
Background to Public Health in British Columbia
(a) The Ministry of Health
5. The Ministry of Health is the responsible ministry for the

province's health
system. It supports and funds the activities of all regional
health authorities and
the Provincial Health Services Authority, including all public
health programs and
services in British Columbia.
6. The Ministry of Health has created a Strategy and Innovation

and COVID-
19 Response Division, which is responsible for supporting the health care and
public health response to COVID-19 in partnership with
the Population and
Public Health Division of the Ministry and the Office of the
PHO (‘OPHO’).
(b) Public Health
7. “Public health” is one component of British Columbia’s health

system and
shares the same overall goals of other parts of the system: reducing premature
death and minimizing the effects of disease, disability and
injury. It is distinct
because it focusses on the health of populations as a whole, rather than
providing health care to individuals.
8. One of the goals of public health is to prevent and manage outbre

aks of
disease within the population. It is also responsible for developing
and delivering
province-wide vaccination programs, including administering the various
vaccinations now available for COVID-19.
9. The PHO is the senior public health official for the provin
ce and is
responsible for monitoring the health of the population and provid
ing independent
advice to ministers and public officials on health issues.
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10. The PHO’s responsibilities are outlined in the Public Health Act and
include, among other things:
a.providing independent advice to the Ministers and public officials on

public health issues;
b.monitoring the health of British Columbians and advising, in an

independent manner, the ministers and public officials on the need for
public health related legislation, policies and practices; and
c.working with the BCCDC, and BC’s medical health officers

(“MHO’s) to fulfill their legislated mandates on prevention, disease
control and health protection.
11. | The PHO leads the public health response under the Public Health Act to
public health emergencies in BC, including the transmission of the coronavirus
SARS-CoV-2 that causes the illness known as COVID-19. The PHO provides
independent expert advice to the Minister of Health and public officials on public
health issues and oversees the work of MHOs.
12. | MHOs are appointed by Order-in-Council under the Public Health Act and
have responsibilities under that Act and many other statutes. The PHO provides
guidance and direction at the provincial level, and regional MHOs implement
policies and programs in their assigned geographic areas. MHOs have broad
powers under the Public Health Act and are, practically speaking, one of the
many workhorses of public health.
13. The health authorities (Fraser Health Authority, Interior Health Authority,
Island Health Authority, Northern Health Authority and Vancouver Coastal Health
Authority) are regional health boards designated under the Health Authorities
Act. Health Authorities are responsible for implementing and enforcing the Public
Health Act and its regulations within their jurisdiction.
14. In the event of a health threat such as that posed by COVID-19, public
health officials coordinate provincial, regional and local public health responses,
including population level interventions and public health measures to prevent
infection by and the spread of the infectious agent responsible for the threat, in
this case the virus SARS-CoV-2.
15. Public health officials also provide direction for communicable disease
prevention and management of COVID-19 by identifying, investigating, and
managing COVID-19 cases, clusters and outbreaks. Public health officials
wh=
include doctors, nurses, environmental health officers, drinking water officers,

dietitians, dental hygienists, epidemiologists, and a wide variety of other health
care professionals.
(c) BC Centre for Disease Control
16. The BCCDC is the scientific and operational arm of the PHO. In this role,
the BCCDC provides communicable disease prevention and control programs for
the Ministry of Health and is the provincial reporting centre for reportable cases
of communicable diseases.
17. The BCCDC manages provincial programs and clinics that contribute to
public health and help prevent and control the spread of disease in BC. The
BCCDC operates the provincial microbiology laboratory, conducts surveillance,
analyses and investigations, and prepares reports on the prevalence and
incidence of communicable diseases on behalf of the PHO. In this way, the
BCCDC provides specialist, clinical, analytical and policy support to the PHO,
government and health authorities, and diagnostic and treatment services to
reduce disease.
18. | The BCCDC maintains the COVID-19 Dashboard, which is an online tool
that provides the latest information on COVID-19 cases, recoveries, deaths,
hospitalizations, testing, and vaccinations in BC. Between March 2020 and April
6, 2022, the COVID-19 Dashboard was updated each business day at
approximately 4:30 p.m. Starting April 7, 2022, the COVID-19 Dashboard will be
updated on a weekly basis. The COVID-19 Dashboard can be found online at:
https://experience.arcgis.com/experience/a6f23959a8b14bfa989e3cda29297ded.
19. The BCCDC also issues, on behalf of the PHO, detailed guidance to the
public on preventing the transmission of SARS-CoV-2 in community settings
such as shopping malls, libraries, child care facilities, and faith-based settings.
20. The BCCDC continuously reviews published scientific evidence about

COVID-19 with a view to determining whether updates to provincial guidance or
policies are necessary.
Background to the COVID-19 Pandemic in British Columbia
21. British Columbia diagnosed its first case of COVID-19 on January 27,
2020.
22. As of early March 2020, COVID-19 was increasing and spread in the
population had emerged in British Columbia. At that time, public health officials
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understood that SARS-CoV-2 was an infectious agent that was causing

outbreaks of COVID-19, that infected persons could transmit the virus to other
persons who they were in contact with, that gatherings of large numbers of
people in close contact could promote transmission, and that there was at the
time no known treatment or cure for COVID-19 and no vaccine to protect against
SARS-CoV-2.
23. On March 11, 2020, the World Health Organization (“WHO”) declared the
COVID-19 outbreak a pandemic. The WHO defines a pandemic as an epidemic
occurring worldwide, or over a very wide area, crossing international boundaries
and usually affecting a large number of people.
24. On March 17, 2020, the PHO issued a Notice of Regional Event under s.
52(2) of the Public Health Act, designating the transmission of the infectious
agent SARS-CoV-2, which has caused cases and outbreaks of a serious
communicable disease known as COVID-19 among the population of British
Columbia, a regional event as defined in s. 51 of the Public Health Act. Attached
and marked as Exhibit “B” is a true copy of the Notice of Regional Event dated
March 17, 2020.
25. The Notice of Regional Event was the first time the emergency powers
under the Public Health Act have been triggered in respect of a communicable
disease in British Columbia. The designation of a regional event allows the PHO
to exercise powers under Part 5 of the Public Health Act, including the power to
make public health orders. As of the date of this affidavit, the Notice of Regional
Event continues to be in effect.
26. On March 18, 2020, the Minister of Public Safety and Solicitor General
declared a state of emergency throughout the whole of the province pursuant to
the Emergency Program Act, because of the COVID-19 pandemic. That
declaration of emergency was extended multiple times and eventually expired as
of 11:59 p.m. on June 30, 2021.
27. The COVID-19 pandemic in British Columbia has been characterized by a

series of “waves” — surges in new cases followed by declines. To date, there
have been five waves of COVID-19 in British Columbia.
28. Each of the five waves of the pandemic are characterized by differences in
the epidemiological circumstances in BC (as well as nationally and globally),
differences in the virus itself, differences in the available scientific evidence and
scientific understanding of COVID-19, differences in the measures taken and the
tools available to public health (for example, whether vaccines were available
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and for which demographic) and differences in the impacts on the population. As
such, the measures adopted by the PHO during each wave of the pandemic
have differed over time to account for these changes.
29. The first wave of the pandemic (March through August 2020), was
characterized by limited scientific and epidemiological information about the
novel SARS-CoV-2 virus and extremely limited immunity amongst the population.
Important control measures for this wave included substantially reducing people
physically interacting with each other through physical distancing which was
achieved in part through strong recommendations to maintain distance of two-
metres, limiting the sizes of groups that could get together, requiring that food
and liquor serving premises provide only take-out services, mask wearing
attention to hand washing and other hygiene measures, and targeted measures
for long-term care and assisted living facilities to protect older people who were
most at risk of very serious consequences, including death.
30. The second wave of the pandemic (September 2020 through March 2021),
was characterized by exponential growth of the virus beginning in the late fall of
2020, and sustained high case levels through the winter and early spring of 2021.
Vaccines became available in BC in December 2020, but were not yet widely
available to the general population until the spring and early summer of 2021.
This wave was anticipated as we recognized that with schools and post-
secondary institutions opening and the change of seasons bringing cooler
weather, people would be interacting more and spending more time indoors,
which would increase the risk of the transmission of SARS-CoV-2 in the
population, thereby increasing the number of people who develop COVID-19 and
become seriously ill.
31. The third wave of the pandemic (March 2021 through July 2021), was
characterized by a peak of cases that was higher than the previous wave. At the
same time, British Columbia’s vaccination program was accelerating and we
were seeing rising vaccination levels among the population.
32. The fourth wave of the pandemic in British Columbia (August 2021 through
December 2021) was driven primarily by the more transmissible Delta variant of
SARS-CoV-2. Generally speaking, based on the available scientific evidence,
unvaccinated people were at higher risk than vaccinated people of being infected
with the Delta variant of SARS-Co V-2 and of transmitting Delta to other persons,
including vaccinated persons. During British Columbia’s Delta-driven fourth
wave, most transmission and infection in British Columbia was occurring in and
between unvaccinated people.
oy ae
33. The fifth wave of the pandemic in British Columbia (December 2021 through
March 2022) was driven by the Omicron variant of SARS-CoV-2. Omicron has
been found to spread even more easily between people than previous COVID-19
variants. During the fifth wave, case rates were very high, resulting in
hospitalizations that exceeded those seen at any prior stage of the pandemic,
which impacted all facets of British Columbia’s pandemic response, including
testing capacity, contact tracing, and capacity within the health care system both
in terms of the system's ability to provide healthcare to patients across the
spectrum and staffing within the system itself due to absenteeism because of
COVID-19.
34. As the COVID-19 pandemic has evolved in British Columbia, and the
available scientific information and epidemiological data change, the measures
adopted by public health officials to combat the COVID-19 pandemic in British
Columbia have been adapted accordingly.
Limiting Transmission of COVID-19 in British Columbia

35. The Province and the PHO have been actively trying to prevent and contain
the transmission of COVID-19 through a series of comprehensive public health
measures, including health promotion, prevention, testing, case identification,
isolation of cases and contact tracing, and more recently vaccination, all based
on the best available scientific evidence.
36. Early on in the pandemic, the virus that causes COVID-19 was identified as
a coronavirus, and the PHO began encouraging the adoption of available public
health measures that were known to limit the spread of coronaviruses, such as
physical distancing.
37. As the scientific knowledge about transmission of SARS-CoV-2 has

evolved, including recognition of both droplet and aerosolized spread, public
health measures have also evolved. Measures adopted in British Columbia to
date include: broad population measures such as PHO orders: environmental
measures (cleaning, disinfection, ventilation); surveillance and response
measures (including contact tracing, isolation and quarantine); physical
distancing measures (e.g. limiting the size of gatherings, maintaining distance in
public or workplaces, domestic movement restrictions); domestic and
international travel-related measures (e.g. limitations on foreign travel, testing
requirements and vaccination requirements) and widespread vaccination, once
vaccines were approved by Health Canada and made available in British
Columbia.
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38. In determining which public health measures were necessary and

proportionate at any given point in time, the PHO considered a wide variety of
information, including the best available scientific evidence and epidemiological
data for BC (as well as nationally and globally) as of the date an order was made,
extended or repealed. These considerations are set out in greater detail in the
paragraphs that follow.
Information Relied Upon by the PHO
39. In exercising her powers under the Public Health Act, and implementing
public health measures, the PHO relies on the best available information,
including the latest scientific evidence, epidemiological data from BC, as well as
national and global data, and scientific modelling from the BCCDC and Public
Health Agency of Canada. The information, scientific evidence, epidemiological
data and modelling available to the PHO has evolved over the course of the
pandemic. In making, amending, extending or repealing orders under the Public
Health Act, the PHO would rely on the best information available to her at the
relevant time.
40. Throughout the course of the COVID-19 pandemic, the PHO regularly
receives and reviews the latest scientific evidence, as well as available global,
national, and provincial level epidemiological data regarding SARS-CoV-2 and
COVID-19, and information with respect to modelling and outbreaks of COVID-
19.
41. Early in the pandemic, the PHO attended daily meetings of the
Federal/Provincial/Territorial Special Advisory Committee of public health officials
from across the country, at which scientific evidence is tabled and discussed. In
2021, this meeting happened two or three times per week. Recently, the
committee dropped the third weekly meeting, so these meetings typically occur
two times per week.
42. Throughout the pandemic, the PHO also attended meetings multiple times a
week with MHOs and public health specialist experts from BCCDC, at which
scientific evidence is tabled and discussed. The MHOs from each regional health
authority also report to the PHO with respect to cases, clusters and outbreaks of
COVID-19 in their region. Recently, these meetings have decreased in
frequency, but still occur two to three times per week.
43. The PHO also receives evidence reviews from the BCCDC and from the
Public Health Agency of Canada on specific issues related to the pandemic,
which are used to develop and adapt national and provincial guidance. She is
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also on the ProMED listserve which synthesizes scientific evidence and sends
daily bulletins.
44. Since the start of the pandemic in March 2020, the PHO has met regularly
with US public health officials from the Pacific Northwest States at which
scientific evidence is discussed. She is also connected to World Health
Organization officials and was part of a working group that developed guidelines
for mass gatherings.
45. The BCCDC publishes situation reports summarizing information about

COVID-19 epidemiology, underscoring data and key trends in the province,
including COVID-19 case counts, British Columbia’s epidemic curve, test rates
and percent positivity, hospitalization rates and deaths, and likely sources of
infection.
46. Between March 23, 2020 and June 29, 2020, the BCCDC published a
situation report every weekday. By way of illustration, attached and marked as
Exhibit “C” is the first daily BCCDC Situation Report dated March 23, 2020.
47. Starting in July 2020, BCCDC published situation reports on a weekly basis.
By way of illustration, attached and marked as Exhibit “D” is a recent BCCDC
Situation Report for the week of March 20-26, 2022, which was published on
April 6, 2022.
48. Each of the BCCDC’s situation reports was provided to the PHO and made
available to the public on the BCCDC’s website.
49. The BCCDC also prepares COVID-19 modelling work, which is reviewed
and relied upon by the PHO. From time to time over the course of the pandemic,
the PHO has provided public briefings about the COVID-19 modelling work that
is done by the BCCDC. The information contained in these modelling
presentations is also considered by the PHO in making, amending and repealing
public health orders. By way of example, attached and marked as Exhibit “E” is
a true copy of the modelling presentation dated August 31, 2021. Attached as
Exhibit “F” is a true copy of the transcript of the PHO’s August 31, 2021 media
briefing explaining the August 31, 2021 modelling presentation to the public.
50. Each of the BCCDC’s epidemiology and modelling presentations can be

found on their website at: —http:/Avww.bccdc.ca/health-info/diseases-
conditions/covid-19/modelling-projections.
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51. Using mathematical modeling, public health generates estimates of

transmission and short-term projections of new COVID-19 cases. The key
indicator of transmission from these models is Rt, (the time-varying reproductive
number), which is an estimate of the average daily number of new infections
generated per case. When the estimated Rt is above the threshold value of 1.0,
this indicates a risk of rapidly growing numbers of new cases. Rt is one of several
indicators used by the PHO to identify trends in SARS-CoV-2 transmission
province-wide and in specific regions.
52. Over the course of the pandemic, the estimated Rt value in the province
has fluctuated. The measures adopted by the PHO, including each of her orders
under the Public Health Act, take into account the Rt value at the time the order
is made.
53. Since the original SARS-CoV-2 virus emerged, it has mutated, which results
in variants of the original virus. If variants emerge that are a greater threat to
public health than the original virus they are called “variants of concern”. Five
variants of concern have emerged: Alpha, Beta, Gamma, Delta, and Omicron.
Each of the variants has different characteristics, including different
transmissibility rates and different propensity to cause serious disease, and
therefore present different risks to the population. Both the Delta and Omicron
variants, which emerged after vaccination was more widely available, have
shown to have different impacts on vaccinated compared to unvaccinated
individuals.
54. The presence of variants of concern in British Columbia, and the

characteristics of the dominant variant in the province at any given time, are
considered by the PHO in determining whether to adopt, amend, extend, or
repeal certain public health measures, including orders made under the Public
Health Act.
55. Although SARS-CoV-2 is novel, evidence of seasonal variation in the

transmission of coronaviruses, well-documented seasonal transmission patterns
of other infectious respiratory viruses, as well as global COVID-19 data to date,
were generally considered in the scientific literature to suggest a seasonal
pattern of enhanced transmission of SARS-CoV-2 in winter months. Accordingly,
over the course of the pandemic, the PHO has considered seasonality to be a
factor in making, amending, extending or repealing orders under the Public
Health Act.
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56. In addition, over the course of the pandemic, public health officials have
learned that the risks of COVID-19 are different in populations depending on their
age group, underlying health conditions, and other social conditions.
57. For example, older people, especially those over age 70, and those who are
immunocompromised, face a much higher likelihood of becoming infected and if
infected, will suffer higher rates of hospitalizations, intensive care unit admissions
and death. In addition, scientific evidence indicates that those living in long-term
care and assisted living facilities, correctional facilities, and homeless shelters,
face a higher risk of transmission leading to serious consequences such as death
to people in those settings.
58. Accordingly, as more scientific information and evidence becomes

available, the orders made by the PHO have taken into account how to best
protect the most vulnerable populations from COVID-19.
Public Health Orders
59. The PHO has made a number of orders under the Public Health Act in
response to the COVID-19 regional event, including new orders and orders
repealing or amending prior orders in response to the changing circumstances of
the COVID-19 pandemic in British Columbia. These orders are available online at
the BC government’s website: https:/Awww2.gov.bc.ca/gov/content/health/about-
be-s-health-care-system/office-of-the-provincial-health-officer/current-health-
topics/covid-19-novel-coronavirus#orders.
60. The PHO can and does amend, extend, and repeal orders to respond to the
ever-evolving COVID-19 situation in British Columbia. In making, amending,
extending or repealing orders, the PHO monitors the surveillance data of case
reports in British Columbia from the BCCDC and national and international
surveillance data respecting the emergence and progression of SARS-CoV-2,
and local, national and international epidemiological data respecting SARS-CoV-
2 and COVID-19.
61. PHO orders and the BCCDC’s guidance documents are regularly updated
to respond to local surveillance data, information about evolving local situations
from MHOs and national and international epidemiological information about
COVID-19. If the current state of scientific knowledge about COVID-19 or the
incidence or prevalence of the disease in British Columbia changes, PHO orders
and guidance are amended or revised in response to the current epidemiologic
conditions in the province.
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62. The overriding concern is to ensure that public health orders and guidance
protect the most vulnerable members of the society and the health care system’s
ability to continue to deliver care for COVID-19-related and other illness, while
minimizing social disruption. As such, changes to orders and guidance are
undertaken where there is epidemiological evidence to support the change.
63. In order to determine whether a particular public health measure should be

adopted, changed, extended, or repealed, the PHO and MHOs have had to take
into account the epidemiological conditions in British Columbia (as well as
nationally, and globally), including transmission patterns, at the time the decision
was made, the scientific information available at the relevant time, scientific
modelling, the characteristics of the virus and presence and characteristics of
variants of concern, the availability of vaccination, the level of immunity in the
population, seasonality, the effects on and capacity of the public health and
health care systems and supporting agencies to respond, and the impacts of the
proposed measures on the public health and health care systems, and on the
population.
64. The orders made by the PHO over the course of the pandemic have
involved a wide range of measures. In general, the orders made by the PHO are
grouped into the following categories:
a. face coverings;
b. preventive measures (including vaccination requirements for certain

health care organization, facility and community health care workers);
c. prevention regional measures (orders which applied only to specific

designated regions of the province);
d. gatherings and events;
e. immunization;
f. food and liquor serving premises;
g. vending markets;
h. overnight camps for children or youth;
i. industrial camps;
j. travellers;
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k. industrial projects restart;
|. personal service establishments;
m. long term care and assisted living staff assignment;
n. agricultural temporary foreign workers;
0. workplace safety; and
p. other orders (including orders related to mink farming and the

delayed return to school in January 2022).
65. Within each of those categories, the PHO has implemented a wide range of
public health measures and has amended those measures as the pandemic has
evolved. For example, under the first Gatherings and Events order-titled “Mass
Gatherings’-made March 16, 2020 at the outset of the pandemic, the PHO
decided to limit gatherings and events to a maximum of 50 people as one
available measure that would assist in limiting the spread of the virus through the
population. The Gatherings and Events order made by the PHO almost two years
later, on March 10, 2022, required proof of vaccination using a BC vaccine card,
in order to attend in certain discretionary settings like sports events and
recreational classes.
Form of Public Health Orders
66. The orders made by the PHO under the Public Health Act have generally
followed the same basic form.
67. At the top of the order, the PHO sets out the individuals or classes to whom
the order is directed.
68. The PHO then provides the rationale for the order in the recitals or
“whereas” section of an order.
69. The body of the order sets out the operative terms, including any definitions.
70. At the end of the order, the PHO generally includes information about
reconsideration and attaches the relevant sections of the Public Health Act as an
appendix.
71. Over the course of the pandemic, the PHO has provided media briefings to
the public to update them on the current state of the pandemic and to provide
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reasons for her decision to make, amend, extend or repeal certain public health
measures, including orders under the Public Health Act.
72. At the outset of the pandemic, the PHO provided these briefings on a daily
basis. In July 2020, the PHO switched to providing briefings three times per
week. From August 2020 to June 2021, the PHO provided briefings to the public
twice a week, with a third weekly briefing added when circumstances warranted.
In July 2021, the PHO provided briefings once per week. In August 2021, when
the fourth, Delta-driven wave of the pandemic again, the PHO provided briefings
twice per week. From September 2021 through January 2022, the PHO provided
briefings once or twice a week, as circumstances warranted. In February 2022,
the PHO provided briefings once per week, with the last regularly scheduled
weekly briefing occurring on March 10, 2022. On April 5, 2022, the PHO provided
a further briefing to the public, explaining her decision to repeal certain PHO
orders effective April 8, 2022 and to provide an update on COVID-19 in the
province.
73. All of the PHO’s media briefings are available online at the following
website: https:/Avww. youtube.com/user/Provinceof8C/videos?app=desktop.
74. At her briefing on April 5, 2022, the PHO advised the public she would no
longer be providing regular media briefings. However, the OPHO will continue to
publish a weekly COVID-19 update, summarizing relevant information on
COVID-19 in the province. Attached and marked as Exhibit “G” is a copy of the
COVID-19 update for April 7, 2022.
Oral Orders
75. In addition to the PHO’s written orders, the PHO has, from time to time,
made oral orders where the risks of transmission were especially high and
measures needed to be adopted immediately.
76. For example, in March 2020, the first orders directed at food and liquor
serving premises were made orally, and subsequently confirmed in writing on
March 20, 2022.
77. On November 7, 2020, the PHO imposed region-specific restrictions for the
Vancouver Coastal and Fraser Health Authority regions only. Attached and
marked as Exhibit “H” is a true copy of a transcript of the PHO’s media briefing
on November 7, 2020 in which she announced her November 7, 2020 oral order.
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78. The November 7, 2020 oral order was region-specific because the data was
showing that transmission and serious adverse consequences were particularly
substantial in Vancouver Coastal and Fraser regions, and that public health
systems in those health authorities were being significantly strained to keep up
with the volume of cases and consequent large numbers of case contacts that
needed follow up through contact tracing to break the chains of transmission.
79. On November 19, 2020, the PHO made an oral province-wide order
prohibiting visitors at private residences and all in-person events, along with
other measures. Attached and marked as Exhibit “I” is a true copy of a
transcript of the PHO’s media briefing on November 19, 2020 in which she
announced her November 19, 2020 oral order.
Regional MHO Orders
80. In addition to orders made by the PHO, MHOs have also made orders
under the Public Health Act to respond to the COVID-19 pandemic in their local
health regions.
81. Generally speaking, MHO orders are used when there is a heightened risk
of transmission of COVID-19 in a particular area of the province, such that
additional public health measures are required to limit transmission in that area
only.
82. Between July 2021 and August 2021, the MHO for Interior Health issued a
number of region-specific orders applicable to the Central Okanagan region and
then later, the entire Interior Health region.
83. Between September 2021 and December 2021, the MHO for Northern
Health Authority issued a number of region-specific orders applicable only to the
Northern Health region (excluding certain local health areas).
84. Between September 2021 and December 2021 , the MHO for Fraser Health
Authority issued a number of region-specific orders applicable to the Fraser East
area of the Fraser Health region.
Reconsideration of the Orders under the Public Health Act
85. Under s. 43 of the Public Health Act, a person affected by a public health
order can request reconsideration if they:
a. have relevant information that was not available to the PHO at the
time the order was made;
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b. have a proposal that was not presented to the PHO when the order
was made and if implemented, would meet the objective of the order
(or be suitable for a written agreement under s. 38 of the Act); or
c. require more time to comply with the order.
86. However, a PHO order is not suspended during the period of

reconsideration unless a MHO or the PHO agrees in writing to suspend it.
87. In general, each of the PHO orders include a reference to the process for
reconsideration of those orders under s. 43.
88. Orders made by the PHO under s. 56 of the Public Health Act, which
require a person to take preventive measures, are also subject to an exemption
process in s. 56(2) if a person to whom the order applies can provide written
notice from a medical practitioner stating that the health of the person who must
comply would be seriously jeopardized if the person complied with the PHO’s
order.
89. Over the course of the pandemic, the OPHO has received hundreds of
requests for reconsideration of orders made under the Public Health Act.
90. In late 2020 and early 2021, the majority of the requests for reconsideration
came from religious groups requesting reconsideration of the PHO’s Gathering
and Events orders which limited in-person religious worship services. The
PHO
considered many of these requests and granted conditional variances (or
exemptions) to a number of religious groups in British Columbia.
91. In April 2021, the volume of requests for reconsideration under s. 43

became beyond the PHO’s capacity to manage and was using resources which
were better directed as assessing and responding to the protection of the public
as a whole. Accordingly, the PHO exercised her power under section 54(1)(h) of
the Public Health Act to suspend the reconsideration of her existing orders at that
time. The suspension did not apply to a request in which an affected person can
establish an infringement of a right or freedom protected by the Charter of Rights
and Freedoms, other than requests to reconsider the prohibition of indoor
worship services, since that issue was determined by the court in March 2021.
92. Following the implementation of PHO orders requiring proof of vaccination,

the OPHO began to receive a large volume of reconsideration requests again. In
particular, we have received approximately 400 requests for reconsideration of
the various orders implementing the vaccine mandate in health care settings, and
-17-
approximately 400 requests related to the Gatherings and Events and Food and
Liquor Serving Premises orders in respect of the vaccine card program.
93. Some of these requests are made on the basis of a medical deferral or
contraindication to vaccination, some are sought based on an individua
l or
group’s rights under the Charter, and many others seek reconsideration on other
grounds or simply because they do not agree with the PHO’s orders. In many
cases, requests for reconsideration suggested alternative measures to those
adopted by the PHO, such as rapid testing or reliance on natural immunity.
Considering and determining each of these reconsideration requests occupies a
significant amount of time and effort from multiple individuals within the OPHO
and requires a decision from the PHO.
94. As of the date of making this affidavit, the PHO has issued approximately
105 active exemptions to orders requiring proof of vaccination, broken
down as
32 health care worker exemptions and 73 additional exemptions pertaining to
the
Gathering and Events orders and Food and Liquor Serving Premises orders,
which includes the 32 exemptions issued to health care workers as they also
received exemptions pertaining to the Gatherings and Events and Food
and
Liquor Serving Premises orders.
95. Exemptions are generally issued on a temporary basis. Some individuals

receive temporary exemptions pending the results of a specialist appointment.
Occasionally, the specialist recommends that the individual proceed
with
vaccination and their approval is rescinded and a denial of their request is
issued. The number of exemptions described in paragraph 94 does not include
exemptions that were issued but have since been rescinded.
96. The OPHO are continuing to review exemption requests and providing
decisions on such requests.
97. Given the amount of the OPHO and PHO’s time and resources being
occupied by this process, resources that are more efficiently and effectively
expended dealing with other facets of managing the ongoing pandemic, the PHO
determined that it was necessary, in the interests of protecting public health, for
her not to consider requests for reconsideration of those aspects of the Orders,
other than on the basis of medical deferral to vaccination, until the level of
transmission, incidence of serious disease, and strain on the public health and
health care systems are significantly reduced.
98. Accordingly, on November 9, 2021, the PHO exercised her power under
section 54(1)(h) of the Public Health Act to issue a variance indicating she will no
- 18-
longer consider reconsideration requests under s. 43 in

respect of certain public
health orders other than on the basis of a medical deferr
al to a vaccination. The
variance has retroactive effect. The PHO issued a similar
variance in respect of
the orders implementing the BC Vaccine Card program.
Best Information on Class Size
99. Not all of the PHO orders applied to the entire population of British
Columbia. Many applied to specific subgroups of the popula
tion only. In addition,
while many PHO orders applied broadly, not everyone the
order applied to would
be impacted. For example, orders limiting attendance at gyms
for the purpose of
engaging in high intensity fitness activities applied broadly
across the province at
various points in time, but would only impact individuals
that attended these
activities and the facilities that offered them.
100. While general population statistics are available

to the PHO, the OPHO
does not have readily available, reliable informatio
n focused on specific
subgroups affected by PHO orders. Although the OPHO
consulted with industry
groups impacted by the PHO orders, and were at times
provided with information
from industry groups with respect to the number of
businesses within particular
industries in British Columbia, | did not take steps to
verify that data and | do not
have information about the reliability of that data.
101. According to quarterly population estimates from

Statistics Canada,
reported on BC Stats and relied upon by the OPHO and BCCDC
, the estimated
population of British Columbia over the course of the pande
mic to date is as
follows:
Q1 of 2020: 5,137,137
“FEam*PDQ20 op
Q2 of 2020: 5,150,616
Q3 of 2020: 5,158,728
Q4 of 2020: 5,156,587
Q1 of 2021: 5,163,919
Q2 of 2021: 5,185,990
Q3 of 2021: 5,214,805
Q4 of 2021: 5,249,635
Q1 of 2022: 5,264,485.
102. The OPHO also relies upon population estimates and projections
prepared
by BC Stats with respect to the population of each regional health authority.
According to publicly available data (generated on April 8, 2022 using
-19-
https://bestats.shinyapps.io/popApp/), the projected population of

each regional
health authority as of 2022 is as follows:
Region Health Authority Year Gender Total

0 British Columbia 2022 Ti 5,263,772
1 Interior 2022 T 82,8436
2 Fraser 2022 T 198,7221
3 Vancouver Coastal 2022 T 1,261,856
4 Vancouver Island 2022 T 880,173
5 Northern 2022 T 306,086
103. The “T” in the Gender column in the tables in paragraph 100 refers to
“Total” and includes both male and female genders.
Statutory Declaration
104. | know of no fact material to the certification application in

this matter that is
not disclosed in my affidavit or that has not been disclosed in
another affidavit
filed, or to be filed by the defendants in response to the plaintiffs certification
application, in this proceeding.
AFFIRMED BEFORE ME
at Victoria, British Columbia
On 11/APR/2022.
A commissioner for taking affidavits

for British Columbia
Marina Goodwin
Barrister & Solicitor
Ministry of Attorney Generai
Legal Services Branch
PO Box 9280 Sin Prov Govt
1001 Douglas Street
Victoria. BC V8W 9J7
Curriculum Vitae - Dr. Brian Patrick Emerson
CURRENT POSITION:
Oct/21 to Present Deputy Provincial Health Officer, BC Ministry of Health
July/18-Oct/21 Deputy Provincial Health Officer (acting), BC Ministry of Health
CAREER HISTORY:
July/03-June/18 Medical Consultant, Population and Public Health Division, BC Ministry

of Health; delegated powers and duties of Provincial Health Officer
Feb/04-Feb/05 Acting Executive Director, Healthy Living and Chronic Disease

Prevention
Jan/01-June/03 Medical Health Officer, Vancouver Island Health Authority, North
August/99-Dec/01 Medical Health Officer, Upper Island/Central Coast Community Health

Services Society
Apr/97-July/99 Chief Executive Officer and Medical Health Officer, Upper Island/Central
Coast Community Health Services Society
Jan/90 —Mar/97 Medical Health Officer/Director, Upper Island Health Unit
Jan — Dec/93 A/Medical Health Officer, Central Vancouver Island (part time)
Mar-Aug/92 A/Medical Health Officer, Coast Garibaldi Health Unit (part time)
Sept/88 - Jan/90 Medical Health Officer, Northern Interior Health Unit

Medical Health Officer, Cariboo Health Unit
Jan/87 - Aug/87 Assistant Medical Health Officer, Central Van. Island Health Unit
July/86 - Dec/86 General Practice, Capital Regional District, B.C.
June/85 — June/86 Rotating Internship, Victoria General Hospital, Victoria, B.C.
ACADEMIC DEGREES:
1987-88 Master Health Sciences (M.H.Sc.), University of British Columbia

1981-85 Medical Degree (M.D.), University of British Columbia
1980-81 Pre-Medicine, University of Victoria
1975-78 Bachelor of Science (B.Sc., Marine Biology), University of Victoria
1974-75 General Sciences, University of Calgary
This is EXHIBIT “_A_” referred to in the affidavit
of DR. BRIAN EMERSON affirmed before me
Update October 19, 2021

4 Oe
A Gommissi ite ig for
British-Colcmbia oe
IN
AWARDS:
2018- George Elliot Award for Lifetime Contributions to Public Health in British Columbia
2008 - Provincial Health Officer’s Award for Excellence in Public Health for dedication and
perseverance on developing the new Public Health Act for BC
PROFESSIONAL MEMBERSHIPS:
College of Physicians and Surgeons of BC

Health Officers Council of BC
B.C Public Health Association
Public Health Physicians of Canada
Canadian Public Health Association
Doctors of BC
Canadian Medical Association
International Doctors for Healthier Drug Policy
BC Friends of Ecological Reserves
PUBLICATIONS:
Emerson, B., & Haden, M. (2020). A Public Health Based Vision for the Management and
Regulation of Opioids. International J. Drug Policy (accepted)
Health Officers Council of BC (December 2017) Determinants of British Columbia’s Opioid

Overdose Emergency (Co-chair of writing committee)
Health Officers Council of BC (October 2017) HOC Submission on Cannabis Regulation to BC

Government (Co-chair of writing committee)
Emerson, B., & Haden, M. (2017). Public health and the harm reduction approach to illegal
psychoactive substances. In S. R. Quah, W. C. and Cockerham & (eds.) (Eds.), International
encyclopedia of public health (2nd edition vol. 6 pp. 169-183 ed., ) Oxford: Academic Press.
Haden, M., Emerson, B., & Tupper, K. (2016). A public-health-based vision for the management
and regulation of psychedelics. Journal of Psychoactive Drugs, 48(4), 243-252.
Haden, M., & Emerson, B. (2014). A vision for cannabis regulation: A public health approach
based on lessons learned from the regulation of alcohol and tobacco. Open Medicine, 8(2), ¢73-
e80.
Kirst, M., Kolar, K., Chaiton, M., Schwartz, R., Emerson, B., Hyshka, E., Thomas, G. (2015). A
common public health-oriented policy framework for cannabis, alcohol and tobacco in Canada?
Canadian Journal of Public Health, 106(8), e474-e476.
Update October 19, 2021 2

lwo
Spithoff, S., Emerson, B., & Spithoff, A. (2015). Cannabis legalization: Adhering to public
health best practice. Canadian Medical Association Journal November. 187(16)
Canadian Public Health Association. (2014). A New Approach to Managing Illegal Psychoactive
Substances in Canada. May 2014. (Co-chair of writing committee)
Health Officers Council of British Columbia. (2011). Public Health Perspectives

for Regulating
Psychoactive Substances -What we can do about Alcohol, Tobacco, and Other Drugs.
(Coordinated writing and publication)
Health Officers Council of BC (September 2013) Submission to the British Columbia Liquor
Policy Review (Coordinated and edited submission).
Book Review (June 2011) Cannabis Policy: Moving Beyond Stalemate by Robin Room,
Benedikt Fischer, Wayne Hall, Simon Lenton, Peter Reuter, POP News (Issue 25), pg 5 - 6,
Canadian Institutes of Health Research - Institute of Population and Public Health, Ontario,
Canada,.
CURRENT MAJOR COMMITTEE ACTIVITIES:
2018 — present: Chair, BC cannabis research network

2006 — present: Health Officers Council of BC, Chair, Standing Committee on Psychoactive
Substances
2004 — 2019: Health Officers Council of BC, Secretary
2013 — present: Federal/Provincial/Territorial Public Health Infrastructure Steering Committee
PAST MAJOR COMMITTEE ACTIVITIES:
1996 — 2002: Health Officers Council Chair-elect, Chair, Past-Chair

First Do No Harm Problem Prescription Drug Use National Strategy Executive Committee
Federal/Provincial/Territorial Prescription Drug Abuse Committee Member
Chaired Public Health Act and regulations development working groups
B.C. Communicable Disease Scientific Committee Chair
B.C. Communicable Disease Policy Committee Member
B.C. Personal Services Establishment Guidelines Committee Member
Federal/Provincial/Territorial Public Health Human Resources Task Group Co-chair, member
Federal/Provincial/Territorial Public Heath Human Resources Enumeration Working Group Co-
chair
Hospital Infection Control Committees (Comox and Campbell River) Member
B.C. Heart Health Coalition Member
Public Health Information System Committee Member
Foodsafe Excellence Implementation Committee Member
Facilities Serious Incidents Tracking System Committee Member
Safe Drinking Water Regulations Committee Member

LS
Ministry of Health representative to the Commission on Resources and the Environment for the
Vancouver Island land use planning process
First Nations Medical Health Officer Health Advisory Committee Member
Upper Island/Central Coast Occupational Health and Safety Committee Co-chair
Upper Island/Central Coast Transition Team Chair — Preparation for regionalization
Salaried Physician Negotiations Advisory Committee
RESEARCH ACTIVITIES:
2019: Reviewer. Canadian Institutes Health Research Team Grant Proposals: Partnerships for
Cannabis Policy Evaluation
2018: Reviewer. Canadian Institutes Health Research Catalyst Grant: Cannabis Research in
Urgent Priority Areas
2018: Attendee Canadian Institutes Health Research Finding Consensus on Cannabis Data
Measures Workshop
2017: Reviewer. Canadian Institutes Health Research Catalyst Grant: Population Health
Intervention Research on Legalization of Cannabis
2015-16: Co-chair Planning Committee Medical Cannabis Research Roundtable with Arthritis
Society of Canada
2012-2013: Co-chair Planning Committee for CIHR funded workshop Cannabis for Therapeutic
Purposes in Provincial Health Systems: A Priority Setting Workshop

st
BRITISH
COLUMBIA
Cliff #1157407
To: Honourable Adrian Dix, Minister of Health

Stephen Brown, Deputy Minister, Ministry of Health
All British Columbia Medical Health Officers
Dr. Evan Adams, Chief Medical Officer, First Nations Health Authority
Dr. Brian Emerson, Deputy Provincial Health Officer (acting)
Dr. Daniele Behn Smith, Deputy Provincial Health Officer, Indigenous Health
Dr. Reka Gustafson, Vice President, Public Health and Wellness
Lorie Hrycuik, Executive Lead, Ministry of Health
Re: Provincial Health Officer Notice

Public Health Act S.B.C. 2008, Chapter 28, section 52 (2)
Further to the provisions of section 52 (2) of the Public Health Act, | hereby provide notice that
the transmission of the infectious agent SARS-CoV-2, which has caused cases and outbreaks of a
serious illness known as COVID — 19 among the population of the Province of British
Columbia, constitutes a regional event as defined under section 51 of the Public Health Act.
On the basis of the information that has been reported to me in my capacity as the Provincial
Health Officer, I reasonably believe that the following criteria found in section 52 (2) Public
Health Act exist:
(a) _ the regional event could have a serious impact on public health;
(b) _ the regional event is unusual or unexpected;
(c) _ there is a significant risk of the spread of an infectious agent; and
(d) _ there is a significant risk of travel or trade restrictions as a result of the regional event.
The purpose of providing this notice is to enable the exercise of the powers in Part 5 of the
Public Health Act in responding to the event.
Signed this 17 day of March, 2020 This is EXHIBIT “_B_” referred to in the affidavit
of DR. BRIA EMERSON affirmed before me
.
SIGNED: _‘? <V/

eeHi
Bonnie
Ss (Grissioner
nouns na)
for taking ffidavits for
Provincial Health Officer
Ministry of Health Office of the PO BOX 9648 STN PROV GOVT

Provincial Health Officer Victoria BC V8W 9P4
Tel: (250) 952-1330
Fax: (250) 952-1362
http://www. health.gov.bc.ca/pho/
BC Centre for Dis€ase Control
a Me ue are Us]
British Columbia COVID-19 Daily Situation report, March 23, 2020
All information is based on direct daily report to BCCDC as of 10:00 AM PT;

Subject to change with reconciliation and/or as data become more complete
Note also that findings are based on laboratory-confirmed case detections in British Columbia (BC) which represent a
subset of actual cases and are subject to changes in testing recommendations and practices.
Figure 1: Map of COVID-19 confirmed cases by health authority, BC, January 1 - March 23, 2020 (N=539)
sbcmeboae Total confirmed COVID cases (deaths) in BC = 539 (12)
Total number of affected long term care facilities (LTCF) in

BC = 6 (4 VCHA; 2 FHA)
‘come This is EXHIBIT “_C_” referred to in the affidavit

dnanen of DR. BRIAN EMERSON affirmed before me
COASTAL (a0] at Victoria, B.C. al ——,
[ess]__| FRASER er
~)
own
a
| 163] A ae foner = faking Affidavits for
British’ Columbia
Table 1. Epidemiological profile reported by health authority of case, BC, January 1 - March 23, 2020 (N=539)
Fraser | Interior | Vancouver Island | Northern Vancouver Coastal n(%)"

Total number (N) of cases 163 40 44 6 286 539°
Median age, cases (years)* 52 47 45 65 54 53
Female sex, cases 80 20 25 4 136 265/486 (55)
Hospitalized (ever) 36 5 4 0 38° 83 (15)
Median age, hospitalized® 73 53 66 - 67 70
ICU (ever) 7 2 2 0 12 23 (4)
Median age, ICU admission® 73 39 66 a 67 71
Deaths 2 0 0 0 11° 13 (2)
Median age, deaths* 383 - - - 87 87
Recovered and off isolation’ 2 8 0 0 136 146 (27)
* Denominator for % derivation is total number of cases (N), except sex for which denominator is as specified for those with known information on sex.
92 confirmed cases are residents or staff associated with six affected long term care facilities.
“Median age is calculated based on those with known information for all, hospitalized, ICU, and deceased cases (n=460, 74, 22, and 7, respectively).
“As of March 22, a new reporting approach has been adopted by VCH which incorporates data collected directly and systematically from hospitals. This explains
the increased tally of “ever hospitalized” without commensurate increase in “currently in hospital” compared to March 20, 2020. Numbers are as reported to
BCCDC by VCH; we cannot vouch further but given the system is new, tallies may be subject to change.
“All are LTCF deaths.
Includes both cases indicates as recovered (2 lab confirmed negative swabs 24 hours apart) and removed from isolation requirements once recovered and at
10 days after symptom onset.
Version: March 23, 2020 1of3

Peer kare te
Table 2. Likely acquisition/exposure of COVID-19 cases in BC, January 1 - March 23, 2020* (N=331)
Health Authority by patient residence

Exposure type Fraser | Interior | Vancouver Island | Northern | Vancouver Coastal | Other’ | Total (%)
International travel 21 9 3 1 24 2 60 (18)
Local 25 5 14 0 16 0 60 (18)
Local + travel” 16 4 2 3 10 0 35 (11)
Unknown 22 8 1 20 0 53 (16)
Pending 2 1 7 1 112 0 123 (37)
*Data as reported in Panorama
“Includes residents from outside BC (E.g., US) diagnosed in BC
°Cases who reported more than one potential exposure (e.g., international travel and contact with a case)
Figure 2: Proportion of respiratory specimens testing SARS-CoV-2 positive* in BC, March 1-March 21, 2020
(N=20,649)
3000 10
9
2500
8
7.
7
2 2000 2$
2 3
a 6 2
5= 1500 5 %
3s
3 ©
o 5S
+ 4 2
s© 1000 @
-Vv 3
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o & i I l f 0
os6 986 @6 +6 86 B6 6FB & 8 DW SB GS 32 Ht NH8 mM8S SFF H 42 © 8B RHR& BDSF AR HD OD A
Oo © mM mM mM mh Mm mM mM M mM MH mM © mM mh mh mh mM mh
2o &£oS 8 @&@Oo @Oo &<oO &§So &So F&F FOo & F< F&F eee Fe° S&Fo |So fFo FSo
SoO SSo S§ooO KR RROo NRoO ANSo KKSo KRSoOo KR KRo
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o oO
RK RK
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KR RK RKo RRR
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o
& RF RFR RK R KRoO RK R KR KROo KR
oS
KROo RKo RK KR
o
KR Qo
ASo
Specimen collection date
mmm Negative Tests mm Positive Tests Percentage Positive
*Participating laboratories include those with confirmatory testing: BCCDC public health laboratory, Vancouver General Hospital, and St. Paul’s Hospital
Data source: PLOVER. Methods and caveats: Test results are tallied at the patient level by date of specimen collection. Case level data means that an
individual is counted once for each specified date. A single individual, however, may subsequently be repeat tested over a span of collection dates (e.g.
until clearance). The relative impact of repeat testing may be greater in the earlier part of the epidemic when more routinely undertaken and there were
fewer tests being done overall.
Version: March 23, 2020 20f3

ree ue ate ee Mutts)
Figure 3: Epidemic curve, confirmed COVID-19 cases in BC by episode date* January 1-March 23, 2020 (N=532)
Case count
60
50°
40
30|
20
10
oe a ee |
RR RRRR SEAR RRR RD SHES ES EGE REESE SH EAS Go
SSRRSRERSSRESRSSRSSSSESSRSKRKSSSSSSSSSS
SRSSAASHASTSSSSTSSS HRS SRSSHSSSSSARRRS
SSSSSSSSSSRANSSSSeS
$$$ Serena seossss
= Symptom Onset Date — Reported Date
*Episode date is based on symptom onset date (n=336), if not available then date COVID-19 was reported to or by health authority (n=196). There are 7 cases
with missing information on these specified date
Figure 4: Percentage distribution of COVID-19 cases, hospitalization, ICU admissions and deaths by age, compared to
the general population of BC, January 1-March 23, 2020
45%
40%
35%
30%
25%
cuill
z&
z
<10 10to19 20 to 29 30to39 = 40to49 «= 50to59 «= G0 to 69» 70to79 = 80 to 89. >90
Age group
™General Population CovidCases Hospitalized ICU mDeaths
*460 cases (79 missing age information); 83 hospitalizations (9 missing age information); 23 ICU admissions (1 missing age information) ; 13 deaths (6 missing age
information).
Version: March 23, 2020 30f3
1 OM OT ecm oom elena ge}
British Columbia (BC) COVID-19 Situation Report

Week 12: March 20 - March 26, 2022
Data for week 12 (March 20 - March 26, 2022) may differ from the data published in the BCCDC weekly report. Data was
extracted on April 01, 2022 for the situation report compared to April 06, 2022 for the weekly report. The situation report uses
the pre-transition data sources.
Table of Contents
! ing strategies in BC, case counts in. ely unde
Epidemic curve and 2 true number of COVID-19 cases in BC. This underestimation has increased compared to the
regional incidence = period prior to the emergence of the Omicron variant in BC. The provincial incidence by
episode date was 29 per 100K (1,543 cases) in week 12.
Test rates and %
positive 3 Incidence by Health Authority from week 11 to week 12:
e Fraser Health incidence decreased from 17 to 15 per 100K
Age profile, testing and 4 e Interior Health incidence decreased from 62 to 55 per 100K
cases * e Vancouver Island Health incidence increased from 28 to 44 per 100K
Severe outcomes 6 e Northern Health incidence decreased from 51 to 47 per 100K
; e Vancouver Coastal Health incidence increased from 17 to 21 per 100K
Age profile, severe 7 Testing of MSP-funded specimens decreased from ~11,200 in week 11 to ~10,200 in week 12.
outcomes fe The percent positivity of MSP-funded specimens increased from 13.1% in week 11 to 15.5% in
week 12.
Care facility outbreaks 8 The per capita testing rates for MSP-funded specimens decreased from week 11 to week 12 in
all HAs except VIHA. The percent positivity for MSP-funded specimens increased from week 11
Wastewater 8 to week 12 in all HAs except FH. From week 11 to week 12, the testing rates decreased or
surveillance % remained stable in all age groups while the percent positivity increased in most age groups.
‘Additional ceasources 9 Age-specific incidence rates increased in most age groups from week 11 to week 12. Incidence
A rate increased the most in the 80+ year-olds from 91 per 100K in week 11 to 116 per 100K in
Appendix 10 week 12,
The number of hospital admissions decreased from 233 in week 11 to 197 in week 12. In week
12, 80+ year-olds had the highest number of hospital admissions (70 hospitalizations). The
weekly number of deaths decreased from 20 in week 11 to 13 in week 12.
In week 12, 2 new care facility outbreaks were declared, based on earliest case onset date. 1
of the 13 deaths (8%) reported in week 12 were associated with a care facility outbreak.
BELOW ARE IMPORTANT NOTES relevant to the interpretation of data displayed in this bulletin:
© Episode dates are defined by dates of illness onset. When those dates are unavailable, earliest laboratory date is used (collection or result
date); if also unavailable, then public health care report date is used. Analyses based on episode date (or illness onset date) may better
represent the timing of epidemic evolution. Episode-based tallies for recent weeks are expected to increase as case data, in particular onset
dates, are more complete.
e The weekly tally by surveillance date (result date, if unavailable then report date) includes cases with illness onset date in preceding weeks.
Episode dates for hospital admission, ICU, and death are defined by admission and death dates. When unavailable, surveillance date is used.
© As of June 15, 2021, per capita rates/incidences for year 2020 are based on Population Estimates 2020 (n= 5,147,772 for BC overall) and for
year 2021 are based on PEOPLE 2021 estimates (n= 5,194,137 for BC overall).
e Laboratory data include Medical Service Plan (MSP) funded (e.g. clinical diagnostic tests) and non-MSP funded (e.g. screening tests) specimens.
© Data sources include: Health Authority case line list data, laboratory PLOVER data, and hospital data (PHSA Provincial COVID19 Monitoring
Solution (PCMS)).
© Case data were extracted on April 01, 2022, laboratory data on April 01, 2022, and PCMS hospitalization data on April 01, 2022.
© Data for week 12 (March 20 - March 26, 2022) may differ from the data published in the BCCDC weekly report. Data was extracted on April 01,
2022 for the situation report compared to April 06, 2022 for the weekly report. The situation report uses the pre-transition data sources.
This is EXHIBIT ¢B—*referred to in the affidavit
of DR. BRIAN EMERSON affirrned before me
at Victori 2C., this.11 day of April, 2022.
BCCDC COVID-19 Situational Report Week 12 7 i 7 Page 1 of 10
*Commissioner for taking ne for

British Columbia
BC Centre for Disease Control
A. COVID-19 case counts and epidemic curves

Due to changes in testing strategies in BC, case counts in this report likely underestimate the true number of COVID-19 cases
in BC. This underestimation has increased compared to the period prior to the emergence of the Omicron variant in BC. Up
to week 12, there have been 355,672 cases for a cumulative incidence of 6,750 per 100K (Table 1, Figure 1). The provincial
incidence by episode date was 29 per 100K (1,543 cases) in week 12, which has decreased from the most recent peak of 407
per 100K in week 52. Incidence by episode date may increase as data become more complete in recent weeks.
As shown in Figure 2, incidence rate decreased in Fraser Health (FH), Interior Health (IH), and Northern Health (NH) from
week 11 to week 12. From week 11 to week 12, incidence rate increased from 28 per 100K to 44 per 100K and 17 per 100K
to 21 per 100K in Vancouver Island Health (VIHA) and Vancouver Coastal Health (VCH), respectively. In week 12, the highest
incidence rate was in IH at 55 per 100K.
Table 1. Episode-based case tallies by Health Authority, BC, Jan 15, 2020 (week 3) — Mar 26, 2022 (week 12) (N=
355,672)
+ Health Authority of Residence Outside
Case tallies by episode date FH 1H VIHA NH VCH Canada Total
Week 12, case counts 293 453 391 145 261 0 1,543
Cumulative case counts 158,555 | 62,362 | 33,110 | 29,309 | 71,946 390 355,672
Week 12, cases per 100K population 15 55 44 47 21 NA 29
Cumulative cases per 100K population 7,979 7,528 3,762 9,575 5,702 NA 6,750
Figure 1. Episode-based epidemic curve (bars), surveillance date (line) and Health Authority (HA), BC
Sept 13, 2020 (week 38) — Mar 26, 2022 (week 12) (N= 347,825)
24000
22500-
21000
19500 360 5
#2 16500
165
§ 15000-
320 §s
280 3
2 13500 +240 8
& 12000 200 a
& 10500 3
9000- 160 &
7500 420 °
6000 ‘
4500- - / ] aa J 80
| wee, nt | oS mi
1800On 40 42 44 46 48 5052
ADE 1 3
atA OTT E
5 7 9 114 13 15 17 19 21 23 25 27 29 31
AaMUHITEANATEER
33 35 37 39 41 43 45 4951135791
-
0
Epidemiological week
FH IH NH Provincial case counts by surveillance date

VCH VIHA Out of Country “*" Provincial incidence per 100,000 by episode date
BCCDC COVID-19 Situational Report Week 12 Page 2 of 10

Figure 2. Weekly episode-based incidence rates by HA and health service delivery area (HSDA), BC
Fraser Health (FH) Vancouver Coastal Health (VCH)
200 Fraser Hoath over VancourerSsate
Hest, ovrat
T0.
a an ase Sau 3 Vercenset
25 eee 560 aaa
429. EN tronics i00- set Shon Gon
ieBh oan ee leas ON, {*
atin, ioB, cass Oa. I
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B. Test rates and percent positive

COVID-19 testing guidelines recommend testing for people who have COVID-19 symptoms, and are at risk for severe disease
or live/work in high-risk settings. As shown by the darker-colored bars and dotted line in Figure 3, the number of MSP-
funded specimens and the percent positivity of MSP-funded specimens have continued to decrease from the peak of
~88,900 in week 51 and the peak of 35.4% in week 4, respectively. Between week 11 and week 12, the number of MSP-
funded specimens decreased from ~11,200 to ~10,200 while the percent positivity of MSP-funded specimens increased from
13.1% to 15.5%.
As shown by the dotted lines in Figure 4, the per capita testing rates for MSP-funded specimens (Panel A) decreased from
week 11 to week 12 in all HAs except VIHA, where testing rate increased from 130 per 100K in week 11 to 144 per 100K in
week 12. In week 12, NH had the highest testing rate at 380 per 100K.
Percent positivity (Panel B) for MSP-funded specimens increased from week 11 to week 12 in all HAs except FH, where it
remained stable at 10.3% in week 11 and 9.4% in week 12. Percent positivity increased the most in VIHA from 21.4% in week
11 to 29.3% in week 12. In week 12, percent positivity ranged from 9.4% in FH to 29.3% in VIHA.
Figure 3. Number of specimens tested and percent SARS-CoV-2 positive, by collection week, BC
Sept 13, 2020 (week 38) — Mar 26, 2022 (week 12)
10 600:
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Note fnveia i + 3420) ara ndetormnate (0 = 17043) “eauta nave Deen excucee
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Figure 4. Testing rates and percent SARS-CoV-2 positive by Health Authority and collection week, BC
Sept 13, 2020 (week 38) — Mar 26, 2022 (week 12)
Testing Rate per 100,000
.... MSP Only
FH
VCH
1H
VIHA
Percent Positive
NH
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Data source: laboratory PLOVER data
Cc. Age profile — Testing and cases

Testing rates and percent positivity by age group
As shown by the bars in Figure 5, testing rates decreased or remained stable in all age groups from week 11 to week 12. In
week 12, testing rate was highest in those aged 80+ at 662 per 100K, which likely reflected the age group prioritized for
testing.
As shown by the black dots in Figure 5, the percent positivity increased from week 11 to week 12 all age groups other than
the 10-14 and 15-19 age groups. Between week 11 and week 12, percent positivity increased the most in the 80+ and 0-4
year-olds from 13.3% to 18.8% and 9.8% to 14.7%, respectively. In week 12, 20-39 and 80+ year-olds had the highest percent
positivity at 18.8%.
Case distribution and weekly incidence by age group

As shown in Figure 6, age-specific incidence rates increased in the <10, 40-49, 60-69, 70-79, and 80+ age groups from week
11 to week 12. Incidence rate increased the most in the 80+ year-olds from 91 per 100K in week 11 to 116 per 100K in week
12. Age-specific incidences may increase as data become more complete. Detailed information about age-specific incidence
by vaccination status can be accessed at BCCDC COVID-19 Regional Surveillance Dashboard.

Figure 5. Average weekly SARS-CoV-2 MSP testing rates and MSP percent positive by known age group, BC
Feb 19, 2022 (week 7) — Mar 26, 2022 (week 12)
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Data source: laboratory PLOVER data
Figure 6. Weekly age-specific COVID-19 incidence per 100K population by epidemiological week, BC
3g 40 42.44 46'48'50 62°13 6°79 1113 18 17 19 21 23 26 27 29 31 33:35°37 39141143 45.4749 51 1-3 8 7 9 11

<10 10to14 = 15to19 “™ 20to 29 30t039 ““ 40to49 = 50 to 59 ~~ ~60 to 69 70to79 ~~ 80+

D. Severe outcome counts and epi-curve

The number of hospital admissions decreased from 233 in week 11 to 197 in week 12. In week 12, 80+ year-olds had the
highest number of hospital admissions (70 hospitalizations). Hospital data include admissions for people diagnosed with
COVID-19 through hospital SARS-CoV-2 screening practices, and will overestimate the number of people who are
hospitalized specifically due to severe symptoms of COVID-19 infection. The weekly number of deaths decreased from 20 in
week 11 to 13 in week 12 (Table 2, Figure 8). Detailed information about outcomes by vaccination status can be accessed at
BCCDC COVID-19 Regional Surveillance Dashboard.
Cumulatively, there have been 29 confirmed cases of Multi-system Inflammatory Syndrome in children and adolescents
(MIS-C) in BC since January 1, 2020. There have been no new confirmed cases of MIS-C since the last report. The median age
of all cases is 9 years old (range from 1 to 16 years old).
Table 2. COVID-19 severe outcomes by episode date, Health Authority of residence, BC

Jan 15, 2020 (week 3) — Mar 26, 2022 (week 12)
Health Authority of residence Residin,
Severe utbomnes by episoue dats FA 1M | VIHA | NH | VCH] outside of canada | Total n/N*(%)
Week 12, hospitalizations 76 48 26 1s 32 0 197
Cumulative hospitalizations’ 9,057 3,432 1,527 | 1,826 3,785 17 19,644/355,672 (6)
Week 12, ICU admissions 2 3 1 4 3 oO 13
Cumulative ICU admissions” 1,432 820 335 412 835 2 3,836/355,672 (1)
Week 12, deaths 6 2 0 3 2 0 13
Cumulative deaths 1,347 366 238 326 716 0 2,993/355,672 (1)
a. Cases with unknown outcome are included in the denominators (i.e. assumed not to have the specified severe outcome).
b. Data source: Health Authority case line lists only. Data may be incomplete and subject to change.
Figure 8. Weekly COVID-19 hospital admissions and deaths by age groups, BC, Sept 13, 2020 (week 38) — Mar 26,
2022 (week 12)
Hospitalization Death
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b, Data source: Health Authority case line lists only. Data may be incomplete and subject to change.

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E. Age profile, severe outcomes

Table 3 displays the distribution of cases and severe outcomes. In week 12, median age of hospital admissions, ICU
admissions and deaths was 63 years, 62 years and 82 years, respectively, based on Health Authority case line lists only (data
not shown).
From week 9 to week 12, there has been a weekly average of <1 death in those <50 years of age, <1 death in 50-59 year-
olds, 2 deaths in 60-69 year-olds, 7 deaths in the 70-79 year-olds, and 13 deaths in the 80+ year-olds (data not shown). The
number of deaths may increase over time as data becomes more complete.
Table 3: Age distribution: COVID-19 cases, hospitalizations, ICU admissions, deaths, and BC population by age group
Jan 15, 2020 (week 3) — Mar 26, 2022 (week 12) (N= 355,562)?
Age group Cases Hospitalizations Icu Deaths
(years) n (%) n (%)® n (%) n(%)
<10 29,517 376 (1) 32 (<1) 2 (<1)
10-19 35,356 294 (1) 36 (<1) 0 (<1)
20-29 71,215 1,182 (2) 128 (<1) 6 (<1)
30-39 67,640 2,038 (3) 313 (<1) 31 (<1)
40-49 52,328 1,998 (4) 412 (1) 64 (<1)
50-59 41,882 2,715 (6) 746 (2) 166 (<1)
60-69 28,114 3,480 (12) 965 (3) 351 (1)
70-79 14,748 3,593 (24) 849 (6) 654 (4)
80-89 9,750 2,891 (30) 332 (3) 986 (10)
90+ 5,012 1,128 (23) 38 (1) 733 (15)
Total 355,562 19,695 3,851 2,993
Median age‘ 36 63 62 82
Among those with available age information only.

b. Data sources: Health Authority case line lists and a subset of PHSA Provincial COVID19 Monitoring Solution (PCMS) data for children <20 years of age.
PCMS data were included as of June 8 2021. Due to this change in data source, additional admissions that occurred since the start of the pandemic are
now included in age groups 0-9 and 10-19 years.
c. Median ages calculated are based on Health Authority case line lists only.

F. Care facility outbreaks
As shown in Table 4 and Figure 9, 609 care facility (acute care and long-term care settings) outbreaks were reported in total
in BC to the end of week 12. In week 12, based on earliest case onset date, 2 new outbreaks were declared. Since week 1 of
2022, the number of new outbreaks have generally been declining and the majority of outbreaks have been in long-term
care settings. 1 of the 13 deaths (8%) reported in week 12 were associated with a care facility outbreak. The number of
deaths may increase over time as data becomes more complete.
Table 4. COVID-19 care facility®” outbreaks by earliest case onset®‘, associated cases and deaths by episode date,
BC* Jan 15, 2020 (week 3) — Mar 26, 2022 (week 12) (N=609)
Care facility outbreaks and Cases Deaths
cases by episode date Outbreaks | posidents tl Unknown | Total |} Residents _ Unknown | Total
Week 12, Care Facility Outbreaks 2 79 11 0 90 1 0 0 1
Cumulative, Care Facility Outbreaks 609 7,853 3,621 7 11,481 1,377 0 0 1,377
Figure 9. COVID-19 care facility’ outbreaks by earliest case onset’, facility type (A) and Health Authority (B), BC’
Sept 13, 2020 (week 38) — Mar 26, 2022 (week 12) (N=541)
30-
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facility outbreak total.
. Care facility settings include acute care or long-term care settings (defined as long-term care facility or assisted living).
c. — Earliest dates of onset of outbreak cases are subject to change as investigations and data are updated.
d. As of week 46, VCH and FH no longer declare outbreaks with single staff cases unless there is evidence of transmission within the facility.
G. Wastewater surveillance
The BCCDC and Metro Vancouver have been testing for SARS-CoV-2 in wastewater at five wastewater treatment plants
(representing 50% of BC’s population) since May 2020, in order to assess whether COVID-19 virus is present and how it
might be changing over time. For each sample collected, Metro Vancouver measures the daily wastewater flow (i.e. volume
coming into the wastewater treatment plants). Wastewater flows can change with rainfall and snowmelt. To account for
possible effects of wastewater volume, SARS-CoV-2 concentrations have been normalized by daily wastewater flow and
referred to as viral load to wastewater treatment plant (copies/day). All COVID-19 positive cases are mapped to each
sewage catchment. As shown in Figure 10 and Figure 11, SARS-CoV-2 wastewater results are compared to the incidence of
community COVID-19 cases.
Key messages with results through to April 2:

e After a period of stability following decreases from the peak of the Omicron wave, wastewater SARS-CoV-2 viral
loads have increased in recent weeks.

SARS-CoV-2 viral loads show an increasing trend in Annacis Island wastewater over the past three weeks.
SARS-CoV-2 viral loads show an increasing trend in Northwest Langley wastewater over the past two weeks.
SARS-CoV-2 viral loads show an increasing trend in lona Island and Lulu Island over the past three weeks.
SARS-CoV-2 viral loads are variable in Lions Gate wastewater and do not show a clear trend.
Figure 10. Wastewater surveillance, FH

Annacis Island wastewater plant (approximate region: Fraser North and South)
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Figure 11. Wastewater surveillance, VCH

lona Island wastewater plant (approximate region: Vancouver)
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H. Additional resources
For maps and geographical distribution of cases and vaccinations, visit the BCCDC COVID-19 Regional Surveillance Dashboard
here: http://www.bccdc.ca/health-professionals/data-reports/covid-19-surveillance-dashboard
Variant of concern (VOC) findings are available weekly here: http://www.bccdc.ca/health-info/diseases-conditions/covid-

19/data#variants
For local, national, and global comparisons of BC to other jurisdictions on key epidemiological metrics, visit the BCCDC
COVID-19 Epidemiology App here: https://bcecdc.shinyapps.io/covidi9 global epi _a
1. Appendix
Vaccination phases defined by vaccine eligibility of target populations in BC
Vaccination Phase 1 (December 2020 — February 2021)
Target populations include residents, staff and essential visitors to long-term care settings; individuals assessed and awaiting
a long-term care placement; health care workers providing care for COVID-19 patients; and remote and isolated Indigenous
communities.
Vaccination Phase 2 (February 2021 — April 2021)
Target populations include seniors, age 280; Indigenous peoples age 265 and Indigenous Elders; Indigenous communities;
hospital staff, community general practitioners and medical specialists; vulnerable populations in select congregate settings;
and staff in community home support and nursing services for seniors.
Vaccination Phase 3 (April 2021 — May 2021)
Target populations include people aged 60-79 years, Indigenous peoples aged 18-64 and people aged 16-74 who are
clinically extremely vulnerable.
Vaccination Phase 4 (May 2021 — November 2021)
Target populations include everyone 12+ years. In September, third dose is available for people who are clinically extremely
vulnerable.
Vaccination Phase 5 (November 2021 — February 2022)
Target populations include everyone 5+. Children aged 5-11 are eligible at the end of November. Everyone 18 and older will
be invited to get a booster dose within 6-8 months of their second dose.
Vaccination Phase 6 (February 2022 — Present)
Target populations include everyone 5+. Everyone 12 and older will be invited to get a booster dose within 6-8 months of
their second dose.

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This is EXHIBIT “_F_” referred to in the affidavit
Dix/Henry - COVID-19 modelling update at Victoria, B.C., this M_ day of April, 2022.
Media Availability a ?
Tuesday, August 31, 2021 . Pn ;
A Commissioner for taking Affidavits for
British Columbia
By Legislature Press Theatre
Adrian Dix: Good afternoon, my name is Adrian Dix. I'm BC's Minister of Health. To my left is Dr Bonnie
Henry, BC's provincial health officer. This is our COVID-19 update for August 31st, 2021. We are
honoured to be here today on the territory of the Lekwungen-speaking people of the Songhees and the
Esquimalt First Nations.
Before | begin, as you know, Dr Henry will be giving an update on modelling with respect to COVID-19. |
want to recognize that today is International Overdose Awareness Day. The coroner gave a six-month
report for the first six months of 2021 earlier today, and 1,011 people died due to our poisoned drug
supply. This requires -- including, of course, 159, | believe, in the month of June -- this requires
consistent and continuing action.
For individuals, take the steps you need to take to be safe in these times because the poisoned drug
supply continues to affect our communities. We need to do everything we can and continue to do to
separate people from this poisoned supply, by providing prescribed, safer options. And also, of course, a
path to recovery in our public health care system, and access to public health care services.
There's an unprecedented effort to do that. That continues. That is at the centre of our action, the
actions of health authorities and a wide range of people in BC every day. | want to pay tribute to all
those working in this area who are involved in this work, both as advocates, as health care practitioners
and as members of the public who are engaged in this issue on this day, and express my appreciation to
all of them.
The work continues. The effort is of singular importance. That public health emergency that is the
overdose crisis is with us, continues to be with us and continues to require significant government
action.
Today, we'll be providing a briefing on COVID-19. It's my honour to introduce Dr Bonnie Henry.
Bonnie Henry: Thank you very much and good afternoon. Before we begin, | also want to acknowledge
International Overdose Awareness Day. It does not go unnoticed to all of us that this is an ongoing crisis
that | have been involved in for five, six years now, that we were making some good progress. We are in
a different place now. It's not that we can only deal with one crisis -- it's that we have our overdose crisis
and a toxic drug supply that is taking too many of our friends, our brothers and sisters, our families, our
colleagues.
We also have to deal with the pandemic that is not, as well, where we want it to be right now. I'm going
to give a quick update of where we are, in terms of the pandemic, give you an update on the
epidemiology and some of the modelling that we're looking at. Then we'll -- some understanding of
where we are now, with regards to this.
To start with, a familiar geographic representation of the case rates by local health area of residence of
the case. This is from August 15th to 21st of this year [inaudible] many parts of the province but we have
local hotspots. That has been what we've been seeing the for last couple of weeks across the province,
including -- and one of the encouraging things to see -- the very low case rates that we continue to see
in the Lower Mainland, where immunization rates are high. The challenge is we have in many local
areas, particularly in the Interior and the North.
We also -- this is the geographic distribution of cumulative case counts since the pandemic started.
Again, we can see there's no area of this province that has been unaffected by the pandemic. Some
areas have had way higher case rates than others. Many of those now are being attenuated by the fact
that we have immunizations.
This gives a sense of our distribution of vaccinations by the local health or community health service
area across the province. The good news is we see very high vaccination rates across the province, but
hotspots that correspond to some of the areas where we're seeing right now the flare-ups and the
numbers of cases go up.
Some of the data that we look at on a regular basis are these dot plots by local health area. The good
news is we can see that where we've been paying attention to some of the higher case rates,
particularly in the Central Okanagan, those have now come down. We also see pockets of higher
transmission rates in areas across the Interior. We know across the Interior, there's been challenges
over this past two months -- everything from the forest fires and the heat and the smoke areas and
displacement of people that have also interfered with the ability to prevent transmission but also to get
immunization rates up in many communities. This is a focus that we're paying attention to now.
We also see some higher case rates in areas of low immunization in the Northern Health region. Some of
those areas -- in Nisga'a and Nechako, for example -- very small numbers can lead to high rates per
population because it is a small population. It does give us an indication that we need to pay attention
to some of these areas as well, where we're starting to see now rising clusters and cases.
This is our epidemic curve from the beginning. What we can see is that starting in the middle of July, we
started to see cases increase again. That's that green line on the top. What is not increasing at the same
rate as what we've seen previously is hospitalizations. They are coming up to a rate that is affecting our
ability to provide health care in some areas of the province. Particularly, we're seeing in the Interior and
now the North the case rates themselves are being driven primarily by the clusters and increases that
we're seeing in Interior Health.
To put it in perspective, in Interior Health, that represents about 15% of the population. As we can see
from this graph as well, the rapid rise in cases in the last month in Interior Health were about 50% of the
cases that we've seen in the last month are in that health area, representing, as | said, 15% of the
population.
While we are seeing increases as well in some of the other health authorities, particularly the more
populous Fraser and Vancouver health authorities, the rate of rise is not the same. We are starting to
see as well dramatic increases in the North again as well.
If we break this down, though, by what we're seeing in terms of people who are vaccinated versus
unvaccinated and just looking from the first of July and separating out what we're seeing in terms of
numbers of people being infected with COVID and hospitalizations, we see a dichotomy. What we're
seeing is this has become a pandemic that is spreading rapidly amongst pockets of people who are
unvaccinated.
We see this very clearly in the cases per 100,000 and in the hospitalizations. For people who are fully
vaccinated -- so, having two doses of vaccine -- that level has been low and steady, and hospitalizations
have been low. We'll talk a bit more in this presentation about some of the breakthrough cases and
where we're seeing transmission happening.
As | mentioned, by health authority, the biggest increase in cases has been in the Interior Health region,
which has accounted for about half of the cases we've seen in the last month. We have also started to
see in the last couple of days a gentle increase as well in Fraser and Vancouver Coastal, and a spike in
cases in the North.
We want to be paying attention to who is getting infected with COVID-19. As we've seen in the last wave
that we've had, it really starts and has been driven with rapid increase in those who are most connected
in our community -- so, young people between the ages of 19 and 39 are driving the rise and increase in
cases. We know in that age group, they were the last of our age groups to be able to access
immunizations and we know that they're very highly connected in that age group -- we're parents.
We're working. We have connections, social connections, where the virus can take advantage of those
who are unvaccinated and can spread rapidly.
We're also seeing the increase, as we did in previous waves, with the 40-to-59-year-old age group. In
this age group, the risk of being hospitalized has gone up. What we aren't seeing is dramatic increases in
young children or in those over the age of 80. However, even though they're small numbers, we are
seeing people over the age of 80 being more likely to be hospitalized if they do get infected.
Henry: ... people over the age of 80 being more likely to be hospitalized if they do get infected. This is
important. If we look at hospitalizations -- we have been watching very carefully -- we know in some
parts of the world, particularly in the US, we are seeing a rise in cases, and severe cases, in children,
particularly children under the age of 12. So we have been watching that carefully and we are not seeing
that, both in counts of children who are hospitalized and we can see the bottom line, the zero to 19 year
old age group, we are not seeing hospitalization rates and we are not seeing rates of hospitalization high
in that group either.
As | mentioned, we do see, if there are breakthroughs or cases in unvaccinated people over the age of
80, the risk of hospitalization is higher and the rate of hospitalization is the highest in that group. But the
numbers of people who have been hospitalized around the province right now are highest in the 40-59
age group. | will show you some more information about the risk in terms of people who are vaccinated
versus unvaccinated.
This is an update of the slide we've presented a number of times looking at the distribution of cases and
hospitalizations and the more severe illness by age. We still see that young children under the age 10,
and the 10 to 19-year-old age group, are much less likely to have severe illness or to end up in
hospitalization or ICU, and that is holding.
What we are seeing continually is that the risk of severe illness is going up in people who are older and
that continues to be driving hospitalizations and deaths.
What we put together with that, however, is seeing the progress that we are making in vaccination
across BC by age group and by numbers of doses. So, people who are 70 and over, we have a very
strong, very high rate of immunization, both for first and second doses, and that is important because
the risk in people who are unvaccinated in that age group is the highest.
Where we still have work to do is some of the younger age groups who are later to come into being able
to access vaccine, but now we have opportunities for everybody to be immunized with both doses in the
next few weeks.
We are going to be focusing on young adults who are going back to university, recognizing how
important it is and how negatively impacted, particularly young adults, have been in this pandemic,
whether it is from unemployment, job difficulties, whether it has been trying to go first year university
online. So we have been putting a lot of time and effort into making sure that we can provide
immunization and support people to get back to universities and to school safely in the next few weeks.
This is some of the information that helps us understand risk and how well the vaccines have been
working in protecting people both from disease, but also from serious illness.
For the past month, from the end of July until August 26th, fully vaccinated people accounted for just
15% of the cases that we had. Over 70% of the cases were in the very small proportion of people, less
than a quarter of people in the province, who are not yet immunized.
Hospitalizations show even a greater disparity where 81% of our hospitalizations of the 394 people who
have been in hospital this month, 81% of them are people who were not yet vaccinated.
When we look at deaths, we know that deaths continue to occur primarily amongst older people. They
are most as at risk and what we are seeing reflected in the number of people who have died, we have
had 33 deaths in that month, and a third of them were in people who were in long-term care.
It reflects the fact that we have very high immunization rates in residents of long-term care, but once
this virus, particularly this highly transmissible strain that we are seeing circulating in BC now, once it
gets into long-term care homes, even older, fully-vaccinated people can become ill and die from it.
That's reflected in the proportion that we are seeing of people who have died.
If we break this down by age, and so along the bottom we have the age categories, and the top row,
what we are looking at is vaccinations in the entire population in BC -- so that is all of the population,
not just people who are eligible -- we see that in the zero to 11, those who are not yet eligible, the
number of people in that age group is about 600,000. Those are the people that the rest of us need to
protect by stopping transmission of this virus and by being immunized ourselves.
When we look at the number of cases, we do have cases in that unvaccinated young group. But we also
have peaks of cases of people in the 20 to 40-year-old age group. If we look across the way, we see very
high vaccination rates in older people and we see the number of cases is very low as people are
vaccinated.
The number of hospitalizations, again, reflects the unvaccinated predominantly are in hospital and
predominantly in the 20, 30 and 40-year-old age group.
We see a shift to older people with breakthrough cases at a lower level being hospitalized after they've
had two doses. And the number of deaths, as | said, reflects the fact that many of these occur in long-
term care. And, sadly, we've had unvaccinated people in their 40s and 50s who have succumbed to
COVID-19.
So that is looking at numbers and the proportions in different vaccinated and unvaccinated age groups.
Really important is to look at rates. So what is the rate of transmission in people who are vaccinated
versus unvaccinated? From July 1st to August 27th, what we see across the board is that case rates
amongst those who were unvaccinated, and this is crude so we are not adjusting for things like age, are
10 times higher than those who are fully vaccinated. That purple line along the bottom is the one to look
at.
What it shows us is that immunization keeps rates low and continually keeps rates low even when
transmission is exploding in communities and we particularly see that in the Interior health region,
where the rate of transmission and the rate of infection in people who are unimmunized, is at least 10
times greater. That is reflected across the board.
If we look at the same information, so case rates by vaccination status, and break it down by age, again
we see a Slight increase in the zero to 11-year-olds, but primarily what we are seeing is people who are
fully vaccinated have a very low and stable case rate across the age groups.
This tells us that vaccines work regardless of the variant that's been spreading, and we know it has been
Delta for the last month during this period of time, that these vaccines, particularly after two doses, are
very protective, protective after a single dose, across the age group and it's primarily those who are
unvaccinated where we are seeing cases rise.
The other part we want to look at is a severe illness, so hospitalization rate by vaccination status. What
we see, again, is that two doses of vaccine are highly protective. So for crude hospitalization rates
among the unvaccinated, it's 17 times higher than someone who received both doses of vaccine.
Even in areas of high transmission, in the Interior and now in the north, we are still seeing that these
vaccines are very protective against severe illness that leads people to need hospitalization.
Looking at that same information, by vaccination status and hospitalization by age, it is even more stark
where people who are vaccinated are protected from hospitalization across the board. A slight increase
in people over the age of 80, but for the most part what we are seeing is very strong protection across
the board, across the age groups, in people who are vaccinated.
So how to sum all this up, looking at where we are seeing case rates, where we are seeing breakthrough,
the numbers and proportions and then adjusting for age? This means if I'm a 50-year-old person who is
unvaccinated, | have 12 times the risk of getting infected with COVID-19, and 34 times the chance of
ending up in hospital, from somebody who has been vaccinated who is the same age as me.
This is important because adjusting for age, we know that our ability to develop response to the vaccine
is dependent on age and our chances of having serious outcomes, if we do get infected with COVID-19,
is also related to age.
What we are seeing is these vaccines are very protective across all age groups, one from transmission,
but particularly from severe illness. The risk is 34 times greater that you are going to end up in hospital if
you are unvaccinated at that same age.
So all along, we've been looking at modelling as ways to help us understand what has happened, where
we can make adjustments and what are the potential for things to happen in the future. One of the
models we look at regularly is the dynamic modelling that looks at our reproductive numbers, what we
call Rt.
The estimates are shown for the last week, and what they are showing now, and we have been updating
these and running the models to understand where we are now, and with the projection for the near
future. We give a range of values because, as we know, there is a degree of uncertainty to every model
that we run.
What we are seeing now is that we were at a place where we had a lot of present them with some
degree of uncertainty, because none of them are right, none of them are predictions. But they can give
you a range of possibilities of what could happen if nothing changed.
In April, we also presented modelling prior to, around the time that we put in our circuit breaker
measures later in March, and at that point, we were able to factor in vaccination by age group into the
models, and so that is why they looked a little different.
But what we saw was the rate of infectious contacts included with vaccination, included in the model,
and recognizing this was one of the things that helped us make the decision to put in the measures that
we did at that time because we recognize that we are not yet at a place where immunization was high
enough that it could prevent some of the transmission chains in our community.
So these two examples of past modelling projections both illustrate how changes in actions actually
changed our pandemic trajectory. It helped us bend the curve, as it were.
In June, we also presented some modelling, and that modelling took into account, again, a number of
interacting factors, which were higher vaccine uptake, that we were ina place of at that time, as well as
what the impact would be of increasing our infectious contacts because we are at the point where, as
cases were coming down, we needed to get back to the social interactions, to those connections and to
workplaces, to businesses, to some of those functions that we had been missing for so long.
So as part of our restart plan, we were looking at what are the potential impacts given our immunization
we were at, given all of the other factors, and the increase in infectious contacts that we were expecting
to happen when we started to open up again through the summer.
It was also, as part of our thinking around the measures that we were taking, where we said an incentive
to be vaccinated was that masks would no longer be that absolute necessary for people who had been
immunized in certain situations, that we were able to gather together outdoors with less restrictions as
rates went up.
As you can see, models reveal that there is uncertainty in everything that we do. And we were following
along a very low trajectory until the middle of July, when we started to see this increase. And this
increase, as I've mentioned, is driven primarily by the lower rates of immunization and the really
dramatically higher rates of infectious contacts driven primarily in the Interior Health.
And so these are things that we could not at the time have predicted but are the reasons why we knew
that we might have to take regional measures to address some of this increasing.
So the other thing that we have learned from the models -- and it has been helpful that there have been
many different modelling groups, both in BC and across Canada, that give us a sense of people using
different models, different parameters and what may happen depending on what they put into the
models. So all models are wrong, as we have said before, but many of them are useful.
It is interesting for me as a decision-maker and our team to be able to look at what other modellers are
doing as well as our own teams, and really, the small changes in parameters can lead to large changes in
outcomes, and that's what we are seeing here with that higher than expected rate in Interior Health in
July and August in the context of lower immunization rates in those communities.
So factoring all this in, we have now gone on to develop the next models to help us understand where
we are now and to inform the decision making as we go in to this next month. So these models are
focusing on at the situation that we are dealing with now and where we could be by the end of
September, recognizing that we have increasing immunization rates, we have a more infectious virus
that is circulating, there is some indications that it may be leading to more hospitalizations in some
people, but also recognizing that across the age strata, we have more people protected in different age
groups and our risk of hospitalization is different depending on vaccination status and age.
So we've factored in a number of those things, as well as how a modest increase in immunization at
different age groups can make a big difference.
The models that we are coming up with now show a lower transmission scenario, so we're talking about
a lower and medium transmission scenario based on what we are seeing with our reproductive number.
And this shows that we are likely to see a gradually steady increasing number of cases over the next
month and slightly increasing hospitalizations over the next month, but not at the rate that were seeing
our daily maximum during the second and third waves of the pandemic -- and that is because of the
protection that we are seeing from immunization.
But the interesting thing, and the important thing that we all need to think about, is that by getting
more people immunized, particularly a small percentage increase in those people 12 to 17, in the 20-
year-old age group, in the 30-year-old age group, in all of those groups who are not yet at that 85, 90%
range, can make a tremendous difference in the trajectory of our pandemic in the next month, and that
would lead to decreased numbers of cases and decreased hospitalizations, and even with a moderate
transmission scenario, so a reproductive number that is higher than what we are seeing right now, with
the same parameters about this more highly transmissible variant that we are seeing in the province,
with the actual protection that we are seeing from vaccination right now, we would likely see an
54
increasing rate of cases over the next month as well as increasing hospitalizations, but that small
incremental increase in immunization means that that will level off and hospitalizations will level off.
So these are the things that we are learning now.
We learned that this vaccine is protection, and that protection is lasting even in people who are older
after two doses. That is important. And that it can make a difference in our being able to get back to
those things that we need to do in our lives. Particularly, we know that having vaccines means that we
can get back to school safely, we can get back to university safely, we can get back to work, we can get
back to doing things like going to hockey games, like going to football games. As long as we have
vaccinated people together, the risk goes down dramatically.
So finally, we put in a model that shows not only the vaccination, the transmission scenarios that | just
said, but one with no vaccinations. So the position that we were in previous waves, where we would see
a dramatic increase with the rate of transmission and the numbers of cases we are seeing right now.
So what does this tell us? This tells us that vaccines are working. That they are preventing thousands of
cases and hospitalizations from occurring, because they are protecting people across the age spectrum.
They are making a difference. But we are not where we need to be yet, and we need to continue to walk
this fine line of trying to reduce the impacts of the virus, both on us as individuals, but on our families,
our communities, but also reduce the societal impacts that the measures we have had to take to
prevent transmission.
So the most important actions we can take now to stop this transmission and to bend our curve back
down, are to decrease our infectious contacts. That means going back to our basics. Wearing masks
when we are in indoor crowded places, those higher risk settings. Making sure we are staying home and
away from others if we are feeling unwell ourselves. Cleaning our hands regularly. Avoiding large
crowds, particularly with unvaccinated people.
Because we know it can spread so easily now in those populations, while doing everything we can to
support our family members, our friends, to be vaccinated. That is the way that we will get through this,
that we will get through this respiratory season, and we will get back to spending time with the people
that we love, doing the things that we need to do and having those activities that we love as well.
We will continue to monitor this data and to look at regional measures as ways to try and reduce the
effects, both of the pandemic and of these measures across the province. We know that regional
measures can make a difference and that we don't need to do the broad measures that we've had to do
in the past.
This has been a long 20 months, and we are walking, as | said, a fine line of balancing the risk of COVID
and this disruption to society that this pandemic has caused. And we see that in so many parts of our
society, whether it is young people who have had challenges in getting jobs, not being able to get back
to educational opportunities, with the dramatic increase in the toxic drug supply that we are seeing and
the effects it is having on our families and communities.
We need to get back to school. We need to get back to university and college. We know those are things
that are important for us as a society and for our future. And we can do this safely, and we also need to
continue to care for each other, to support each other, to reduce those transmission risks, to support
everyone in our family and our community to be vaccinated and to get us through with kindness and
compassion and patience. Thank you.
Adrian Dix: Thank you, Dr Henry. That was a significant presentation, | won't take long.
| want to make a couple of points. First of all, as of today, 3,908,860 British Columbians received their
first dose of a COVID-19 vaccine. That is 84.3%. 76.5% have received their second dose. The number of
people who have a single dose is down to 7.8% of people.
We have seen since the Premier and Dr Henry introduced the BC vaccine card, which would be coming
into effect September 13th, a significant uptake over the last week in immunization. | want to
acknowledge groups who have really stepped up in the last week. Those, first of all, in the categories of
12 to 30, have seen an increase in their rate of vaccination twice the level of the provincial average.
Which means that what we know, that particularly those 18 to 24, who have really stepped up and who
are currently vaccinated at an 83.8% level, and will soon pass the provincial average, are really stepping
up and understanding, | think, the value of vaccination now. And that is an important and positive thing.
Secondly, we have seen the Interior Health and Northern Health areas have trailed in terms of overall
vaccination by health authority. We've seen the largest increase for first dose immunization in those two
health authorities, which is a positive sign and we need that to continue. Because | believe we can do
this together.
| want to remind people, and you will get a chance to review the slides presented by Dr Henry today,
and | would like to remind people of the slide on page 20 says. It says that after adjusting for age
differences, unvaccinated people are at greater risk of infection, hospitalization or death from COVID-19
than fully vaccinated people. In terms of cases, 12 times more likely. In terms of hospitalizations, 34
times more likely.
And that is why, as you understand, the measures that or being taken from the BC vaccine card to
regional measures focus on where we see transmission now. We've got to continue to support each
other and work together in these times.
One of the things that is striking, if you look at the charts and the provincial maps on page 2 and 3, is
that many of the places that are seeing highest transition now have not seen that much transmission
through the whole period of the pandemic. What that says to us is that wherever you live, whether you
live in Nelson or Fort St John are Surrey or Victoria or Port Alberni, wherever you live in BC, we have to
be there and support one another in these times.
That is why we have to continue to take the measures that we need to all take to reduce the
transmission of COVID-19. But what is centrally important is that the increases in vaccination that we
have seen in the last week continue. That we go from 84.3% to significantly higher than that, and we
aspire to do what | think British Columbia can do, which is to lead the world in our level of vaccination.
Because you see in this modelling, you see it everywhere, that when we get vaccinated, we make
ourselves safer, we make the ones we love safer, we make our communities safer, we are able to do
things that we can't do if we're not vaccinated.
It is the right choice for this time, and | encourage everyone to take advantage of it as soon as they can,
to get registered right away, today and to get vaccinated with their first dose. And if they've had their
first dose, to get vaccinated with their second dose.
And while we do a lot of discussion about the age question, people who are about 148,000 British
Columbians over the age of 60 who are unvaccinated as well. And those numbers mean and apply to
that group of people too. | want to encourage everyone to consider that choice. Consider the ones they
love, consider their community, consider that we are living with all of the challenges of this COVID-19
pandemic and other challenges, like the public health emergency that is the overdose crisis and others.
To take the step that we can all take today as people and get vaccinated.
Thank you very much, and we are happy to take your questions.
Q&A
Reporter: I'm just wondering, this model that you have with the moderate transmission shows that we
could be headed for record levels of transmission in about a month, more than 1,000 cases a day. And if
we look at the previous modelling, when we were approaching that level, we saw other measures
coming in to try to stop that transmission. Are you considering any other measures at this time?
And I'm just wondering how you are feeling about the contact tracing that is happening at this time? Is it
manageable, or are things being done differently to kind of cope with the numbers we are seeing now?
Henry: Really good questions. So we have put in some measures. Looking at the models over the last
few weeks, the importance of wearing masks again in those indoor settings, the measures that we are
putting in place for the post secondary and for schools, making sure that we can do that safely,
recognizing how important they are.
But also the regional measures that we've put in place in the areas where we are seeing those clusters
and outbreaks that are spreading and affecting different parts of the community, whether it is
businesses being able to operate or the health care system. And sadly, like across Canada, we have a
very thin line of defence in our health care system, and it can be a small number of people that can
whelm the system, as we saw in the Interior, as we are seeing in the North.
So as we are seeing with my public health colleagues, yes, it is straining some of our case and contact
management, but we are focused again on making sure that every case gets contact and that we
understand the risk settings. So we are prioritizing risk settings, but it is not so much because we are
whelmed with cases, which is part of it, but it is also because we know that some people are at lower
risk now. So you are at lower risk of being infected and lower risk to transmitting to others if you are
fully vaccinated.
And what we're finding is the transmission chains from social interactions, from a party for example,
where we might have seen 30 or 40 people out of 100 being infected a few months ago, now that the
majority of the people in that environment are immunized, we are seeing just the unvaccinated and a
small proportion of vaccinated people. So it may transmit to five or six people.
Henry: It may transmitting to five or six people. Yes, we have modified some of our contact management
for some of those very low risk settings or priority places if people have not been in group communal
settings for example.
We are committed and will continue to do case management of every single case and contact follow-up,
particularly in those higher priority settings.
Reporter: | have a question for a colleague. The ministry of Education is working on improving
ventilation in classrooms. Are you advising them, based on the airborne transmissibility of the original
type of COVID or the Delta variant? Why aren't you doing more to promote better ventilation in other
workplaces and social settings given how many cases we are seeing?
Henry: Absolutely. Ventilation has been something we have been working on from the very beginning.
Every school in the province has done an assessment, and | know the minister of Education was talking
about that.
The way this virus is transmitted has not changed. Whether it's the strain we had last week, the strain
we had last year, the way it is transmitted has not changed. The dose that you need to be infected has
gone down, so a more transmissible virus means that you just need a smaller amount, generally. We
think is that is what it is. A smaller amount can cause infection.
All of those things around ventilation are important. We did a lot of work with WorkSafe BC around the
higher risk workplaces, for example, like food processing plants where we saw a lot of transmission. We
have done a number of different measures, and we see that they are working. Some of them are
ventilation. It's about barriers. It's about immunization of people in those settings.
That right now is holding, but we are continuing to work with WorkSafe BC around workplaces around
the province, around some of these really important issues.
Reporter: Talking about kids -- and we know everyone is going back to school next week and are anxious
-- you said that there isn't a great increase in children. Looking at the situation reports, it has gone from
45 in the zero-to-10 group on July 24th to 322 in the most recent one, and then again it is a five times
increase over that same four weeks for the older students.
Are we just going to see an explosion in schools when they come back? How are you going to keep up
with contact tracing there if it is already strained?
Henry: These are things that we try to focus on, understanding the context where transmission is
happening to children. We know from last year that the measures we had in place in schools meant that
there was very little transmission in school settings. That's why we have put in place the same measures
that we had pretty much in place last year -- the focus on ventilation over the summer, the importance
of masking, the importance of not having crowding and people gathering together particularly indoors
and wearing masks in those settings.
We don't expect to see an explosion of cases. It is absolutely not surprising that we will see an increase
of cases, and they're related to communities where we are seeing increased transmission in the
community.
Again, the most important thing we can do is to have all of those who are eligible for vaccination in the
school setting to be immunized whether that's school staff, educators, parents of children who are not
yet able to be vaccinated. It is really important, because your child's risk is directly related to the risk and
their family of the adults in their family and the older siblings. We already are with the school boards to
make sure that we have vaccines available in the first few weeks of school. Those are going to be
important things.
lam really heartened when | talk to young people in school. | talk to educators. We know how to do this.
We safely kept schools open last year. We saw the impact when we started to immunized teachers and
people who work in the school as a priority, and transmission rates went down. These are the things
that will make schools safer again this year.
It's going to be a really important and good thing for kids to get back into the classroom next week. It's
going to be a little bit anxiety-provoking, of course, but encouraging children to wear a mask -- even
young children -- in the school setting and to keep all of those measures in place that we know work.
Reporter: One thing they didn't get answered there is about the contact tracing and how the tracers will
keep up with it if they are already a bit swamped and strained with what is going on in the province right
now? Is there any way for parents to know if their teachers have been vaccinated, and how will they
know if there have been cases in schools? Is it the same notice as last year?
Henry: We are not concerned. The priority, of course, will be those settings like schools. All of the health
authorities have prioritized that as one of the settings where we will be following up on every case.
We're following up on all of the cases, but schools are absolutely a priority.
We have been rehiring over the past few months and bringing back in some of the case and contact
management staff who had been redeployed to things like immunization programs. All of that has been
happening. | am confident we will be with every single school as we have been over the past two years
to make sure that we can manage every communicable disease including COVID.
It will be slightly different this year because the risk is different with the high rates of immunization that
we are seeing, and we have seen now that transmission to people when you have that wall of
vaccination is much, much less. We will not be doing the notifications to school if there has been a single
exposure. They will be doing an assessment as we do for every communicable disease, and every
individual who is at risk will be notified.
We've heard very clearly from people that the majority of people felt that the school-based letters were
more anxiety-provoking than helpful. We will absolutely be keeping the schools informed and working
with the schools with our school response teams to make sure that every single case in the school
setting is identified, that contacts are managed, and that the people are informed about what is
happening in the school setting. Every cluster or outbreak will be reported.
Reporter: Relatively lower vaccination rates in the Interior, which means thousands of people in many
small towns are completely unvaccinated. Given that pretty well all of these towns have small hospitals
or, certainly, a small number of ICU beds, is there concerned that it wouldn't take much to overwhelm
some of the ICU beds?
We already have a physician in Trail worry last week that there were four out of six beds with COVID
people, and he was worried that it wouldn't take much to overwhelm the critical care system in some of
these towns with low vaccination rates. Is that a genuine concern?
Henry: It is. | think there is a couple of things that we have going for us, if you will. We're are seeing very
high immunization rates in older people. Older people are more likely to end up in hospital. As the data
shows, that does not mean that people aren't going to end up in hospital, and as you say, we are
stretched very thin. We have a very thin healthcare system right now, particularly in critical care.
People have been doing this for a long time. We've seen through the summer that ICUs have not been
empty. They've been filling up with non-COVID cases of people who have serious illness that needs to be
managed.
Yes, physicians are tired. Nurses are tired. Our health system has been working on this for a long time,
and it is stretched. That's why we took the measures we did in Kelowna and in Kamloops to try to
address some of the issues that we are seeing in some of these communities where illness in healthcare
workers can affect the ability of the hospital to function as well as illness in the community. | think you
can talk to some of that.
Dix: | think the point that Dr Henry made is very important in that regard, is that if you look at older age
categories, they're pretty consistent throughout the province. There is a difference between, for
example, Fraser Health and Northern Health and Interior Health overall, but that difference is focused in
on those under 50.
We do see a significant risk of hospitalization, and | think that the point we make about our health care
system is that one of the reasons why we're building so many new hospitals and investing so much
money in increasing staff is that our health care system prior to COVID-19 was running in March of 2020,
prior to any hospitalizations due to COVID-19, 103.5 percent of capacity, and some of those other issues
are moving back to where they were. It's why we're building hospitals, it's why we're increasing our
training, it's why we're investing in surgeries, it's why we're doing all of these things in our health care
system.
So, while we see fewer people in hospital right now than we did at the height of the third wave, or |
think it reached about 503, we're at about a third of that level, it still puts significant pressure on the
system and does regionally.
So, that's the reason why it's so important why we're taking the strategies we are using now, it's so
important that people get vaccinated. It's why we're focused in on where the transmission is, which
leads to hospitalization, which is on those who are unvaccinated and it's really important do that.
And | am heartened by the efforts being made everywhere in BC for people to get vaccinated, that we've
seen this uptick in the numbers in the last week that we need to continue to see in the Interior and the
north, because that's going to help us as well. Regional measures that were put in place, for example, in
the Central Okanagan to help us and they help all of those working in our health care system to deliver
all of the services that are needed for all of the health conditions, including mental health and addiction
services, but as well all of our hospital and other services.
So, this is the work we need to do. So, the message everywhere is that the more we raise vaccination
levels, the better it is.
| live in a community health service area of 50,000 people around Renfrew-Collingwood, about 46,000 of
them are currently vaccinated. About 93 percent. It's a little over 46,000. About 3,300 aren't vaccinated,
but still our situation will be even better if we reduce that number even more.
So, we have to do this work everywhere in BC and the part of the effort to reduce transmission and
increase vaccination -- the reduced transmission will flow from that -- is to ensure that we have the
resources in place to deal with all of the other health problems we are facing.
Reporter: Further to Liza's questions about schools.
Dr Henry, earlier today you said you were just on a conference call with some counterparts with the US
Centre for Disease Control about school kids and schools starting again. Just wondering if you picked up
anything new from their experience or did they also, perhaps given our successful year of opening
schools, did they ask you for tips on what to do?
Henry: Some really interesting things, actually. It was a good exchange of information. Obviously, we
wanted to understand what the plans were, how things were working, and we think it's challenging with
ten provinces and three territories and they have over 50, as you know. Fifty-one.
So, basically, what we were trying to understand is the reports that we were seeing about increasing
rates of severe illness and hospitalization in children that has been reported in the US, and those data
are being looked at right now, but it really looks like it's a function of immunization in the community
and where you have rates of transmission that or very high, it affects young people as well as older
people.
It doesn't seem to be virulence. So, the Delta variant, which is the predominant variant that's being
transmitted across the US. It's hard to tease out a number of factors, but it really is related more to
areas where there's lower immunization. They are seeing higher rates of cases in the community,
including higher rates of cases in children.
So, that's something that we're seeing reflected in our data, as well, and reassures us that it's not
something that's inherent in the virus right now. It's more about how important it is that we all protect
those who cannot yet be immunized.
Reporter: | just had a question in regard to the reproductive rates of 521. Here at Island Health it's
showing a higher number then most of the rest of the province when we had some of the lowercase
rates and higher vaccination rates. So, I'm just wondering if you can explain some of the factors that
drive this reproductive rate?
Henry: The reproductive rate is how many people | transmitted to on average for every infected case.
How many people on average does every infected case transmits to. It's a combination of things and yes,
we see on the Island, as you say, lower case numbers, which means there's wider confidence intervals.
So, it's somewhere in between that range. But what is reflects is a higher rate of infectious contacts,
which means somebody who's infected with the virus is having contact with more people and able to
transmit it to more people. :
So, things that we do that stop that are staying away from others if we're feeling unwell ourselves. If
we've been exposed to somebody who has COVID-19, not going a into closed environments and talking
with other people, keeping our groups low, but also things like wearing masks in those indoor settings,
cleaning our hands, all of those basic things. But also right now we're seeing that if you are vaccinated
and you've been exposed, your risk is much, much less.
So, immunization and yes, as you say, we have very high rates of immunization on the Island, but it's not
equal across all age groups. So, what we're seeing is transmission in clusters to groups of people who
are unvaccinated and that's mainly people younger in the 20 to 40-year-old age range.
So, driving up immunization and staying away from others who are sick and getting tested. Those are
the important things to try and bring that back down again.
Reporter: A question for a colleague. Private care operators are saying that hundreds of long-term care
workers are preparing to quit and move to acute and community health care settings where vaccines
are not currently mandatory.
So, we're wondering if you have any plans to implement mandatory vaccines in other health care
settings.
Henry: The short answer is yes. | think I've indicated this before. We know that there are some settings
where it is incredibly important to prevent transmission of this virus. One, to keep ourselves healthy as
health care workers and we talked about a how stretched the health care workforce has been over this
past year.
So, it is incredibly important that we keep ourselves well so that we can care for people in the health
care setting, but also so we're not passing it on to our colleagues, and we know there are high-risk
settings in acute care and home care and community care.
So, we have been working through. Obviously, there's labour relations issues that we need to work
through and we have been working those through with the unions and with others. And so you will hear
something about that very soon.
| don't know if you want to talk through this as well, but the short answer is yes. This is an important,
important measure for all of us in health care across the board, from acute care to long-term care. We
know it's most dangerous and most lethal in long-term care, and that's why we started with that group
of people and we need to ensure that everybody in that setting is immunized and we're working
through the details for the other health care settings.
Dix: That's right, and | think the message across the board in health care and everywhere else is to get
vaccinated. We made this point. It's important, as well, on Vancouver Island as everywhere else in BC.
| know that Vancouver Island has a somewhat older population than other regions of the province,
which leads because in populations over 60 we have a very high vaccination rate, to a higher overall
vaccination rate, but it simply can be higher under 50 and higher in some regions of the Island.
So, we want to make those efforts to make sure that that happens.
With respect to health care workers in general, the other point that we're obviously concerned about an
acute tears every hospital in BC, but particularly regional hospitals, have a number of what we call
ultimate level care beds. People who are effectively either waiting for long-term care are in a form of
long-term care within a hospital, so some of the same conditions apply and the risk apply, and so
obviously that's something we're looking at and you're going to hear more about with respect to both
acute care in the community in the coming short while.
Reporter: Dr Henry, given what you said about the importance of those around kids being vaccinated to
protect them, we know that they are far less likely to be hospitalized and get really sick from it, but why
isn't the province mandating vaccinations in school settings for teachers and staff and students 12 and
over?
Henry: So, you know, these are the challenging discussions and mandating any medical procedures,
something that we don't do lightly. And so we look at the risk and we do it proportional to risk. As we
talked about, you know, long-term care is a setting where if the virus gets into that setting from
somebody who's non-vaccinated or even vaccinated, but when it gets into that setting it can have a
tremendous effect on the health of people who are living in that, on residents particularly, and we know
that how serious that can be and that's why we focused on health care workers who are working in long-
term care.
There's a broad range of settings in community care and acute care, but also we know that the strain on
the system is very high right now and has been for a long time, so immunization becomes incredibly
important in settings where the downside impacts of somebody being infected are slightly less and
absolutely, you know, we have been watching and we know how important it is to prevent infection in
everybody. But this virus is with us and we know that vaccinations also not 100%, so we have to take a
measured approach.
And yes, we've made prioritized school staff early on to make sure that they had access to vaccines,
where schools 12 to 17 only recently had access to vaccines as they were approved, and we expect that
vaccination for the six to 11 year olds will be coming hopefully soon in the fall.
So, we need to look at what other measures are there to protect people, what the level of immunization
is in the population and take an action that's proportionate to the risks.
So, |am comforted that we have very high levels of immunization in school staff. We want it to be 100%
and we're going to be going out and making sure that we can get it up there as high as we can, because
teachers know, educators know, school staff know that they want to keep themselves well and protect
their families and protected all of the students in the school setting.
But | also think it's incumbent on us all. Parents of young children as well. It's important for you to be
immunized so that we keep our schools as safe as possible, but we also know that there are other
63
measures that help augment us as we go through respiratory season and we'll be working with schools
to do that, too.
So it's a really complicated risk-based assessment that we do and complicated is the right word, but
making sure that we take the risk and benefits into account and do it in a way that's proportional.
Reporter: Are booster shots going to be made available here in BC. We know that Alberta just
announced that they're starting to roll out or moving towards booster shots, third shots for seniors.
When could we see that happen in BC and for whom?
Henry: So, that's something that we've been following the data on for some time.
So, there's two groups of people that we're focusing on right now. One is there's been some data that
shows that people who have certain immunocompromising conditions, so people who have hematologic
malignancies. So, blood cancer. People who've had a solid organ transplant and are on immune-
suppressive drugs or stem cell transplant and a certain class of immune-suppressive drugs.
There's data that increasingly shows that they don't necessarily develop a respond to after two doses of
vaccine, and that a third dose may actually increase the probability that they'll have a good immune
response. So, it increases in both 55% of people, which means it's not as panacea. People still have to
pay attention and it's still important for the rest of us to protect those people whose immune systems
aren't able to manage as strong an immune response. But the National Advisory Committee on
Immunization is looking at those data, as is our BC immunization committee, and operationally we're
putting together the plans to be able to provide that third dose to those groups of people, and | expect
that that will happen in the next week or so.
The question about when and if a booster is required for residents of long-term care. It's a little bit
different across the country, and those are also data that we've been watching very carefully. The
National Advisory Committee is looking at it. Our immunization committee is looking at it.
So far we are not seeing a diminution of protect of across the board in long-term care, but we're
watching that carefully and we need to determine what is the appropriate interval, and it's looking like it
may be because most residents in long-term care received their vaccine at an extended interval and we
know now that that gives a stronger, longer lasting protection.
So, we need to determine what is the optimal interval, and it's probably somewhere -- I'm speculating a
little bit because | have not seen the latest on the data that they're not analyzing. It's probably
somewhere around six to eight months.
And so that would put us for most people in long-term care somewhere around Octoberish, which
means that we can...
So, we're gearing up to be able to provide a third dose around that period of time and we'd be looking
at providing influenza immunization around the same time.
So yes, absolutely, these are, as you can tell, questions that we're looking at the details on. The National
Advisory Committee and our BC immunization committee are looking at it and we'll be coming up with
our recommendations around the best options and the best timing in the coming weeks.
In terms of the rest of us, whether everybody needs a third dose and | know we've seen countries like
Israel, the US has been speculating about, you know, six months or eight months, but we're in a
different situation.
So again, these are areas where we need to look at the vaccine effectiveness and the protection that it's
continuing to provide across the board. We've also started very early on here in BC and across Canada
with an extended interval, as they did in the UK and that as | said, it gives us a stronger and longer
lasting protection.
So, we want to make sure that we know the appropriate timing and whether it's needed. Countries like
the US and Israel, they stuck to the very narrow window of time for the most part, and so have been
focusing on booster doses in people that got their first two doses quite close together.
So, the data that we're seeing right now doesn't show that we need a booster dose yet. It maybe
sometime in the new year for the average person starting with age probably, and we're also watching
the vaccine manufacturers around modifying the spike protein, for example, in the mRNA vaccines to
more closely match what we're seeing in terms of circulating strains. So this would be similar to what we
do for influenza strains that change.
So, we need to balance all of those factors with the protection that we're seeing and from the data
today you can see that we're still getting very strong protection across the board and what is the
optimal timing with which booster dose.
So, lots more to come on that over the next few weeks and months.
[hith, embc, zpz, sss]

This is EXHIBIT “_G_” referred to in the affidavit
of DR. BRIAN EMERSON affirmed before me 85
at Victoria, B.C., this Tt-day of April2022.
en a 7
BRITISH <A
COLUMBIA A Gomimissioner for taking Aidaviis for
———————— British Columbia
INFORMATION BULLETIN—
For Immediate Release Ministry of Health
2022HLTHO116-000522
April 7, 2022
B.C. shifts to weekly COVID-19 data reporting
VICTORA — As British Columbia continues to take the next step in its COVID-19 response, the
Province is transitioning from daily to weekly COVID-19 reporting.
Beginning on Thursday, April 7, 2022, COVID-19 dashboards and reports issued by the British
Columbia Centre for Disease Control will be updated on weekly basis here:
http://www.bccdc.ca/health-info/diseases-conditions/covid-19/data
The new reports will focus on key measures of severity and trends over time, similar to how
other communicable diseases are reported.
The new system continues to provide the data required to guide public health decision-making
and allows everybody to have an accurate picture of the COVID-19 climate in their area.
Data will be updated Thursday afternoons and will provide information from the past full week,
from the previous Sunday to Saturday.
The first reports and updates will include data up to the week of March 27 to April 2, 2022.
The new COVID-19 reporting approach aligns with a shift away from a “case-management”
model to a "surveillance” approach that focuses on identifying meaningful changes in COVID-19
trends over time across different regions of the province. It is similar to how government
monitors for other serious respiratory illnesses through FluWatch.
Description of changes
Cases will be based on an individual’s first PCR test through the Medical Services Plan (MSP).
« Inthe current system, case counts include both laboratory data and health authority line
lists. The latter health authority-based line list workflow will be discontinued with the
updated approach.
« Comparisons between the two systems indicate that the number of reported cases show
similar trends over time.
Hospitalization reporting will leverage the hospital occupancy data that is currently used to
report on “currently in hospital” for all hospital metrics.
¢ With the move to use of broader administrative data there will likely be a one-time
increase in the number of cases ever hospitalized.
¢ The weekly situation report will move to reporting on critical care, in line with the COVID-
19 dashboards. There will also be an increase in the number of cases ever in critical care.
Death reporting is changing to rely on data from Vital Statistics, the agency that registers all
deaths in B.C. and reports on death statistics reported by BC Coroners Service.
* Inthe current system, each death in someone with a documented COVID-19 infection
was reviewed to determine if the death truly resulted from the COVID-19 infection.
These were documented on health authority line lists through manual workflows.
¢ Inthe new system, all deaths that occurred within 30 days of an individual’s positive lab
result will be reported, regardless of whether the underlying cause of death was
determined to be COVID-19 or not. This broader definition means that some deaths will
be reported that are not related to COVID-19. Knowing when a death occurred can take,
on average, four to six days to enter the system.
* The new approach relies on more preliminary information from an automated data
linkage and discontinues the manual, resource-intensive approach.
* Mortality data will be reviewed retrospectively once the cause of death is reported by
Vital Statistics in order to better understand the true scope of COVID-19 mortality. Cause
of death information takes, on average, four to eight weeks to enter the system.
¢ Reporting of deaths in this system is different from the previous system and is not
comparable. A new separate death data stream will be started while access to the
previous records will remain.
Historic data: The transition to a new system will not result in a retrospective altering of past
data.
» Any comparisons between the two different time periods should be made with caution.
* Data files with daily numbers will continue to be made available albeit once a week for
download from here: www.bccdc.ca/health-info/diseases-conditions/covid-19/data
Continuity of reporting
As noted above, despite changing frequency, the COVID-19 dashboards and reports will
continue to be updated. This means that for as long as there remains a need to guide public
health decision-making, data will continue to be available on the following topics:
¢ Epidemiological trends and comparisons

* Case data, including variants and outbreaks
* Vaccine reports, including immunization coverage
Contact:
Ministry of Health
Communications
250 952-1887 (media line)
Connect with the Province of B.C. at: news.gov.bc.ca/connect

67
This is EXHIBIT “_H_” referred to in the affidavit
of DR. BRI affirmed before me
at Vic: i of April, 2022.
Media Availability, 07-Nov-2020 e
Dix/Henry - COVID-19 VCH/FH crackdown oe ot reso oF Taking Aas ~
By Vancouver Cabinet Offices
Adrian Dix: 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. This is our COVID-19 briefing for Saturday, November 7th.
We are honoured to be here on the territories of the Musqueam, of the Squamish and Tsleil-Waututh
peoples. We are honoured and thankful to them for allowing us here today. We're obviously having this
briefing today, we'll be having another briefing on Monday at 3:00 in the Press Theatre in Victoria.
With that, it's my honour to introduce Dr Bonnie Henry.
Bonnie Henry: Thank you and good afternoon. This is another challenging here in BC. | will start by
announcing we have 567 new cases reported today in BC, of COVID-19, bringing our total to 17,715
people in BC who have been diagnosed with COVID-19.
The new cases included 122 people in the Vancouver Coastal Health region, 411 people in the Fraser
Health region, three people in the Vancouver Island Health region, 22 people in Interior Health, and nine
in Northern Health. We now have over 100 people who are in hospital, 31 of whom are in critical care or
ICU.
In addition, we have one new health care outbreak, The Residence in Mission. So we now have 37 active
outbreaks in our health care system, 33 in long-term care and 4 in acute care.
This abbreviated number that we have today is the reason we are having this discussion and this briefing
today.
As you know, in the last two weeks, we have seen a dangerously high and rapid increase of COVID-19
cases and outbreaks affecting primarily our health care system, but also many other places across the
province, particularly here in the Fraser Health and Vancouver Coastal Health regions.
We are also watching what is happening around the world, and we are not alone in seeing this rise in
cases. We have seen them in jurisdictions all around us and around the globe. We have had transmission
in a number of workplaces where the virus has really accelerated, including fish processing and food
processing facilities, retail locations, places like car dealerships, indoor group physical activities, and
other places around the province, but particularly concentrated in this region.
We have had many episodes of transmission in people's homes over the last few weeks, as we know.
We have talked about this. We've also had transmission in health care facilities across the Lower
Mainland. The result is that we're seeing a steady increase and worrisome increase of people with
serious illness requiring hospitalization and intensive care. From the outset of our pandemic, the goal of
our COVID-19 response has been to maintain capacity within our health care system, so we can support
and care for people not only who are suffering from this virus, but for all of the other health care needs
that we have to protect those who are most vulnerable, particularly now we know, our elders and
seniors.
As well, as to keep as much as possible going in our communities, because we know that, as well, has
affects on our health and wellbeing. We need to keep our essential services and essential activities from
schools to work places open and operating safely. Right now, this is in jeopardy.
As a result, we will be taking further actions and we must now step back from our restart activities. We
need to take urgent and focused actions, here in particular in the Vancouver Coastal and Fraser Health
regions, to avoid the serious consequences for all of us. Not just in this region, but around the province.
Today, | am putting in place new provincial health officer orders for all individuals, places of work, and
businesses in communities within the Vancouver Coastal and Fraser Health regions, with the exception
of the Central Coast and Bella Coola Valley. The orders will be in effect for the next two weeks. From
today at 10:00pm through to Monday, November 23rd at 12:00pm. This will give us a chance to stop the
transmission. To have a break in that rising transmission rate that we're seeing. We need to focus our
attention on that now.
The orders will focus on four areas: on social gatherings, on travel, on indoor group physical activities,
and on workplace safety. Right now, it's very important that everyone in these areas of Vancouver
Coastal and Fraser Health significantly reduce their social interactions. We also need to better manage
indoor group physical activities where we have seen rapid transmission of this virus.
We also are requiring all businesses and worksites in this area to revisit and ensure strict adherence to
COVID-19 safety plans and adequate COVID-19 safety plans. We'll be working with WorkSafe BC, with
our public health inspectors, and our bylaw officers around this region to facilitate that.
| know this is hard. | know we don't want to have to be doing this. We have to support each other right
now to make this break. We appreciate this takes a sustained daily effort, and these efforts are critical
to keeping our businesses, our schools, open and our community safe as we go into winter.
So today's orders include, in more detail, for social gatherings there are to be no social gatherings of any
size with anyone other than your immediate household. This includes indoor gatherings of fewer than
50 people, even in controlled settings. It supersedes our masked gathering order that we've had in place
for some time. Funerals and weddings may proceed with your immediate household, but there are to be
no associated receptions inside or outside your home, or at any public or community venues.
This is a time-limited order, but this is what we need to do now. We need to stop our social connections
where we, unfortunately, are seeing this virus spread, and spread to those we are closest to and that we
care most about.
For travel, we are strongly recommending that travel into and out of areas of Vancouver Coastal and
Fraser Health should be limited to essential travel only. Those who live outside these areas should not
visit unless it is urgently required or essential and travel through only when needed. In addition, travel
for sports into and out of this region is suspended for this period of time.
In terms of group physical activities, this unfortunately is an area where we have seen spread in multiple
different settings. As of today, businesses, recreation centres, or other organizations that organize or
operate indoor, group physical activities must stop holding these activities until updated COVID-19
safety plans are in place so they can be held safely. These need to be approved by our local medical
health officers.
This includes spin classes, yoga classes, group fitness, dance classes or other group indoor activities
where people are increasing their heart rate and we have seen repeatedly, not just here, but around the
world that these are venues that we see rapid spread of this virus. Even with people who don't
recognize that they are ill.
Indoor sports, where physical distancing cannot be maintained, are suspended for these two weeks. This
includes no indoors competitions or games for this short period of time. These activities can be replaced
with individual exercise or practice and drills, as we did previously before we started the phases of our
restart our sports programs. That allows everyone to maintain safe, physical distancing when
participating in these important physical activities. | will note that this is not applying to physical
activities that part of a school-based program.
We also need to pay strict attention to increasing physical distance off the field of play, so areas like on
the bench, or when we're warming up ahead of time, or in some cases, where there's spectators. Our
advice has been for the last few weeks that we need to reduce or not have spectators, particularly at
children's games, whether they're inside or outside.
For workplace safety, all businesses and worksites must conduct active, in-person screening according to
our COVID-19 safety plans for their workers on site now. We must go back to those plans and re-enforce
the importance that they have. Workplaces must ensure that all workers and customers maintain
appropriate physical distancing, wear masks as appropriate and be especially vigilant in small office
spaces, in break rooms and kitchens. This is where we're seeing people transmit the virus to each other
in our work settings.
We also know that in some work settings, places like restaurants when COVID safety plans and the new
restrictions.reducing the hours, making sure that we have physical barriers, small numbers of people,
that we don't see transmission of this virus, but we do see it when those plans slip, or when they're not
being followed or adhered to religiously. Right now we have to go back. If we cannot maintain those
plans, then local medical health officers will shut those businesses down and we have seen that happen.
It may need for people, if they feel they cannot maintain those COVID safety plans in a restaurant, then
looking at other options like take-out only. In addition, we need to consider going back to actively
supporting people working from home for certain businesses if that's possible.
We will be, as | mentioned, increasing active inspections with public health, WorkSafe BC, and our bylaw
officers in this local area. We know that this has been hard for businesses. We have seen measures slip
in some businesses, and that has led to transmission. So now is time for you to re-look at your COVID
safety plans, to go to the WorkSafe BC website, to update the plans, and to re-enforce them. And if you
are a worker, you need to look at those plans and make sure you are adhering as well.
We need to redouble our efforts, as we are seeing multiple places where this is being transmitted within
those settings, and then spill over into health care settings, into our families, into our communities.
We know that some of the facilities that provide these group physical activities, for example, have
already taken steps, such as screening participants, reducing density, increasing spaces, putting in
physical barriers. We know that some people have been doing a good job on that. What we are doing is
looking at the literature around the world of what we know is safe, and we will be revising and updating
the guidance from public health and from WorkSafe. We will be working with the communities and each
business and group to make sure that when you have appropriate safety plans in place, you can re-open.
Finally, I'm also going to order that party buses, group limousines, and other perimeter seating vehicles,
which is the technical name, are ordered to stop operating until further notice, effective immediately.
As you know, provincial health orders are always a last resort. But right now these additional measures
are needed. They are needed here in this community, in Vancouver Coastal and Fraser Health regions,
and | am working very closely with our public health teams, our medical health officers in these regions
to make sure that we can support all of the needs we have in this community to keep everyone going
and functioning with the essential services that we have.
We need everyone to help us to keep this wall strong. We know that we need, now, to redouble our
efforts to protect our hospitals, our schools, our families, our workplaces, our communities and our
elders.
Now is the time that we need to do this, despite being tired, despite the uncertainty, despite what has
been happening for the last few months. This is the road we must walk right now. We must walk it
together.
We need now, more than ever, to support our local businesses, our local schools, our local communities
and our own families. This virus has shown us that it doesn't recognize any of our geopolitical social
boundaries and that we are all in this together. We will come through it together.
We will get through these challenges. We have flattened our curve in the past, and we will do it again.
It's going to be a challenge for all of us. But we must do it together. This next two weeks will be critical
for us. | am calling on all of you to do this together, to do our part, and to remember how important it is
to do this by being kind to each other, by staying calm, and by being safe.
Thank you.
Dix: Thank you, Dr Henry.
First of all, | want to start by expressing my condolences to the one person who has passed away from
COVID-19, or to their families and friends and caregivers to the one person who has passed away from
COVID-19 in the last 24 hours.
We know for this family and for those caregivers, like in the case of the 273 who have passed away from
COVID-19 up to today, that this is an extraordinarily difficult time. It's a difficult time to grieve. We are
thinking of that family today, and of all those families today, as they deal with their grief.
As Dr Henry has said, 567 cases of COVID-19 today. Just to put that in context, as you know, in the last
two weeks especially, we've seen a significant increase in COVID-19 across our two Metro Vancouver
and beyond health authorities, the Vancouver Coastal Health authority and the Fraser Health authority,
from Chilliwack to North Vancouver and West Vancouver. Yesterday, an all-time number of cases of 546.
Today in those two health authorities, 533 cases.
Hospitalizations have risen to just over 100. While this is below the peak in the early part of April, the
149, and well below our capacity to address it, nonetheless it is reflects the severity of COVID-19 in our
province.
In addition, | would say yesterday, and this is particularly important to Dr Henry and myself, there were
seven health facility outbreaks declared in 24 hours from Thursday to Friday. There was one further one
today. This is a matter of serious concern to us. As all of you know, the level of COVID-19 and the
response to COVID-19 and the levels of mortality and transmission have consistently been lower in BC
than other jurisdictions across North America, and indeed across the world. Even in the last week, our
rolling daily average of cases was about 8.5-per-100,000 here in BC. That compares, for example, to 108
in Belgium, or 97 in Switzerland or 70 in France or 30 in the United States. That said, we need to take
urgent and focused action now to significantly bring down the rate of transmission across our two Metro
Vancouver health authorities. Not doing so will have serious consequences for all of us, independent of
our age, if our health care system in the Lower Mainland cannot provide the quality of care needed to
respond to accidents, to surgical, medical care due to increased sickness rates among health care
workers or excessive demand on in-patient beds. That's why the actions announced by Dr Henry are so
significantly important.
| want to note, and continue to note, that the most intense public health effort of our lifetime is
underway in BC to keep us safe from COVID-19. The effort is massive in its size, its scope and
commitment. It's important, it's crucial to all of us, so is our ongoing individual duty, of course, to stop
the spread and keep one another safe as we enter the winter of COVID-19. As all of you know, we have
seen very little evidence of influenza so far, but we are expecting and we are entering respiratory illness
season. That will present continuing challenges for all of us. As | noted on Thursday, we have now hired
an additional 580 contact tracers, surpassing the initial target of 500 first announced in August and
provided approval to increase the total number of contact tracers to approximately 800 additional
positions. We currently have 78 candidates in the offer process, and over 300 candidates in the
interview stage. In the Fraser Health authority alone, we've added 259 contact tracers in the past two
weeks, and have approximately an additional 200 in progress.
In the past week, we've increased our overall daily lab testing capacity from 16,085 to 18,633. We'll
exceed our target of 20,000 by the middle of the month.
| want to send a message of deep gratitude to those health care workers providing services directly to
patients, as well as those behind the scenes who are working incredibly hard to keep us safe and our
health care system safe and operating fully.
It is up to all of us to take the necessary steps directed by the PHO to substantially reduce transmission
in the Fraser Health authority, and the Vancouver Coastal Health authority in the next two weeks.
The pandemic is tough on all of us, but we will get through this, and there is indeed hope on the horizon
in the new year with potential vaccines. But right now we need to take action. No ifs, ands or buts. The
time is now in Metro Vancouver, in Fraser Health, in Vancouver Coastal Health. Full-on, full-in everyone.
For those who live in the rest of the province, you need to keep your guard up, and double down on the
actions that we know will keep us safe, in our home and in work places. In our communities. | will repeat
again, the virus does not follow geographical boundaries, it does not care about how nice we are. It lives
to transmit and we must, in this time, to do everything we can to avoid this.
| want to say something, finally, and in particular, to people live in the health authorities outside of
Fraser Health and Vancouver Coastal. We have, today, more active cases in the Interior Health authority
than we have had during this pandemic. Nothing like the rise in cases we've seen in the area around
Vancouver and Fraser Health, but still significant cases. We've seen in other jurisdictions, jurisdictions
that have had very few cases and seen that change very quickly.
In Northern Health, we've seen significant outbreaks in the northwest area, in the central area, in the
northeast area, we have in Interior Health. we've seen outbreaks on Vancouver Island. What is required
now is to remember the provincial health orders that are in place and to follow the guidance and to
follow the orders. This is a worldwide pandemic, and we need to address it everywhere in BC.
In BC, we can turn the tables on COVID-19 by not turning on each other. We need to turn our trend
around. We need to support each other, all of us. We must not give up or lose purpose or hope when
others stumble. We must fight COVID-19 and we must fight it harder than at any time so far. Let it be
said here and now, the worst of the pandemic can, and will, bring out the best in each of us.
We're happy to take your questions.
Henry: Can | just clarify something? | guess before we start on the questions, just to clarify. the orders
that are put in place today are regional orders. So they are provincial health officer orders that will be in
effect in the affected here in Vancouver Coastal and Fraser Health. | understand there was some
confusion about that. Reporter: Thanks for taking my question. | think at the last modelling update you
mentioned that the numbers in BC were increasing in a linear fashion rather than exponentially. Has
that changed? Have we reached an exponential growth? Or are there any specific areas or regions of BC
that are increasing exponentially more than others?
Henry: That's exactly the reason we're here today. We were seeing linear growth, which was concerning
but controllable. And in the last two weeks, we started to see rapid increasing growths, so more
exponential growth, particularly focused in the Vancouver Coastal-Fraser Health regions. That's the
reason why we're taking these additional actions, to address that rapid transmission and rapid increase
in people being affected here in this region. We will, on Thursday, be presenting the monthly update in
the numbers, and the modelling that we've been using that has shown this to be the case here.
Reporter: The number of people that are being monitored by public health has been continually and
rapidly increasing. | know that there have been some jurisdictions that have stopped contact tracing
because the numbers are so large it was no longer useful or possible. Would you be able to say where
we are in relation to that situation?
Henry: Another good question. One of the reasons why, again, we're taking these actions today. We
have been able to continue with our aggressive and pinpoint contact tracing. And our case
management, so identifying where people are being infected and that is what has helped us understand
the scenarios, the settings where we're seeing transmission to larger numbers of people. These
measures that we're taking today are to try and reduce those numbers so we're transmitting to, that
people are transmitting to. We now have community transmission in this area, which is at that point
that even small groups we can get rapid transmission to larger numbers and then it gets multiplied from
there.
Yes, we are still able to manage with the additional contact tracers that we started hiring earlier on in
the summer, when we were having a bit of a lull, because we knew this was going to be incredibly
important for helping us keep things open that are supportive for our communities and our society.
So right now, yes, in Vancouver Coastal and Fraser Health, we are still doing contact tracing and case
management of every single case. That is why we need to take these actions for the next two weeks to
get those numbers back down again, to reduce our numbers of contacts so that if we're carrying this
virus, we are not spreading it to the 15 or 20 people that are in our spin class or... [Vancouver Cabinet
Office audio interrupted at source] Reporter: During the course of the pandemic, we've really taken a
province-wide approach. Obviously we're seeing more cases now in Vancouver Coastal and Fraser
Health, but with cases increasing elsewhere, I'm wondering why you didn't choose to apply these
restrictions across the province?
Henry: This is something that we've had ongoing discussions about. We do have PHO orders that do
apply across the province, the most recent of which was around social gatherings in one's home. And
those continue to apply. In discussions with my public health colleagues and other parts of other
regions, we feel that we are able to manage the cases that we know where the clusters are coming
from, and that the measures that are in place there are working.
We're not seeing that rapidly increasing numbers of cases like what we're seeing in this region. And
geographically, this is a region where there's a lot of movement back and forth between Vancouver,
Surrey, Chilliwack, the Lower Mainland region. That is where the focus of this activity and where the
amplifying of the outbreaks is happening.
We made the decision that we need to take time-limited additional measures to reduce that rapidly
increasing transmission rate here. It does not mean that we're out of the woods and we can back off in
other areas of the province. It just means we need to keep holding the fort there, continuing to pay
attention and do the things that we need to do there.
Reporter: | know you mentioned the exemption of the Central Coast. Can you tell me why it's exempt?
Henry: The Central Coast and Bella Coola Valley are geographically quite different, in terms of where
people travel back and forth and their interactions with things like health services, where they're more
closely aligned to some of the lower-risk areas in the province right now. It made more sense to not
include them in these orders, to allow for ongoing. what's the right word? So the catchment area for
health care, for example, is more aligned with Interior Health region. We didn't want to put in barriers
that were not necessary in those areas.
Reporter: My question is for Minister Dix. Maybe Dr Henry can help too. From my understanding, there
was a meeting between Premier Horgan and influential members and residents in the Fraser Health
community yesterday. I'm wondering what were the key takeaways from that discussion and how are
you really working to further cultural care in that particular region? What are you going to do with the
information you received from residents and influential voices yesterday?
Henry: | cannot comment on that meeting. | don't have any knowledge about it. But | can tell you | have
been working, and Minister Dix as well, but we have been working with our Fraser Health colleagues and
have had a number of conversations with local media, but also with key people and influencers and
health care providers and others in the Fraser Health region.
As you know, we have had an increase in cases there related to a whole bunch of different things. We've
talked about this a number of times over the past month or so, and even into late summer where we
started to have a steady increase. We have been doing outreach in different cultural communities,
ethnic communities, and different geographic communities in the Fraser Health region.
Dix: Thanks for the question. That meeting is one of about a dozen I've had with people Fraser Health in
the last period, to talk about how we can better communicate and better work together to see that the
guidance of Dr Henry is followed everywhere in the province.
That particular call 1 think you're referring to is with leaders in the South Asian community, but we've
had similar calls with leaders from other communities in both recent periods and before. | would expect,
for example, on Monday you'll see a renewed media campaign from the government on some of these
questions and as it builds out in multiple languages. But what the message there was, and the message
at every meeting is, is that we can all be better influencers, better teachers. We can lead in our
household, we can lead in our communities, we can lead in multiple languages. We can lead by
following, in a sense. by showing how and working together on how, for example, at a time of
celebration of life when we can't get together, how we can support people who are grieving, how at a
time when we can't get together that we can celebrate events such as Diwali or Christmas, how ina
time when we can't get together in person, how we can continue to support one another through the
real and profound mental health and social challenges brought by the pandemic everywhere in the
world. There are lots of takeaways. I've been doing a lot of talking, but also a lot of listening to people as
to how we can better communicate that message.
In May, as you know, we conducted a survey of 300,000 BCers that was filled out in multiple languages
at that time to hear from people how to better communicate. We've got to continue to do that effort. |
expect you'll see some of those takeaways taken away. But mostly by us in terms of how we deliver the
message, but also what we're doing is enlisting everyone. | want to repeat that today, for everyone to be
leaders on our core messages. Right now we can't gather together in private homes. We just can't do
that. How we have to continue to wash our hands and stay socially distant, how, in our work places, we
can keep our customers and co-workers safe. How we can do these things and why it's necessary. It is so
important that our hospitals and our surgeries continue to work at full capacity, that we continue to
ensure that elders are safe in long-term care, that we continue to have classroom education and
businesses operating and people working. These are the values and the things we want to do.
| was very moved by the presentations on the call yesterday, as | have been on the multiple calls I've
been on in the last weeks and months, and we're going to continue to talk, of course, but we're going to
continue to learn how we can better deliver the message. We can all be better leaders and better
teachers. | take away a lot from what people tell me today, by email and in meetings.
Reporter: Fraser Health has had 400 cases test positive in the last two days, each day. | know the goal is
to keep schools open. If we continue at 400 cases a day in Fraser Health, will schools in that reason be
expected to still be open? | know we don't have a lot of transmission in schools, but is 400 a danger
level?
Henry: Obviously schools are one of the things we want to protect because we know how important it is
for teachers, for students, for families to have schools operating. What you say is exactly right, we've
had a number of exposure events higher in those areas where there's higher community transmission.
This is something we know.
If there's more. what happens in schools reflects what's happening in our community. That's why the
focus is on reducing transmission in our communities. What we have not seen is a lot of transmission
events in schools. Schools are not amplifying this virus. They are merely reflecting what's going on in the
community.
So, yes, we need to make sure that we're taking those precautions if we're a teacher or a student and
there's people in our family who have COVID, we need to stay away from school. That is working. What
we are seeing is that the plans that are in place in our communities and in our schools are working to
prevent transmission and public health is working very closely with schools to make sure that that
continues.
Reporter: More of a clarification because I'm already getting questions from people on Twitter. What
impact does this, if any, have on kids' minor indoor hockey?
Henry: Minor indoor hockey. those are some of the things, some of the sports teams that we're looking
at. We need to take a pause in this region right now and make sure that these can continue, but we're
not having games across regions, we're not travelling with hockey teams or other sports teams, that we
take a step back and make sure that they're able to do this safely. And | will also say that we need to
focus right now. We talked about this a few weeks ago, that we need to make some decisions given that
we're ina very unusual year with this pandemic. That may mean that we don't play on multiple hockey
teams or multiple sports teams. If we're involved with school sports, then we may not want to be
involved with sports outside of the school setting, so we keep those potential connections small.
The other things that are really important are the none-game field settings where we can and we have
seen people get together. Whether it's parents or the players themselves on the bench, in the locker
room, afterwards when families are getting together. We have seen transmission happen in those
settings as well. The off-the-field of play settings. We have a working group that's been working with
viaSport, for example, here in BC, and the amateur sports agencies with the public health teams at BC
CDC and from the regions that have been looking at sports in particular. They will be supporting this
region and making sure that they can take measures that keep all children safe.
We know how important it is to continue with physical activity. We don't say stop it all, but we need to
say is for this next two weeks we need to take a step back from some of the reopening and that there's
no travel for games, and that we focus on keeping kids active in a safe way.
Reporter: With this new order, what happens to people where you live alone, perhaps, and have been
really limited to the safe six? Does that now go down to the safe zero?
Henry: No. | hear you. It's very challenging for those who live alone. Yes, those are where you can have
those very small number of people who are in your bubble. So it really is about looking at your
household and the connections that you have and reducing those social connections where we have
larger groups of people.
We've talked about going down to six. For some people that is a lot. For many people, that have large
households, that may be too many. Now we need to scale those back. It means if you have one or two
people that you are close with that you are considering, your family, your bubble, your household, then
stick to those people.
Dix: One small point to say that at the beginning of the pandemic we started a program that a colleague
and the seniors advocate, Isobel Mackenzie, helped lead with members from all the political parties and
what involved the United Way and Better at Home and what it intended to do was address issues of
social isolation and we're obviously continuing with those efforts.
This is a two week period. What I'm asking people to do in addition to all the other things we're asking
people to do is to reach out to people via phone, via FaceTime, people who might be in the
circumstances you're describing, and provide them with support at this time. We know. and one of the
reasons we're taking the kinds of actions that are being taken today, is to ensure that those kind of
necessary. those kinds of other impacts that happen with respect to COVID-19 don't happen in this
period.
While we can't get together in person, | would like everyone to reach out to someone they know or
someone they love, or maybe only knowa little bit, who might be isolated and reach out in these times
and talk more and be available more on the phone and via the internet and other means so that we can
get through this period together and support one another in these times. | think that's what BCers have
done extremely well from the beginning of this pandemic, and that's what we have to do now.
Reporter: Just wondering, there are some jurisdictions, countries like Australia which have taken more
restrictive measures like actually closing borders to outside travel including within states and then also
places like South Korea which have used tracing apps which maybe have a little bit of an evasiveness to
it, to really knock down the numbers, like to orders of magnitude lower to what they are right here in
BC. Is there any consideration as to taking those measures to get this under control?
Henry: [audio interrupted at VCO] .what measures seem to work and we know what measures work
here. They have worked before so we are taking a measured approach, I'm very aware of what's
happened in Australia. We have been watching very carefully there, it is a lot easier when you are an
island to control movement back and forth and we talked about them at some length about should this
be across the province or in the areas where we are seeing this mostly.
| believe we're taking measures that will work in the areas where we need to pay attention right now.
We always are looking at do we need to do more? When can we back off and allow things to open up
again?
In terms of apps, Korea, I've been on a number of calls where they have talked about the issues and how
they used their app or not and it is not a tracing app, it's a notification app and we, right now, the way
our processes are working, we don't feel it would be helpful to add that sort of an app in though we are
leaving the door open we certainly think that there are areas where it could assist in notifying people
and | have said this a number of times, places like if we go to bars or parties, and of course right now in
this area, we are not doing that. So we need to take account of these measures and make sure we are
doing what we need to do right now to keep as much as we can open to support our communities here.
Reporter: Is it a recommendation that people don't travel outside of their health region borders or is it
an actual order? | am just wondering for example with BC Ferries, does that mean that, you actually
aren't allowed to take a ferry to Vancouver Island if you live in either FH or VCH? Or is that just a
recommendation?
Henry: It is a recommendation in the very strongest terms, right now we need to go back to what we
were doing in March and April and May where it was essential travel only and we recognize that there
are very valid and important reasons why people have to move to different areas of the province but we
also recognize that this virus travels with people and we bring our risk with us and we take that risk back
from where we have been.
So right now, we are advising in the strongest terms that people need to stay in the local community,
reduce their social interactions and travel when it is essential.
Reporter: In terms of these new orders, how will household gatherings and restrictions on those be
enforced?
Henry: [audio interrupted at VCO] .we have not always. we have not made a focus on enforcement and
we don't necessarily need to enforce it. These are the rules and we know that people understand the
rationale for the rules and that for the most part they follow them. So we are telling people that this is
the risk in this area right now and these are the things we need to do to protect our families and our
communities and our health care system and it's very important that people do take these actions now.
Having said that, we do have the ability to enforce rules and that can be done through public health
inspectors, we have now also the ability to enforce them by bylaw officers and police, but | don't believe
that is necessary. We don't need a stick for people to realize the importance of taking these measures
now, for this time limited period, to break those changes of transmission, to bend our curve.
Reporter: Many experts continue, including doctors are advocating for collecting race-based data. You
know they are saying that Black Canadians are disproportionately contacting and dying from COVID-19
because they are working on front lines like factories and retail work. | mean, at this point, you have
touched on this in the past, what do you think will be done in the near future? What do you think should
be done?
Henry: [audio interrupted at VCO]. challenging this and from the outset of this, we have been. we have a
way we can link indigenous data and that we have been following that in particular because we know
the differential impacts pandemics have had on First Nations communities in this province and this
country. So that has been our focus. We have been working with the federal government to come up
with a standard for how we collect raced-based data or desegregated data by race, the challenge that
we have run into is that means additional questions on our case investigation form and that means
additional time to actually enter that data and it has not been collected in a systematic way, although
we tried through the summer, we were hopeful we would get a reprieve and be able to add in some
additional measures - that was not to be. As you know, at this point, we do not have the capacity to add
that information to each individual case report form. And we don't, frankly, have a coordinated
information technology system, an IT system that allows us to easily transmit and share that information
either across the province or across the country.
So we are not able to do that on our case-based investigations. We are focussing on the public health
actions that we need to take for every individual person in the midst of this pandemic. Having said that,
there are other ways that we can retrospectively look at the impacts of the pandemic, and of the
measures that we have put in place to deal with a pandemic on populations in BC. And one of the ways
they have done that in the past is the survey that we did that had desegregated information collected
that helped us understand that better and we are looking at ways that we can. we are talking with the
government and our provincial and territorial colleagues about how can we do that by linking
information with things that we know about neighbourhoods and census tracks and things like that and |
know there has been some work done in Toronto that we have very similar align with so it has been very
much a challenge, we absolutely believe that if you don't measure and look at those differences that we
are going to be missing inequities and we have seen that in the survey we did and we are continuing to
look at how we can address those issues but we were not able to add it in a way that allowed us to
continue the. as you can imagine it is quite a detailed process for every individual and there is now over
17,000 people who understand this a little better, when public health calls you, it is a stressful thing for
people to either find out that they have this disease or that they have been exposed to it. There are
many, many questions that people have and our focus is on finding out how the virus is being
transmitted and where it is coming from so we can put in those control measures, so we have not added
it to our case report forms at this point.
Reporter: [audio interrupted at VCO]. | will go through them quickly and if you can touch on each of
them that would be great - what are the restrictions on gyms? Is it just indoor sport that is impacted
here? Does it include, soccer or other outdoor sports? What happens with churches and other faith
groups and gatherings? Are those impacted by the restrictions? And what happens at. if a grandparent is
care taking for their grandchild, can they go to their home to do that? Or tutoring? Or home daycares?
Henry: Sure, so what this refers to is. so in terms of the gyms we are talking about the in-door group
activities in gyms. So there are gyms that are operating where they are doing one-on-one or where
people go in and there is adequate space and they can be on machines that are separated from each
other. It is those group activities that are done in the in-door setting that we are talking about. For some
gyms or businesses that is their only model and they need to either stop or make sure that they have in
place approved safety plans and that will be working. local public health will be working with those
facilities around those. So it does apply to those group activities within a gym setting so some
community centres for example have a gym where there is weight lifting that people do individually,
those sorts of things can continue and when we are talking about the sports teams, some restrictions
are on the indoor sport and some restrictions like. restrictions on traveling outside the region to play
games are on the outdoor sports and the indoor sports. Does that make sense?
What other questions? The churches, so those are not social gatherings those. so the fifty person limit
with the fiscal distancing and all of the important restrictions that have been in place around churches
and other religious centres remain in place and | will again take this opportunity to send my thanks and
gratitude to the many, many faith leaders around this province who have been supporting their
communities and their congregants in doing this safely and | know it has been hard for many people not
to come together and worship together or have their ceremonies together but we cannot do that yet.
We will be able to come together again but it is not that time yet. So the mass gathering restriction
apply there. In terms of going to a household to look after children and daycares, the orders do not
apply to those. It applies to social gatherings.
Reporter: Last one about people visiting from outside the province. | know Gord alluded to this but, is
there a restriction on people coming from outside the province to visit in FH and VCH? And will you be
having a conversation with BC Ferries or the federal government about imposing additional restrictions
at ferries asking people if they are traveling if it is essential travel?
Henry: The short answer is no. We have never had restrictions on people coming in and out of the
province. We have again asked our. you know across the country we have all talked about you know
staying put, we are seeing a resurgences in every province in this country with the exception of the
Atlantic bubble perhaps but certainly Manitoba, Saskatchewan, Alberta, Quebec and Ontario are in the
same boat so we are asking people not to come unless it is essential travel into this region right now
recognizing that that is where our biggest risk is and we are asking people here not to travel unless it is
essential but no we will not be putting in orders or restrictions on BC Ferries.
Reporter: | want to ask a bit about the social gatherings outdoors and at restaurants and how that will
be working andif that will be restricted as well to just our households but in a restaurant or outside our
homes, how does that work?
Henry: [audio interrupted at VCO]. we have across the province here which means no more than six
people at a table, no table hopping, everybody wearing masks, keeping their distances, those
restrictions are still in place and we have also, as you may recall, we have limited the hours or operation
and serving of alcohol. Since we have done that, restaurants that have been following those rules have
not had transmission events. We are now however, in this region, you know, we know that the
community transmission is higher so we need to pay attention to those rules and | know there have
been concerns that in some restaurants there has been slippage of these rules or that we as consumers
in the community have maybe become complacent and feel that these rules don't apply to us.
We will be cracking down on those. We know, the inspectors know where the restaurants are, we have
been working with WorkSafeBC and we will be paying attention, particularly to restaurants because we
know it can become an environment where we have seen transmission to large numbers of people
when these rules aren't being followed so now, fair warning, but now is the time, we need to all pull
back in this region and make sure that we are following those safety plans because when we follow
those, they work. So we are not adding additional measures there and | am sorry, | lost the last part of
your question.
Reporter: It was just about social gatherings outside our own homes.
Henry: So when we have those rules in place, then those are. but the other part of it, you know, parties,
events, right now for the next two weeks, those are not to happen.
Reporter: So regarding the indoor [inaudible] what kind of changes to their plans are you looking for
compared to what they have already presented right now and when is the earliest that they could re-
open?
Henry: [audio interrupted at VCO]. we have a team that has been looking at the risk that has become
apparent across the world, across Canada and here in BC for some of these activities so we know that
there are some spin class or spin companies that only do that, that have put in barriers like people only
going at the same time with a cohort of people, putting in physical barriers between bikes for example,
keeping the music down low so we are not shouting, making sure that the ventilation is adequate, |
know some of the spin classes have been outside and that is of course less risky, so there are things like
that.
We know that there is enhanced and best practices around dance studios and other indoor group
activities that we need to upgrade and update our guidance on and that will be worked on in the next
few days so the soonest that we can see people with the appropriate measures reopen will be in the
coming week. | think what we have seen is that some gyms are doing this really well and some gyms are
not. So, what they need now to really show that they have these plans in place because we have started
to see increased numbers of people that report that that is where their infections have come from so it
will be a process and it will be a process that will take a the very least days and for some facilities this
risk period, they may choose to stay closed.
This is EXHIBIT “_!_” referred-terin the affidavit
of DR. BRIAN E SON affirmed before me
at Victoria, B-C., this
TT of April, 2022.
Media Availability, 19-Nov-2020 sa _—)
Dix/Henry
- COVID-19 update Cee
By Laelslature Press Theat A Commissioner
for taking Affidavits
y Legistature ai British Columbia
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. This is our COVID-19 briefing for British Columbia for Thursday, November the
19th, 2020.
| want to say we're honoured to be on the territory of the Lekwungen-speaking people of the Songhees
and the Esquimalt First Nations.
Tomorrow, Friday, at around 3 o'clock we'll be providing a written briefing with relevant information
about COVID cases in BC. On Monday we'll be back here in Victoria, in the Press Gallery theatre, briefing
-- Dr Henry and | will be -- at 3 o'clock. And with that it's my honour to introduce Dr Bonnie Henry.
Bonnie Henry: Thank you very much and good afternoon. So for today | want to report a total of 538
new cases of COVID-19 in BC, including nine epidemiologically linked cases, bringing our total to 24,960
in BC with COVID-19. The new cases by health authority -- 178 are in the Vancouver Coastal Health
region, 309 people are in the Fraser Health region, 12 people reside in the Vancouver Island Health
region, 28 people in the Interior Health region, and 11 people are from the Northern Health region.
We now have 6,929 active cases of COVID-19 in the province in all of our health authorities, of whom
217 are in hospital, 59 of whom are in critical care or ICU. We have had, sadly, one additional death in
the last 24 hours bringing the number of people in BC who've died from COVID-19 to 321. As always, we
send our deep condolences to the family, to the care providers of this person, one of our seniors who
we've lost from long term care.We now have 9,929 people under active public health monitoring across
the province and 17,207 people who have recovered from COVID-19.
We have six new health care outbreaks to report, and no new ones that have been declared over,
bringing our total to 59 active outbreaks in our health care system -- 40 in long term care and assisted
living and 19 in acute care. We also have an additional outbreak in a community to report and this is at
the Fluor BC LNG joint venture, a contracted site of the LNC Canada plant and project in Kitimat, where
we have a number of workers at that site who have tested positive for COVID-19 and the investigation
with Northern Health and the owners and contractor of that facility are ongoing.
So today, as is no surprise to anybody, we are in our second surge and it is proving to be a challenge.
While we all hoped that we would not experience a second wave based on what has been happening
around the world, around this country, and around our province, we anticipated that this may occur. We
knew that every pandemic that we've ever had had more than one wave and this has been proving to us
and to people around the globe that this is a challenging virus to deal with.
Despite where we may be today, | remain confident and | know we will get through this, but we need to
take more action now. COVID-19 is a virus that is proving to be a long road, this pandemic, and this is
the road that we must travel. It will have bumps and will have challenges and we are facing them today.
As we know, we have seen a significant rise in new cases, hospitalizations, and, tragically, deaths. Four
weeks ago we had about 175 cases a day and | was anxious then.
Yesterday we had over 700 people in our province affected and we know that our hospitals are getting
stretched, our ICU capacity is getting stretched, our communities are suffering. We also know that as
more people are infected the risk of somebody younger and others having severe illness or dying are
greater, and tragically this past week we had a young person in his 30s who died from COVID-19. This is
a reminder to all of us that this virus can have tragic effects on the people we are closest to and the
people we love.
We also have over 50 active outbreaks in our health care system. We have seen that transmission has
happened sometimes in social events in our communities and it's spilled over into our long term care
homes and our hospitals. This increase has been most acute, as we know, in the Vancouver Coastal and
Fraser Health regions of the province and that is why | put in regional orders about ten days ago.
However, as we've been watching so carefully over the last few weeks, it has become apparent that this
surge in transmission is happening across the province.
We are now seeing increased activity in terms of community transmission, outbreaks, and effects on our
health care system in every health authority in the province. So now we need to do more. We need to
keep our essential service, our essential activities open and operating safely. We need to keep our
schools open and operating safely and our workplaces that can be open safely open.
And we need to relieve the stress on our health care system right now.
Right now we are holding our own but we know that if people cannot access health care that it is not
only people with COVID-19 but people with other urgent health issues that will suffer and we need to do
this across the province.
As a result, | am extending the regional orders that currently apply to the Fraser and Vancouver health
regions across the entire province and | am putting new province-wide orders in place.
These expanded orders will come into effect today and run until for starting with a two week period.
That's the period of the incubation period and we will be extending the orders from November 23rd so
that the orders across the province will be in place until December 7th at midnight.
We want to ensure we get through 1 to 2 incubation periods and we will be reviewing our progress
regularly as we move through this next two weeks.
We want to see a clear and notable difference and slowing of transmission in our province, across the
province, so that we can get back into that balance that control that we have with public health.
So what does this mean? This means that the orders with regards to our social gatherings apply to the
entire province.
Right now we at home need to only socialize with our immediate households.
We need to delay inviting over friends and family for this period of time and reduce our social
interactions as much as possible outside of our homes.
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As a result, I'm ordering that there'll be no social gatherings of any size with anyone other than your
immediate household. This applies in our homes, vacation rentals and in the community and in public
venues including those with less than 50 people in controlled settings. Your immediate household can of
course include roommates and if you live on your own, you can visit with up to one or two people if you
regularly spend time with them. We need to go back to what we were doing in April and May and March
when we had our pandemic bubble.
And so if you are somebody who lives alone, that's that one or two people that you have a close
relationship with.
All indoor and outdoor events as defined in my gathering and events order are not allowed to take place
until further notice. So that goes back and that's a bit of a technical language of the mass gathering and
events order is on the website and it refers to the restrictions and limits the maximum number of people
we could have in an event was 50 and these events could take place in many different places.
Those are now suspended across the province for the next two weeks.
While places of worship are to have in no in-person group services for this period of time -- I've had the
privilege of meeting with a number of our a large number of faith leaders from around the province --
and this is important and they understand that we need our faith services more than ever right now but
we need to do them in a way that's safe. With the community transmission that we're seeing and the
fact that we have seen transmission in some of our faith based settings.
We need to suspend those and support each other and find those ways to care for each other remotely.
The exceptions will be those important events -- funerals and weddings and ceremonies such as
baptisms -- which may proceed in a limited way with a maximum of ten people including the officiant.
There are be to be no associated receptions inside or outside your home or at any public or community
based venue associated with these important celebrations.
The exceptions do include other activities that happen with COVID safety plans in these gathering sites,
including medical group sessions, sessions like NA and AA meetings with a maximum of 50 people, less if
the space is smaller. And ensuring that you have COVID-19 safety plans that are in place and are being
acted upon.
It also does not apply to those very important work functions that we have. What we are talking about is
reducing our social activities both in our home and outside our home and around our work periods.
So if | work in the social services and | need to check on families, this does not apply to that situation as
well. As well, if we have people who are doing work in our house, people who are grandparents are
coming to pick up children. Those are not social gatherings. Those are essential functions that happen in
and out of our home. And so those are not affected by this order.
| have for many, many weeks made clear the importance of wearing masks particularly now as one of
the measures that we have that can prevent transmission along with those important things that we
know work like physical distancing, cleaning our hands and staying away from others when we're not
feeling well.
But based on continued requests, particularly from the retail and other public sectors, to have more
explicit direction for the use of masks in indoor public and retail spaces. I've asked the Minister of Public
Safety and the Solicitor General to issue a requirement for the wearing of masks for all indoor public and
retail spaces for staff and customers except where eating or drinking.
This means if you are at work at your desk you do not need to wear a mask, but if you are in a shared
workspace, a common space or a public space like elevators, hallways and other common areas you do.
If you are behind service counters and you have plexiglass between you and everyone else, you do not
need to wear a mask unless there are others back there with you.
If you are serving customers, you do need to wear a mask. If you are in a restaurant, you need to weara
mask when you are not at your table. That includes coming into the restaurant, leaving the restaurant,
going to the washroom. And staff must wear masks when they're interacting with others and with other
staff and with the tables.
Again, this does not apply to anyone who is unable to put on or remove the mask on their own. We
know that there are people with certain conditions and disabilities in some ways that would make mask
wearing challenging.
It does not apply to children under the age of two and we need to be aware that some peoples
disabilities or inability to wear a mask may not be readily apparent to people.
Technically this will mean mandatory wearing of masks in all indoor public and retail spaces, not only as
a workplace health and safety issue, as one of the mandates that we have had, but also to ensure that
owners and operators of these spaces have the support behind them to ensure that customers are
aware of this mandate as well.
The use of the Emergency Act to do this will enable us to cover that overlap of workplace and public
safety around this issue.
As | announced last week we need to understand and better manage and control indoor group physical
activities where we have seen transmission happen.
We've seen notable levels of transmission and there are some particular activities that are higher risk.
| have tasked the group to look at this issue over the past 10 days and as of today | am ordering that all
businesses, recreation centres or other organizations that organize or operate indoor group physical
activities that include spin classes, hot yoga and high intensity interval training must stop until further
notice.
All other group fitness activities indoors can continue to operate but they must adhere to the updated
guidance that we are developing.
This is a change from what we put in place last week for the lower mainland. It gave us an opportunity
to -- once we recognized that there was transitioning happening.
Transmission happening in some of these settings. We took the opportunity to stop those, to put a
pause, so we could understand the conditions that made these more risky in some situation and others.
So what we have determined that it is a combination and this is nothing -- this is what we're learning
over time, it's those closed environments where we have people close together where we're exerting
for and when we have poorer ventilation and when there's often loud music, those are the settings that
are most at risk. And we are seeing around the world that those are our challenging settings and they
invite this virus to spread. We know that at this time of year when we know the virus is spreading faster
in the climate that we have right now and the higher rates in our community, that these high risk
activities cannot happen for the foreseeable future.
So that is the focus that we are looking at right now.
We had included other indoor group fitness activities like dance, like some of the other lower intensity
fitness classes and we will be updating the guidance on how those can operate safely, including
additional space, reduced numbers, making sure that people have book ahead for example and have the
same class with the same people at the same time.
So there's a number of new guidelines that are being finalized and will be posted.
Last week | made the requirement that people had to adhere to the updated guidance and had to have
their new plans approved by the local MHO before they could restart these activities. That is no longer
the case.
We have narrowed down those activities that we feel are too high risk to happen right now and those
will be suspended. All other indoor group activities must, as we've had in the past, must update their
COVID safety plans to adhere to the new guidelines and have those publicly posted.
They are however placed on our watch list and we will be watching carefully because we know even
some of these lower risk activities if these plans are not followed intensely, that we can have
transmission. We will be monitoring this and we will be shutting down gyms or studios where these
safety plans are not being followed.
There were, | understand, a small number of these facilities that may have included some of these high
risk activities that had received a notice from Vancouver Coastal Health. That notice will be rescinded if
you have any of these high risk activities. So spin classes, hot yoga, high intensity interval training. Those
are not approved right now.
For all sports -- the other issue that we talked about 10 days ago was about reducing contact sports
indoors and we have looked again at the measures and the risks that are associated with ongoing
sporting activities.
We also recognize how important it is particularly for youth but for adults as well to have the
opportunities to engage in these sporting activities in a safe way during this pandemic.
So what we have done now is that we will continue with VIA Sport Phase 3 activities with the exception
there are to be no spectators at indoor or outdoor sports and there will be no travel for any of these
sports outside of your local community.
So that is the restrictions that we need to have in place now across the province to ensure that we can
have these important sport activities continue, but in a safe way during this pandemic.
I've seen the incredible effort that so many businesses and organizations have put in to retooling,
adjusting their businesses to make sure they can stay open and do it safely. The vast majority of
businesses around the province are doing a great job.
We only have to look at things like hair salons and spas and retail stores to show that when rules are
followed and when safety measures are in place we're not seeing transmission of this virus and we see
that as well in restaurants where we are following the conditions that we've put in place that we don't
see transmission.
Right now, we are asking all office based employers to temporarily suspend those important efforts to
safely get workers back into their workplaces and to support working at home where possible until at
least the new year.
For anyone going to work it is important that we minimize all of those social interactions with our
colleagues before, during and after work. Those are the things where we are seeing transmission in
communities, in workplaces, around the province and it is many different types of workplaces. So many
of them are essential workplaces. We know we have seen it recently in food production plants in retail
outlets where staff are gathering together.
We've seen it in every setting from banks to car dealerships to other settings, where it is staff who are
getting together and we don't remember that we have to take precautions with each other, that we
have our own social networks, our social connections and can inadvertently bring that virus in and
spread it within our work settings as well.
We talked about this for the Lower Mainland, but across the province active inspections will be
increased in all business settings to ensure that we have those important COVID safety plans and that
workers and the public are protected in all settings around the province. And | want to make a particular
note about bars and pubs. As you know there are some challenges with the way liquor licenses are run;
those are settings where we have confirmed that safety plans may not be followed and people may be
mixing in a way that can be risky. We will be paying particular effort to inspective COVID safety plans to
make sure they are being adhered to in these settings, and if we have challenges, if we find they are not
being adhered to these businesses will be closed down.
Specifically in the Vancouver Coastal and Fraser Health regions where we have seen a lot of transmission
in recent weeks related to spillover into workplaces. I've asked one of my deputy provincial health
officers to work with the environmental health officers from both Fraser Health and Vancouver Coastal
Health to establish a rapid response team to focus on those workplace issues, to liaise with the
inspectors from WorkSafeBC, but also to find and target the clusters and outbreaks that we're seeing
and manage them rapidly. Part of that, again, will be shutting down businesses where the safety plans
are not adequate.
This is the time for everybody to pay attention, to make sure you revisit and step up your safety efforts
to ensure these protocols are fully implemented. | know many people did an excellent job very early on,
but we have seen slippage. This means all businesses and worksites across the province must conduct
active, daily health screenings; it can be done through an app, online, or when people arrive at the site
and businesses need to ensure that all workers and customers maintain that appropriate physical
distancing, maintain all of the safety measures in place and wear masks when needed.
| also want to talk about travel. We talked about this 10 days ago, and | am not putting a travel order in
place. However, as the Premier mentioned yesterday, it is our expectation that everybody in BC right
now limit their travel as much as possible unless it is essential. It is limiting our recreational and travel
for social reasons that we're talking about. This includes travel within the province and travel to other
parts of Canada. I'm asking people again: we need to step back, we need to stay local. Stay within your
community as much as possible. Od course if you need to travel for work, for a medical appointment, for
reasons that are essential that does not apply.
| absolutely recognize that tourism is important to our communities, our economy and the significant
effort that many of our tourist businesses have put in place for safety plans for guests and staff. The
challenge we are facing is that we have seen a significant increase in transmission across many
jurisdictions across this country -- we wish we had the same small number of people coming here as to
the Atlantic Bubble, but that's not to be for us. The challenge we are facing is people are coming to BC
from these other jurisdictions as well, and we know for international travel there are appropriate
mechanisms in place for quarantine that is not in place for travel inter-provincially, so we are asking
people coming to BC in the next 2-4 weeks to postpone their trip here if they can. If not, then we need
to be sure that they will minimize the need to be aware that the expectation is that they will follow the
orders that we have in place here and these orders are enforceable. That will mean minimizing your
social interactions with others, making sure you follow all orders and guidelines we have in place here.
For students who may be returning home, keep to your household only when you come back; that
applies to people who are returning to be with their families right now. As previously noted, any travel
within the region is suspended for sports for everyone right now.
What does this mean? It means yes, you can move about within your region. If you live in Pentiction you
can go to Summerland. If you live in Victoria and want to go to Tofino -- not such a good idea right now.
If you need to go to a store in another community then plan ahead and go as infrequently as possible for
this next short period of time.
If you are thinking about skiing, go to a local mountain. And if you are in doubt, postpone it until a time
when we have better management of the transmission we're seeing in our communities right now. The
focus of this is making sure that we can keep our communities functioning, we can keep our businesses
that are working safely open, we can keep the pressure off our hospitals, our ICUs, our long-term care
homes. We can protect those people who are elders and seniors and people in need of health care. As
well, it's important for us to keep schools open. We know that schools are an important, safe place for
children around this province.
Many of the additional efforts announced today are to focus on those priorities including our schools. As
| noted last week, transmission in schools has been low but we have had many, many more exposure
events from the adults and the students in our school settings. I'm also hearing that this is concerning to
our parents, to teachers, to all of us in the school community, and we need to make sure that we can
keep up and make sure everybody is informed as best as possible.
We know this is most acute in areas where most of our schools are, and right now where most of the
transmission is happening, and that is in the Lower Mainland in the Fraser and Vancouver Coastal Health
areas. This week I've directed one of my deputy provincial health officers to lead a coordinated effort to
try and manage and improve that situation with a focus of working with our teams in Vancouver Coastal
and Fraser Health to have a coordinated approach to identifying and managing school exposures and
outbreaks quickly, and to improve our ability to manage these events together with our school
communities. As part of this, | also remind parents and caregivers to be aware of things like mingling and
the drop-offs before and after school and reminding the adults in our settings that the out of classroom
interactions are important to manage safely as well.
Getting through this surge in new cases and through our pandemic requires all of us to do our part and
to support each other to do this. We need to urgently reduce the level of transmission and our cases
across the province in these next two weeks. We need to ensure our health care system can meet the
health needs of all of us here in BC.
| especially want to recognize and appeal to young people and young adults to help us in this effort. |
know how difficult this has been for you and the impact on your lives. | know you have been missing
birthdays, graduations, and celebrations of these important transitional moments in our lives. | also
know that you have been role models and inspirations. Young people have proven that they have
resilience, that you're adaptable and that you're brave, and I'm calling on all of you right now. | need
you. | need you to be super heroes, to step up, to hold the line and to help all of us get through this.
As we approach the darkest days of this year, there is light at the end of that tunnel. We know that
there are vaccines on the horizon and | am hopeful that early in the new year we'l start to have some of
those tools to help us protect those who are most at risk. But right now we all need to focus our efforts
on slowing the spread and bending our curve back down.
That is what will get us through these next few months. We need to support our friends, our neighbours,
and take care of those who are most at risk. We need to protect our hospitals, our long-term care
homes, our seniors, our elders and our communities. We will get through this and we will do it as we
have been doing it: by being kind to each other, by being calm even when it's uncertain and anxious, and
that is what will keep us safe.
Adrian Dix: | wanted to start by expressing my condolences, those of the Premier and those of the
province, to the family of the person who passed away in the last day from COVID-19 in BC in Fraser
Health. We know what a difficult time this is to grieve and every case, every person matters to their
family, to their friends, their community. | think it's fair to say this has been particularly difficult week,
particularly in long-term care with people passing away and | want to express our profound thoughts to
all of the families, all of those who have lost loved ones in this pandemic which is significant and very
challenging right now to grieve.
| wanted to express my ongoing appreciation to the extraordinary teams in public health. You've heard
from Dr Henry that 6,929 active cases of COVID-19 in BC, 9,977 people in isolation under public health
surveillance, and significant numbers of people in our hospitals -- 217 people, 204 in the Fraser Health
and Vancouver Coastal health Authorities. It's that context, the fact that over the last four weeks our
rolling average, our seven day average of case counts has increased four times, the fact that the number
of people in hospital has increased over that four week period -- some number between 60 and 70 have
been bouncing around to today's number of 217. The fact that the number of people in ICU has gone up
and the fact that we have a significantly greater number of outbreaks in our long-term care homes --
these are all reasons for action.
When we summarize those actions, when we say gathering right now only with the people in your
immediate households, when Dr Henry orders that outside social gatherings -- not the 50 person
maximum -- but outside social gatherings not occur in this two week period. We discussed with faith
leaders yesterday, more than 140 of them from around BC with the Premier and Dr Henry, that places of
worship will move to virtual services for this period with the exception of baptisms, weddings and
funerals where a maximum of 10 people can be, but where there are no associated receptions. When
we ask people to travel for essential purposes only, when we ask all businesses in BC to revisit their
safety plans to ensure active daily screening of workers and the other conditions that are so central to
the control of COVID-19. When it's ordered under the Provincial Emergencies Act that it's mandatory to
wear masks in all public and retail spaces, for staff and customers and all workplaces, elevators,
corridors between shared areas, group or break rooms and shared kitchens except when people need to
eat.
It's because of that that we need people to suspend and ensure that as many people as possible in office
settings can work at home and continue to work at home, we're increasing site inspections and we're
saying there are no more indoor group fitness classes and we're saying there are specific rules for
people involved in team sports; no spectators at indoor sports events and no travel outside of your local
community for sports related activities and that the effort of the public health care system expands
outward.
All of those things are what we can do together to help stop the spread and help our fellow citizens, our
families, our friends, our communities, our workplaces, the children in our society who need to go to
school, all those who need surgery and need our support in long-term care. These are the means
through which, in every part of BC because the number of cases in the three other health authorities
have increased, all of us can help flatten the curve but also do what we want to do in this pandemic --
which is our part.
| wanted to give two reports that | usually give on Thursday -- I'm going to do them very briefly because
this has been, as you know, a very busy day. Pursuant to the Premier's announcement at the end of
August, 702 contact tracers have been hired in BC; that's an increase of 66 from last week, 434 more are
in the interview stage and 102 in the offer stage. We're also funding culturally sensitive contact tracing
supports for 76 positions with the First Nations Health Authority -- that's more than 1,000 people in the
end because we're going to add the number of people we intend to hire to do contact tracing. It's going
to now be 950 plus the 76 in FNHA -- more than 1,000 people in addition to those who were doing
contact tracing prior to the Premier's announcement in August.
Finally | want to say with respect to surgeries that rom the week of November 2nd to 8th we set a
record for this year in the number of surgeries completed in BC, both scheduled and non-scheduled
surgeries -- that number was 7,280. This past week, the 9th to the 15th, the number is less because of
Remembrance Day -- it's 5,520; more than the equivalent period last year. This reflects an extraordinary
achievement by our entire health care system. Essentially and simply, the question remains: do we
fight? Do we fight together in this important time when we perhaps see some opportunity, with respect
to vaccines, on the horizon? Do we fight right now to reduce the spread of COVID-19 in BC and help one
another help each other help ourselves get through this pandemic?
| think the answer is yes -- we all have the tools in our hands, the guidance provided by our medical
health officers, guidance provided by Dr Henry to do so. These orders today give us all the means to be
100% all in. | can tell you that our health care system is, our health care workers are. Across BC society,
people who work in our grocery stores are, people who work in transportation are, | know the people in
education are. We need to all be 100% all in in the battle against COVID-19. These orders give us
direction and we must give them the power they require to be effective. We need to make these orders
work to stop the spread and being 100% all in will get each of us and all of us there.
Reporter: | just would like to ask why the travel restrictions are not a provincial order, and what would
have been different if you had gone that route in terms of checking to make sure people are traveling
inappropriately or having some mechanism to sort of stop and make sure that they are following the
rules?
Henry: You know, it's exactly that.
| don't believe that we need to do that. We have a lot of essential travel that comes back and forth. We
get a lot of our essential goods that come here on the island by ferry, back and forth and through the
United States and other parts of Canada.
So, to step up that infrastructure and to have some mechanism to do that is very challenging, but we
also know that when we had these same requirements in place earlier this year that people took them
to heart. We're talking about recreational and social travel, and it's very challenging sometimes to be
able to understand.
| know | started to get concerns from people again that they're seeing Alberta licence plates and US
licence plates, and it really is about remembering that we don't always know people's stories and there
are many reasons why somebody may be coming. They may have been here for a number of months
now. We know that. They may have a need to check on a family member.
There's many different ways that we understand essential travel and we trust people to take the right
actions now because we are all being affected by this.
Reporter: Can | get a sense from you what kind of metrics you'll be using to determine if these
restrictions are successful over the next two weeks? Is it daily case counts or how much of a percentage
decrease you see in certain areas to be able to know that this is the circuit breaker method that you've
been talking about?
Henry: We watch a lot of things. Certainly daily case counts are part of it and our rolling average,
because the day to day variation can reflect a number of things.
So we are watching that very carefully. We're watching our ability to find people quickly, and that has
been challenged particularly in the Lower Mainland health authorities where we have had so many
cases per day. It's been a challenge for us to find people to find their contacts in a safe and quick way, in
a timely way.
So we're watching that.
We're watching a very important metric that helps us understand if we're holding on in public health,
which is the percentage of people where we cannot link them to a known case or cluster, and being able
to follow up and stop clusters before they grow into larger outbreaks.
And so we're at the brink with that, and that is the area that I'm most concerned about. Initially that was
in the Lower Mainland health authorities and that's why we put the restrictions on there to start, but as
you have seen, you know, there are things that we are learning about this virus, that it can spread more
easily, that people's trajectories of how they move from place to place are not always linear, and that
means we can get wide transmission before we recognize it.
So we need to put these in place across the province now and we'll be watching that. We'll be watching
the spill over piece into where people are getting infected and where they're going. We now are seeing,
as you know, long-term care breaks and acute care facilities outbreaks.
So yes, those are important.
We have seen a decrease in the number of people who have been infected from attending social
gatherings. So, it is making a difference in the Lower Mainland. We started to see that decrease.
Now we need to focus on some of the workplace settings where we're seeing increases and long-term
care we're seeing increases.
So, it is a balance. There's a whole bunch of things that we look at and agonize about every day, but
those are the basic ones.
Reporter: | just want to go back to the issue of Fraser Health, which | know was something dealt with in
the background briefing on this. Public health officials, especially in light of the new high counts there
today, public health officials are sort of flagged such issues as dense housing and essential workers as
key to the high counts in the Fraser Health region, but these are presumably relevant to other parts of
BC.
So, are there more essential workers in Fraser Health? More dense housing? What's making these high
counts so distinct? What would explain these high counts?
Henry: There's a variety of things. We know that the highest population base is in the Lower Mainland,
particularly how we've broken it up by health region. The largest health region by population is Fraser
Health. It's a lot younger population with larger numbers of families and children. The vast majority of
our schools by a large amount. The highest numbers of schools are in the Fraser Health region. We have
lots of families that live in multi-generational homes. There's cultural reasons why people come
together, why it's so important to have community together in large numbers.
| know many of my colleagues and friends who are from the South Asian community, for example. You
know, having two or three hundred people is your immediate family is normal and is important and is
part of how life is lived, and these are things, unfortunately, that this virus can exploit. It doesn't
recognize who we are, but it recognizes that when we're in crowded situations indoors that we can pass
on.
And from the very beginning we have said that this virus is transmitted most often to the people we are
closest to. So we are seeing some of that effect.
We also know that many of those high risk businesses, essential businesses like our food processing
plants, like fruit warehousing. All of those places are in the Fraser Valley. Poultry plants. We know that
much of the trucking industry, people live there, and many of our essential workers, health care workers
in Vancouver Coastal live in the Fraser Health region.
So, there's a whole variety of reasons why we are seeing increased numbers there. We knew that was
likely to happen, but we had that rapid increase in the middle of October that was a whole bunch of
different issues coming together. Once it was social gatherings, it was the fact that this virus was being
transmitted, that we were having things indoors. | think right now we're seeing that reflected in a
smaller scale around the province and we all need to pay attention to the things that we can do to stop
our social interactions, to put the brakes on this virus now.
Dix: Just one thing further to remember and | very strongly believe this. | know Dr Henry does as well,
that we're all in this together, and there was a time early in the pandemic when more of the cases, even
though Vancouver Coastal Health was smaller, were in Vancouver Coastal Health. The reverse of what
we Say about Fraser Health, which is BC's youngest population, also has an impact on other health
authorities. Vancouver Coastal Health is essentially the same number of people who passed away as
Fraser Health, even though it has significantly fewer people.
In the middle of the summer in Fraser Health, a disproportionate number of our cases within Fraser
Health were in the Abbotsford area. Now it's in Surrey, but we have cases throughout the province. And
just to put it in context, | think the number of cases today outside of the Metro Vancouver health
authorities is 51. Well, four weeks ago that averaged about four or five.
This pandemic is everywhere. We need to support each other everywhere, and that is right now
particularly true in Fraser Health.
These circumstances can change in communities and it shows why the steps we have to take in Fraser
Health today need to be taken everywhere and why it's so important, | think, and Dr Henry made the
decision today to extend the orders that were for Vancouver Coastal Health and for Fraser Health to the
whole province.
| live in Vancouver Coastal Health, four for blocks from Fraser Health. That's an administrative
distinction, but what it tells us | think, what all of this information tells us is what a difficult pandemic
this is. How difficult it is to manage this and how we're all in this together. Every single one of us.
Reporter: Given these numbers that are still consistently high, are there any specific or distinct
strategies being considered to get things under control or the numbers down in Fraser Health? If yes,
what, and if not, why not?
Henry: I've sort of announced all of those strategies that we're talking about, in particular we focused on
supporting our contact tracers in the Lower Mainland -- so both Vancouver and Fraser Health -- to get
on top of being able to find people in a timely way, to make sure that we're catching, that we're
understanding where the clusters are happening, getting on them quickly and focusing on where we are
seeing transmission happening.
So, having our, for lack of a better name, a rapid response team that one of my deputies will be
supporting with the environmental health officers, focusing on where we are seeing transmission now in
some business settings, focusing on what we've been doing all along, but enhancing our ability to
protect our health care system, whether it's long-term care or acute, where we're seeing outbreaks
happening.
So, there is absolutely an intense focus on that, but the measures that you're seeing today are the ones
that we expect will work if we all do our part.
Dix: Just one statistical thing as well. We've transferred significant contract tracing capacity to Fraser
Health, including 43 staff people from the Provincial Health Services Authority who do contact tracing to
Fraser Health. Obviously the largest share of the people we've hired are working in Fraser Health.
Dr Henry and | had a chance when we were in Surrey recently to see them do their work and they're
doing an extraordinary job, and | think we'll continue, obviously, as we have in the past, to focus
resources where resources are needed.
So in terms of the significant amount of resources being transferred, obviously in terms of the resources,
the health care system, contact tracing, primary care to support our hospitals, support for long-term
care. Obviously right now Fraser Health is at the centre of all that, although we have significant issues in
all of the other health authorities.
Reporter? Dr Henry, | just want to ask about masks. Why the switch now after there's been a lot of
questions queued towards that? Will people be given a badge or some sort of identifier to show that
they can't wear a mask or don't have to for those physically unable to and why no masks schools?
Henry: Okay.
So, the answer to the first question is as | have said many, many times, there is a mandate in our
occupational health and safety and that is what is reflected in the orders that are coming from the
Minister of Public Safety. | stand by what we have always had in place and | think we won't get into
semantics, but what we have said is it is my expectation that we wear masks as an important piece and
no more important than now in terms of one of the measures that we have to prevent infections.
Sorry, | got distracted by . . . You had three questions.

We take people at their word. There is no way that we will force people to have medical notes or other
things. We need to trust that people who cannot wear masks, and there are some people who cannot
wear masks. We need to be able to accommodate them, and that will mean in some cases that they can
have remote pick up or that they go to receive services at times when there are other people not
around, and | think we have to focus on people in retail settings going into get a driver's licence
renewed. Those are not the situations where we're seeing transmission of infection, but it is important
that workers feel that they are protected and that they have the appropriate measures in place to
require both workplaces and people who are entering those public spaces in retail spaces to protect
them and protect each other.
Schools are not public open spaces. You cannot go walk into a school. We have layers of measures of
protection in place in schools, and like | wouldn't wear a mask sitting at my office, we don't expect
children to wear masks sitting at their desks all day long.
We do have expectations in schools around those common areas where children and adults in the
school setting are mingling and those are part of the safety plans that are in place in all of the schools.
Reporter: | apologize for the multipart questions. This is going to be another one.
A lot of questions around what it means to have activities within your own community. So, can you
explain to people when these sports games take place where can people go to play? Is it your city? Is
your neighbourhood? Your health authority?
The same with something like skiing? How far can someone ski to one of the North Shore ski hills?
And another point of clarity that faith organizations have brought up is what if they're holding things
like, in some cases Gurdwara holding community .. . They prepare meals for a number of people in the
community. Are they still allowed to gather in order to hold those events to provide meals or other
things for community?
Henry: Addressing the second one first, and we did talk about things like that, and no, it's not an event
to prepare meals, and they need to have COVID safety plans in place, which they have in many of the
settings where meals are provided, and they need to be individually packaged.
What we aren't having is people coming in and sitting together and having those meals. They have a
process and | have tremendous admiration for the Gurdwara, in particular, who do this, where they
provide those meals to families in need. So those absolutely can continue.
| know many of our faith buildings are used for 12 step meetings, for example, or for day care or for
additional studies for children, and those can continue with the appropriate safety measures in place.
Those are not events in the context of this order.
In terms of how far can you go? Well, you know, this is not an order. This is telling people to use their
common sense, and when we're talking about the sports teams, part of the sports networks and the
sports organizations had interregional travel. So they have their own defined regions and that needs to
stop. You can play the games within your own region only and there's no travel between different areas.
That is where we're seeing the risk, and the risk is people carpooling together, having to stay overnight
because some of the regions where, you know, from south island to north island or, you know, Powell
River to the mainland. That has to stop right now. We can't have that type of travel.
We also need to pay attention to those pre-game, post-game, off the field play situations where we're
coming together, and that's where the no spectators come in because we have seen that people are
getting together. It's hard. You know, you go into the locker room.
So, having provisions in place, and | know some teams have done this really well, where people come
pre-dressed and so we're not in the locker room. We have to resist that temptation to go out with the
guys after the hockey game.
So, those are the things that we need to put aside right now so that we can continue to focus on the
opportunities, particularly for kids, to get out there with their teammates, to do drills, to have games in
their local community.
Reporter: Dr Henry, thank you for taking my question.
A portion of it you have already answered, but could you explain, or rather, elaborate on the new orders
around religious places. Can people visit temples and go to Gurdwara with their families, or are you
banning visits to religious places completely?
Henry: No. I'm not banning visits to religious places at all. There needs to be processes in place so that
people can go. They can keep their distance. They wear masks when they're in common areas -- all of
the things that you have been doing so far.
What we're saying is those services that were explicitly under the event order, where people came
together at specific times and it was up to 50 people in a space, depending on how the large space was,
that we need those to be suspended for this short period of time, because we have seen that despite
our best efforts we have transmission happening in those events.
Reporter: In terms of essential travelling, if someone has booked a vacation to maybe go to Whistler
next week, are you asking them to cancel it?
Henry: I'm asking them to consider whether they need to go, whether this is the time they can go, and if
they can postpone it.
Reporter: Dr Henry, when it comes to the mask mandate, when does that come into effect? How is that
going to be enforced? Will there be fines? What can an employee do if somebody comes in and refuses
to wear a mask?
Henry: Those details are being worked out by the Ministry of Public Safety and the Solicitor General
under the Emergency Programs Act.
It does give owners and operators of retail spaces, public spaces the ability to call on police. It also
means that there can be fines and there are ways that they can deal with employee safety under the
Public Safety Act.
96
The details will become clear over the next week.
Reporter: Yes. On schools, parents are wondering if the winter break will be extended. Some might see
these numbers and think maybe they need to pull their kids out of school.
I'm just wondering when that decision will be made and what case numbers need to be, essentially, to
keep schools open?
Henry: As we have seen all along, schools are a safe place. We are not seeing lots of transmission. We've
seen lots of exposure events. And that reflects what's happening in our community, so we are not at the
point where we would consider closing schools.
And we know that we have to do our best in the community so we can protect the essential work that's
going on in schools, how important it is for children.
| just have to say that | so admire our teachers and educators and the work that they've been doing to
make sure that children have that learning experience that is so critical for them at this point in their
lives. We need to celebrate and support the work they're doing and part of these orders is to make sure
that we can continue to do that.
In terms of over the holidays, those discussions are ongoing. It is not only about the schools. It's about
our community. It's about a number of different issues, and there are many people that need to be
involved in those discussions.
When we have come up with our decision about that, we'll let you know.
Reporter: For out-of-province residents working in BC on major projects, like the Trans Mountain
pipeline, for example, who might go home to Alberta or from Kamloops to the Lower Mainland, for
example, to see families on their days off, I'm assuming, would that be deemed essential travel? Yes or
no?
And how much of a concern has this been for you and health officials about the potential spread from
those situations, especially when you consider the cases reported at LNG Canada today?
Henry: Yes, it is essential travel. Work travel is essential travel.
Industrial camps have been a huge concern of ours from the very beginning. You will recall that we
actually have an order around a COVID safety plan in industrial plants and other settings, like the
silviculture in the summer, where we had thousands of people coming to plant trees over the summer
period.
Those safety plans have been really good. They have worked. We've had very few cases. Those cases
have been isolated. For people it's been a challenge, | know, for people working in those environments
because they cannot have those social interactions that they would normally have had in those work
environments. They've have barriers in place when people come in. There's testing in place, as needed.
There's isolation and monitoring of contacts. We've had less than half a dozen individual cases of people
being having exposure events, so, people coming in and testing positive for COVID.
So this is our first outbreak. It was caught and is being managed.
We know there's about 30 or 40 people who are in isolation and being monitored. We don't believe that
there have been exposures in the community.
| know Northern Health is working really carefully with them on managing this outbreak.
It is a reflection of the risk that we run across the province -- across the country -- when rates are high all
over the place.
So far, the safety plans have been something that we have been focused on and are important and have
been working.
Celebrating the things. .. . They planted three million trees this summer, trees that would have been
lost if we had not had those plans in place and been able to get people up into some of the more remote
areas to do the planting.
Reporter: Yes. Thanks for that answer. Just a quick question for clarity because, obviously, this is an
extension for the restrictions already in place for the Lower Mainland, but it's new for places like Interior
Health. Is this immediate from when you spoke about this about an hour ago, or would it be 10pm
tonight?
Henry: We're saying midnight tonight. And then we'll catch it up. All of these will apply until at least
December 7th. We will be monitoring and we'll be talking, of course, over that period of time and
watching how things are going, and adjusting if we need to.
Reporter: Thank you. My question, | would like to ask Minister Dix if he can talk a little more about, and
maybe, before Dr Henry.
When you see what's going on in Quebec with schools [audio drops out] if it's something that you're
thinking about here.
And then if Minister Dix can say this in French, if school is going to be closed or if the Christmas holidays
are going to be extended for kids here in BC.
Henry: | have to say that | know that Quebec was making an announcement at five o'clock their time,
but | have not heard what the announcement was, so | can't actually respond to your question, other
than we are looking at whether we will extend the holiday break or not.
There's pros and cons, as we talked about the other day here, on doing that and there's implications on
a variety of different parts of our communities. That decision has not yet been made here. [sss, adv, agg,
mjag, mcfd, ctz, edu, embc, empr, envy, fin, forr, hith, tnf, jtst, lbrr, mhaa, maz, pjjh, pssg, msd, tacz, tran,
dbc

2022-04-12 - Affidavit No 1 of B. Emerson

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2022-04-12 - Affidavit No 1 of B. Emerson

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This is the 1* affidavit of

Dr. Brian Emerson

Canadian Society for the Advancement of Science in Public Policy

!, Dr. Brian Emerson, of 1515 Blanshard Street, Victoria, in the Provinc

2. | make this affidavit in support of Her Majesty the Queen in Right

3. | am authorized to give evidence in this proceeding on

Background to Public Health in British Columbia

(a) The Ministry of Health

5. The Ministry of Health is the responsible ministry for the

6. The Ministry of Health has created a Strategy and Innovation

7. “Public health” is one component of British Columbia’s health

8. One of the goals of public health is to prevent and manage outbre

a.providing independent advice to the Ministers and public officials on

b.monitoring the health of British Columbians and advising, in an

c.working with the BCCDC, and BC’s medical health officers

include doctors, nurses, environmental health officers, drinking water officers,

(c) BC Centre for Disease Control

20. The BCCDC continuously reviews published scientific evidence about

Background to the COVID-19 Pandemic in British Columbia

understood that SARS-CoV-2 was an infectious agent that was causing

27. The COVID-19 pandemic in British Columbia has been characterized by a

Limiting Transmission of COVID-19 in British Columbia

37. As the scientific knowledge about transmission of SARS-CoV-2 has

38. In determining which public health measures were necessary and

Information Relied Upon by the PHO

45. The BCCDC publishes situation reports summarizing information about

50. Each of the BCCDC’s epidemiology and modelling presentations can be

51. Using mathematical modeling, public health generates estimates of

54. The presence of variants of concern in British Columbia, and the

55. Although SARS-CoV-2 is novel, evidence of seasonal variation in the

58. Accordingly, as more scientific information and evidence becomes

Public Health Orders

63. In order to determine whether a particular public health measure should be

b. preventive measures (including vaccination requirements for certain

c. prevention regional measures (orders which applied only to specific

d. gatherings and events;

f. food and liquor serving premises;

h. overnight camps for children or youth;

k. industrial projects restart;

|. personal service establishments;

m. long term care and assisted living staff assignment;

n. agricultural temporary foreign workers;

0. workplace safety; and

p. other orders (including orders related to mink farming and the

Form of Public Health Orders

Regional MHO Orders

Reconsideration of the Orders under the Public Health Act

c. require more time to comply with the order.

86. However, a PHO order is not suspended during the period of

91. In April 2021, the volume of requests for reconsideration under s. 43

92. Following the implementation of PHO orders requiring proof of vaccination,

95. Exemptions are generally issued on a temporary basis. Some individuals

longer consider reconsideration requests under s. 43 in

Best Information on Class Size

100. While general population statistics are available

101. According to quarterly population estimates from

https://bestats.shinyapps.io/popApp/), the projected population of

Region Health Authority Year Gender Total

104. | know of no fact material to the certification application in

A commissioner for taking affidavits

Oct/21 to Present Deputy Provincial Health Officer, BC Ministry of Health

July/18-Oct/21 Deputy Provincial Health Officer (acting), BC Ministry of Health

July/03-June/18 Medical Consultant, Population and Public Health Division, BC Ministry

Feb/04-Feb/05 Acting Executive Director, Healthy Living and Chronic Disease