PHO/MHO News Transcripts...Page 3 PHO/MHO News Transcripts able to open again once we are confident...

PHO/MHO News Transcripts

April 22, 2020

Quoted: Reporter, Adrian Dix, Bonnie Henry

Adrian Dix: I just wanted to say that last night 13,000 tuned in to the virtual town hall in the

Vancouver Island Health region, co-hosted by Mitzi Dean MLA and Sonia Furstenau MLA, with CEO Kathy McNeil, and medical health officer Dr Richard Stanwick, who received and answered many questions from the public.

Tonight there will be a virtual town hall in Northern Health, hosted by MLAs Mike Bernier and Doug Donaldson, and with Kathy Ulrich, the CEO of Northern Health, and Raina Fumerton, the

medical health officer in Northern Health. And tomorrow, April 23rd in Interior Health, Katrina Conroy and Norm Letnick, MLAs, will be hosting a town hall with Dr Sue Pollock, the MHO for Interior Health, and Susan Brown, the CEO of Interior Health.

We're honoured, as I say, to be here on the territory of the Lekwungen-speaking people, the Songhees and the Esquimalt First Nations. And I'm honoured to introduce Dr Bonnie Henry for

today's COVID-19 update.

Bonnie Henry: Thank you, and welcome to today's update for April 22nd. We have 71 new cases who have tested positive today, bringing our total of test positive cases in BC to 1,795. That includes 745 people in the Vancouver Coastal Health region, 747 in the Fraser Health region, 110 people in the Vancouver Island Health authority, 153 in the Interior Health region, and 40

in Northern Health region.

We have a number of outbreaks, as you are aware. We have three new outbreaks in long-term care facilities that were announced earlier today by Fraser Health, all of them in the Fraser Health area. And, as we know, we have been putting a lot of attention to detecting any cases in

our long-term care sector very early. That's a reflection of the numbers that we're dealing with.

We have 20 ongoing outbreaks, in addition, in long-term care, assisted living, and one which is

in an acute care unit. In addition, four of the long-term care facility outbreaks that were active in Fraser Health have been declared over. In our other outbreaks, we have 77 cases associated with the Mission federal correctional facility. And the ongoing investigation and support to that

facility, with Fraser Health, including the infection prevention and control, and outbreak investigation, continues. There are five inmates who are in hospital currently.

In addition, we have the 28 cases we talked about yesterday that reflect the outbreak that's ongoing, and the investigation that is ongoing into the poultry processing plant in Vancouver Coastal.


In terms of our case status, 103 people are currently hospi talized, and of those, we have 46 people who are currently in critical care or ICU in BC. We have an additional three deaths to report today, bringing our total of people who have died from COVID-19 in BC to 90. They were

all people in long-term care homes. And our hearts go out to the families and he care givers. We now have 1,079 people who are fully recovered from COVID-19.

As we talked about yesterday, we continue to experience new community outbreaks in BC. And this, of course, is very, very concerning to me, and to all of us. This tells us that we have more work to do to break the chains of transmission in our communities, and to make sure that every

individual, every business, every community, every family, does what we need to do to break these chains. And that is everyone, all the time. We can't afford to have any weaknesses in our firewall if we are going to be able to move ahead into our new normal.

We know people are tired of staying apart from their loved ones. We know we are tired of not being able to do the social connections and events that we are used to doing. But to ease

restrictions, we need to have a decline in both the number of new cases, and the numbers of outbreaks. And as I have said many times, there are things we can control, and there are things that we don't have control over.

What is happening around us, both in the US, and in other provinces in Canada, and internationally, affects us. And we know that that is one of the reasons why we have to be so

vigilant here in BC. Until we clear this hurdle, we can't begin to make changes.

One of the most important things that we all need to do is to stay home if we're not feeling well. And with no exception right now. We know that many people experience very mild symptoms with this virus. And some may think it's just the sniffles, or perhaps even just allergies at this time of year. It makes it really hard to tell if you have COVID-19. But, you can

still transmit it to others, even with very mild symptoms.

So let me be 100% clear. Right now, if you are ill, whether you feel it's a cold, whether you feel it's allergies, whether you are concerned you might have COVID-19, stay home, stay away from others, and immediately contact us. And we can help you get tested if that's appropriate.

We also expect that employers need to pay attention to this, and need to be responsible. You must have measures in place to ensure everyone who is working is healthy, and can keep a safe

distance from each other in the workplace. We do not penalize employees for staying home if they are ill during this pandemic. We also -- employers -- need to understand that an outbreak in your business has effects on all of us. It also can have significant financial impact, both for the

business, and for your employees.

As we have seen with a number of businesses recently, an immediate shut down is required so

that we can ensure that we're not passing this on in those situations. Your business will only be


able to open again once we are confident that it can operate without putting people in danger -- the employees, or the community.

So, as we are planning for what we want to do in the near future, in our new normal, these sectors and businesses need to think about this. We need to address these issues before we can reopen safely. We need to have measures in place to keep people safe, to avoid further

outbreaks. If we start having these types of outbreaks and spread in our community, we can overwhelm our system. And that is what we have been working so hard to avoid for the las t few months.

So we need to have enhanced cleaning, both personal hand hygiene, as well as in our environment in the workplace. Being able to keep a safe physical distance, and supporting

employees and others to stay away if they are ill.

We need to have a plan for every business that is open, in the event that an outbreak should occur, so that we can detect them early; we can remove people from the workplace; we can connect with public health and ensure that we are isolating people appropriately so they aren't going to be transmitting it to others.

There is an order providing this guidance for industrial camps. And we have given guidance for

those essential businesses that have been open. We need everybody to follow these. And we need the same from other businesses as we look to opening things up in the coming weeks. We need to keep our firewall strong. And we have to be 100% committed to all of us doing our bit

to see our way through this storm.

I want to take a minute before I finish today to just say a word to... We're aware -- I think many

of us are more aware today about the details of the senseless tragedy that has unfolded in Nova Scotia, a place that is very dear to me, in this time of unparalleled challenge. And I just want to say to my Nova Scotia family, wherever you are, and to my RCMP family, know that I'm

heaving a sigh and a wish for thee, and will mourn with you from afar.

So all of us need to do our part. And we need to continue to support each other in doing that.

We need to be calm, and to be kind to each other, and to be safe.

Dix: Thank you very much, Dr Henry. I know that everyone in BC agrees and has the same feeling for the people of Nova Scotia today, and what they're going through, and the collective grief that people are going through in Nova Scotia.

I also wanted to start by acknowledging the families of the three people who passed away from COVID-19 in the last 24 hours in BC. Two were in Fraser Health, one in Vancouver Coastal

Health. All were in long-term care. But all those families are going through grief right now, and not just the grief of a loved one passing away, but the grief of the circumstances we're in when


people are often separated from the ones they love in these very important moments, in families, and in communities.

So our condolences and our thoughts go out to all of them. As Dr Henry has said, today is a day, in terms of the numbers, which often people will analyze after these press briefings -- and we have 71 more cases today -- reflecting the situation in Vancouver at United Poultry, in part, and

others as well.

And the numbers, in terms of acute care, where we have 103 cases, which is, I believe, the

lowest number we have had in the month of April, down from a high of 149. And in critical care, 46, which is also the lowest amount we have had in April, show the continuing effort made by the community, I think, to break the links of transmission of COVID-19, and something that we

have to continue to commit to.

In acute care hospitals today, there is about a 62.1% occupancy rate -- 4,222 vacant beds -- as I report 46% of critical care beds are currently occupied. And there has been some interest in what's happening in emergency rooms, whether people are seeking the care they need. Again, yesterday, more than 4,000 people visited emergency rooms across BC, which is up from just

under 3,000 on April 6th, although we continue to be down from the normal, say March 9th, when it was approximately 6,500 visits.

So that tells you that people are, from where we were on April 6th, returning and using health care service when they need to use them. And I think that's an important thing, and something

that we will continue to encourage.

Often we celebrate people who are working, and essential workers. I wanted to acknowle dge

that April is construction and skilled trades month. There are frequently events recognizing people in construction, skilled tradespeople across BC. And obviously, there isn't the public recognition and the public celebrations that often accompany this. But we know that thousands

of construction workers are working on roads and hospitals and other critical infrastructure needed to keep water and electricity flowing; that construction sites, and worksites have made significant adjustments to the way they operate. And we wanted to acknowledge them, all their

contributions, both to BC society, and to our communities in every part of BC.

I also wanted to offer, for the people who live with dementia, or who are supporting a loved

one living with dementia, people know about the First Link Dementia Helpline. It's available as a resource. This is run by the Alzheimer's Society of BC. Helpline staff and volunteers can provide support and information -- very important in these times -- about resources in the community.

And that number is 1-800-936-6033. And just to let people know that the Alzheimer's Society has extended First Link Dementia Helpline hours in English. That number, again, is 1-800-936-

6033. It is now Monday to Friday, 9:00 am to 8:00 pm.


In Cantonese and Mandarin it's 1-833-674-5007. And that is Monday to Friday, 9:00 am to 4:00 pm. And in Punjabi, 1-833-674-5003. And that is Monday to Friday from 9:00 am to 4:00 pm. And I wanted to acknowledge the extraordinary ongoing work in this difficult time of the

Alzheimer's Society, which I think everyone in BC who has ever been associated with theAlzheimer's Society knows that work, and will appreciate that in these times, that work is even more important.

There are a lot of ongoing questions about surgery and the resumption of surgery. I just want to note that from the period of March 16th to April 19th, the total number of postponed surgical

cases in BC was 13,988. The total completed cases, because, we of course, have continued with urgent scheduled and unscheduled surgeries, is 11,936.

So even though we have deferred and cancelled what are sometimes called non-urgent scheduled surgeries, but essentially scheduled surgeries are all important, as we know. There continues to be a lot of activity, in terms of surgeries in BC. And extraordinary wrk continuing to

be done. We have never had this period in surgeries, it should be said, this need to renew on the scope, and to go back, potentially, to having surgeries again in BC, to resuming elective surgeries, which we hope to do, of course, at some point.

I just want you to know, as we proceed with this work, our commitment to patients has not wavered. You are not forgotten. You are the centre of what we are doing. And we have been

planning a resumption of surgery, which we are continuing to work on, ever since elective surgeries were cancelled. That work continues. And I want everybody to know, who is waiting for surgery, that they are in our hearts, and in our thoughts, and most importantly, in the work

that is being done across health authorities in BC.

And finally, I think we see the case -- whether it's Cargill in Alberta, whether it's United Poultry

here in Vancouver, whether it's the circumstances at the federal institution in Mission -- the significant and ongoing risks posed by COVID-19 to the health of people in BC. And what it says to us, surely, is that we have to continue to do what we need to do; to be 100% all in. This is

particularly important in light of these outbreaks.

On the question of working sick -- and just so everyone understands, there will be, and we are working hard on ideas of how we can move BC forward from this point -- but what is not going to change, what cannot change, and what has to happen now, is people have to stay home when they're sick. And this is going to be part of the new reality during this period of pandemic.

Sometimes, I think, there is the sense that it's the brave thing to do, or the courageous thing to

do to play hurt or to work sick. Well that can no longer be the case. And that is the responsibility of both employers and employees. That is something we have to continue to work on. But we have to especially have that happen now.


Since we have been giving these briefings in January, that has been a consistent the me -- washing hands, not touching your face, but most importantly, staying home when you're sick. It's the key part. It may be the most important part of being 100% all in. And we really need, in

light of today's numbers, and in light of these community outbreaks, we really need people to be 100% all in right now.

Finally, the Premier announced today the April 27th opening of the urgent primary care centre in James Bay and Victoria. It shows what we're continuing to do -- we need to continue to expand our public health services across BC.

If the last few months have told us anything, it's how important public health care is to everyone, and we're going to continue to make these efforts. As you saw earlier this week in

Castlegar, Vernon, and Abbotsford, those efforts have expanded through urgent primary care centres and today I was delighted to hear the Premier's announcement of the opening in Victoria on April 27th.

Q&A

Reporter: The other day you mentioned this study in California of antibodies which had suggested a more widespread infection rate than had been detected with conventional testing.

Could you discuss the obstacles here in BC to going to antibody testing? I know you've said there are some reservations or we haven't found a reliable test yet, but could you discuss what those are? The other day you also provided a good discussion of the significance of the

reproduction rate, but you didn't say whether we know enough here in BC to know what it might be here. Could you address that as well please?

Henry: Let's start with the serology testing, and I will note that there has been quite a lot of discussion in the medical community about the study that was done in California, particularly because it was done on a sample of people and the sample of people were recruited through a

social media site. So in many people's opinion it was likely to be a bit biased towards people who had concerns that they might have had infections.

The other thing that has become really apparent is that the test they were using is one that has not yet been sufficiently validated and there is a relatively high false positive rate, so that is one of the concerns. The critique -- as we know, we're all trying to learn a lot from the science of

what's going on around the world, and that means that many papers are getting out into the public before they can have, what we call, a peer review.

Some of the peer concerns about the paper from California are around how they recruited people and the validity of the test, which speaks to one of the challenges that we have. We have to make sure we know how the test works before we use it to make such types of studies

and we have a number of them planned, very similar to what they did in California. However,


using random samples of blood from a different source, from community blood samples that were taken for other reasons and there is a way we can do that -- we have a research process set up to help us understand, like they were trying to do in California, how many people in the

community might actually have antibodies.

The challenge in California was when they came up with their estimates, part of what they

looked at was plotting the number of people who had died in Santa Clara County with the estimates of how many people might have been infected, and it was somewhere around 4% or 5%. I will note -- that's not enough to have community immunity, or herd immunity, but it was

much higher than the number of people who had actually been tested when the first phase of the outbreak went through that county.

Part of the conclusions from this study, which was done under a very small sample, was that they extrapolated, oh it's not really that bad, the death rate is only about 0.2% which is closer to what we would see with seasonal influenza. It's unfortunate that got picked up as one of the

conclusions because I don't think that is supported by the test, because it has a higher rate of false positive, or by the information that came out of that study.

In terms of what we are doing here, we want to make sure that we have actually validated the test in the population that we know have been affected here in BC so we can understand what is the false positive or the false negative rate from this test. With every test that we have, it's

not 100% either way and it depends on what's most important: whether you want o make sure you're catching everybody, or if you want to make sure that you're only catching people who have the disease you're looking for. We've seen this challenge around the world with the

serology tests that people are using; the UK purchased 3.5 million of one type of test and found out that it had an unacceptably high false positive rate and false negative rate, and that leaves all of us with a dilemma.

Which is to say that the BC CDC is working with the population, and actually, perhaps one of the good news stories is that we are working with the people who survived infection at the Lynn

Valley Care Centre. There's a good proportion of them to ask them to participate in helping validate this test because we know they're people who have tested positive for this virus. That work is ongoing and I'm hopeful that we'll have a valid test that we can use, as we've

mentioned before, to have a broader understanding of how many people in our community have been infect, but also to be able to understand who has antibodies after being affected.

It also helps us look at some of the contact tracing and understanding of outbreaks in our communities as they happen. We are weeks... maybe? Sometime in the ne xt week to ten days we should have a much better idea of which tests we can use for which pieces of this. We are,

of course, part of a national consortium to look at how we can use zero prevalence to understand the pandemic across Canada.


In terms of our R0, it's a challenging thing because it's one of those parameters. It depends, as we've talked about before, on how infectious the virus is, how long you're infectious to others, and how much contact you have with others during your infectious period. This gets down to

why distancing is so important -- if you don't have contact with somebody, you can't pass this on, and that helps reduce our R0. We were probably at R2 or R3 early on as we were having increased transmission in our communities, which means that every person who was infected transmitted it to two or three other people.

We are now down below R1, but we can only say that looking back. It's a helpful marker to get

so we can understand what are the things that tell us we're having increased or decreased rates of transmission. The modellers at the BC CDC are working with us on that, and at UBC and Simon Fraser we're talking with our clinical colleagues, looking at how can we use things like

hospitalization, the number of people in ICU to help us estimate how we're tracking with our reproductive number over time. We'll be presenting some more of that in the coming days, probably later next week.

Reporter: I was wondering what exactly is the criteria to declare someone recovered from COVID-19 in BC. Can you tell us whether it defers by health region or whether it's changed

recently? Also, are there people in BC who have tested or tested positive or shown symptoms of the virus after they were thought to have recovered?

Henry: We have criteria. We have two different criteria for how we are determining whether somebody's recovered. It is the same across BC, but I will address one issue in a minute.

Initially, around the world, we were using after symptoms have resolved and you had two negative tests. The nucleic acid test, the NAT that we were doing, at least 24 hours apart. We are still using that criteria for people who are hospitalized because they have more severe

disease, for people who are immune compromised because we know they can shed virus for longer periods of time, but we also have what we call a clinical criteria, recognizing, as we did at one point, where lab testing took some time.

We've also recognized, as we've learned around the world more about this virus, that some

people can actually shed the virus for periods of time, but it's not live virus. They're not going to transmit it to others. There is a couple of papers, including one out of Germany, that helped us look at that. Essentially, they were not able to find live virus after eight days from symptom onset, once people's symptoms have resolved.

This is for people who have a mild illness, which is a large proportion of the people in BC who've

tested positive. If you have a mild illness, you're at home, your fever has resolved, everything -- except sometimes people have a lingering cough that may go on for a period of time -- and you're otherwise well, you're back to your normal activities and it's ten days since your onset of symptoms, then we consider people able to be out of isolation and recovered.


That's the criteria that we're using across the province. There was a point when Vancouver Coastal was just using the algorithm for mild disease and they didn't have a physician oversee some of the reports. It turned out that not everybody, after ten days, had their symptoms

resolved. We went back and recalculated that number in the daily follow up with people. There was a bit of a reckoning that happened last week to make sure that we weren't over including people. And there were some people who have mild disease, but their symptoms progressed and lasted longer than ten days. We're still concerned that they might be able to transmit it to

others. They aren't considered recovered until their symptoms resolve completely. That's kind of the complex criteria we use.

We have had people early on, particularly with people with mild illness. We were testing them. They had to have two negative tests, and we found that people would be negative and then

positive, and then negative and then positive, and sometimes it went on for some time. We now know that it's very unlikely that they will shed virus that could infect others. That's been shown again in South Korea recently, where they've had upwards of 80 or 90 people who, after a period of time, tested positive for the virus again but, again, not having symptoms, and it does

not appear that they're infectious to others.

We're still learning a lot and it's sometimes complex. We have to try and keep on top of all of the different combinations and permutations that happen.

Reporter: I wanted to ask, again, just because I've been inundated with e -mails from people who are very concerned about this policy involving not letting staff work at more than one facility. I've been hearing some people in Kamloops, I've been hearing from people in the Tri-

Cities area, pretty much all over the province, that they're worried that people are still working in facilities that they could be carrying this virus to other places, like long-term care homes where their loved ones are.

Henry: As we've said, it's quite complex. There are some people who are not part of this. For example, we know doctors go between facilities. They may have patients in different areas. We

know that there are pharmacists who are in facilities. There's a group of people who are excluded from that. They are not, however, excluded from the need to use appropriate personal protective equipment and to minimize their visits and take all of the precautions that

we need them to take. There's a small percentage of people who need to work in both acute care, for example, and maybe one long-term care home.

It's not a blanket that everybody is at one. It may be some people not recognizing who are the people who need to go between facilities, recognizing that they need to do it with all the precautions that we have put in place.

I will also say, and maybe I'll ask Minister Dix to address it, but it's taken some time to sort out all the combinations, again, that effects so many people. It's particularly a challenge to make


sure that we have the appropriate nursing staff and care aides that are able to care for people in each facility.

Dix: This principle came out very early on, I think, after the outbreak at Lynn Valley. It certainly applied very early on at facilities, which were affected by outbreak. Subsequent to that, there has been a policy direction and then a provincial health order. At first, because Vancouver

Coastal Health was affected first, it preceded ahead of Fraser Health. You'll see, I think, very significant progress in Vancouver Coastal Health. Island Health had fewer numbers of people working at multiple care homes, as is the case with Interior Health, although they had some.

Island Health completed its work, I think, earlier, and Fraser Health, which has thousands of people in the circumstances, has been ongoing in doing that work.

It is happening. It's a provincial health order. It's a direction, and that is going to be the direction from now on. It involves thousands of people. I think the task will be completed soon. But the order is in place and that's the direction that we've headed in and that we're on and is

absolutely necessary in these times. We have to make sure the consequence of that is that care homes have adequate staff to take care of people in care.

In general, there's 29,000 people in publicly funded care, and more, obviously, who are in a strictly private system or have involved in private care home in some ways. In those 29,000 beds, there's some health authority owned and operated ones or non-profit ones or for-profit

ones. But all 29,000 of those beds are public beds. Ultimately, due to availability, people have some choice. They make those decisions. We have to ensure that standards are high across the piece, and that's what's happening now.

It's been an extraordinary effort, but I think it reflects the extraordinary impact on long-term care of COVID-19 and the necessity to make these changes. It is happening, Marcella. There

may be some people who haven't had it finalized yet, but I think it's been an extraordinary effort to date and it's our expectation that it'll be completed soon.

Reporter: If we continue to flatten the curve into May, do you foresee any modifications on restrictions of visitors to senior care homes and hospitals?

Just by way of a clarification or an update, what is the policy around visitation around someone dying of COVID-19 in hospital, and what is the policy around a first outbreak in a long-term care

home, like where we'd have one on Vancouver Island? Is it to remove the patient to a designated area, or leave them in place?

Henry: In terms of restrictions of visitors, there are exceptions right now, particularly for people in long-term care, also in hospital, who are at end-of-life in particular, and yes those exceptions we expect to continue. I absolutely hope to be able at least have one family visitor be available,

be able to go into long-term care to spend time only with their family member.


There still will be restrictions in place, in that they'll have to only go to their family member. I don't see us being able to open up care homes like we had, where there's group events and families and others come in to be with people, but I do hope we'll be able to open it up to at

least have one family member be able to come and spend time. I know how difficult it is, not only for the families who are watching, but for our seniors and elders in long-term care, particularly people with dementia and other medical conditions. The same in hospital. It has been very much a challenge for people who are dying of COVID-19, because of the infection

prevention and control risk.

I know in intensive care units in hospital they're going to extraordinary lengths to make sure family can be as close as possible, recognizing that we have to wear PPE and make sure that the staff are protected as well.

With an outbreak, it depends on the resident, it depends on what room they're in and how well they can be isolated. Sometimes they're transferred to hospital, but it's not automatic. It

depends on the family's wishes, the resident's wishes, and how well somebody is able to be cared for and isolated within the facility.

Reporter: Can you go into a little bit more detail about what we're learning about the outbreak at United Poultry? We heard from the premier earlier, talking about how workers were going there sick. Can you give us a sense of how the contact tracing is leading, what you're learning

about what was in place at the facility, or what wasn't, so that message, once again, can be driven home to people watching this?

Henry: This meat processing plant, as all of them are, are part of the essential services we need, in terms of our food chain. My understanding, from Vancouver Coastal Health, who is doing the detailed investigation. obviously I get reports from them on how it's working. They had a report

of a person in the community who had been tested for COVID-19. In the course of our contact tracing, and understanding the case investigation -- part of what we do with everybody -- the person identified that others in their workplace were ill. So an inspection was done at the

workplace. Vancouver Coastal Health went there and realized that there were people who had respiratory symptoms who were in the workplace. So arrangements were made for everybody in the workplace to be assessed, and for an inspection to be done to understand how close they

were together, what protocols they had in place for things like hand washing, what protocols they had in place for people not coming into work if they were not feeling well, whether there was oversight of those.

Obviously quite a few others of the people who were on site at that time that Vancouver Coastal went on site tested positive, and they are now all home. The factory has had to be

closed down because of the amount of illness, but also to ensure that appropriate precautions and changes to the workflow could be done to safely protect the workers in that facility. Those are things that are ongoing.


In addition, Vancouver Coastal and Fraser. a number of people who worked in the facility actually live in the Fraser Health region, and it is our convention of how we investigate these that we investigate it by a place of residence. So Fraser Health is working with Vancouver

Coastal to ensure that every individual case. we find out who their contacts are, who their family contacts are, who they may have had other close contact with. Those people are being isolated so that if, and when, they develop symptoms they will not be transmitting them to others.

It is ongoing. This has only been day three since the outbreak was detected. There's a lot of

work being done right now across the Lower Mainland to get a better handle of what's going on.

Reporter: We're just hearing about a case of someone who was apparently released from some sort of institution. I'm not exactly sure on the details, but was released from an institution and tested positive for COVID-19 and may have been on their way to a half-way house in Prince

George, but stopped for a visit at a First Nation reserve. There's concern about this.

I'm wondering if you're aware of this case, and if you have any insight as to how that could have

happened.

Henry: There are ongoing challenges, as we've talked about, around our outbreak at the Mission correctional facility. We are aware that inmates have come to the end of their time and have been released from that facility. I'm also aware that there's a number of issues, in many

regions, around indigenous people going home to their communities, and yes we are monitoring this.

I know that the First Nations Health Authority has been in touch around this specific issue, as well as involved health authorities. We know there's been a number of issues, both in Fras er Health, in Vancouver Coastal with people coming there as well as Northern Health and

Vancouver Island. It is a challenging thing, because we know we've had cases and outbreaks. I shouldn't say outbreaks because we've had transmission in communities in all regions of BC that have affected indigenous peoples and First Nations peoples. So it's part of our ongoing

challenge in managing, particularly when we get these outbreaks. The Mission facility outbreak is the second largest one that we are dealing with right now.

It's complex, it involves our federal partners at Correctional Services Canada, it involves a lot of work that Fraser Health has been doing to try and make sure that we have the right infection prevention and control measures in place to protect the inmates, and people who work at the

correctional facility and our community. Part of it is being notified when people are leaving the facility and making sure we can support them. Because as with every outbreak, with every close-contact situation, we want and will be supporting people to be able to self -isolate for that 14 days so that they're not in a position of transmitting it to anyone else.


Reporter: You've talked about the second wave of the pandemic in the past. And today, Robert Redfield, the director of the US Centre for Disease Control, is saying that he fears the second wave is going to be lethal and far more serious than this wave, because it's going to coincide

with the start of the regular influenza season.

I'm just wondering, what is Canadian public health's take on that second wave? And what

impact is that going to have on any easing of restrictions?

Henry: I have talked about it as well. And we look historically. And the construct that we have

been looking at, and which he has referred to -- Dr Redfield is referring to -- is what has happened with influenza pandemics, where we have a second wave in the respiratory season. We don't yet know, and I have talked about this as well, whether there is a seasonality to this

coronavirus.

But it is very concerning to me. And we have talked about this as well. Once we have influenza complicating things, and the other respiratory viruses that we see, it's much more challenging to detect which one is influenza, which one is RSV, which one is parainf luenza, which one is COVID-19.

And we know, with COVID-19, it can be under the surface for quite some time. So that is why it

is so important for us to do everything we can over the coming weeks. We have managed to control this one fairly well right now. But we are starting to see community outbreaks, and we need to get on those right away.

So important for us to try and get this down to zero as much as we can now. And that is why we have been emphasizing how important it is not to be around others if you're sick, because,

come the fall, when we start to see other respiratory viruses again, it gets much more complicated for us. And that is when we're planning -- we're planning as well for the fall -- when we start to see respiratory viruses. And we know that influenza puts people in hospital every

year. And we know that this is going to put people in hospital as well.

So yes, there is very much a potential for a surge come the fall. And that is one of the things

that we are working very hard to have in place -- the surveillance that we need, the testing that we need, the contact tracing in our communities that we need. But we need to do everything we can now to try and stamp it out as much as possible, so that we a least have a fighting

chance when we're going into the fall.

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