2021-12-24 BC

NB: I have a tendency to say “we” when I am talking about BC public health. I am not employed by pub health (or actually anyone at the moment). I say “we” as a British Columbian invested in the system. It is OUR health care system.

Press Briefing

Testing

Case counts continue to soar.

Yesterday the province maxxed out the testing with 21,123 tests. That’s our limit, that’s all we can do in BC. We are limited by how many machines, reagents, and lab techs we have, and we can’t buy enough machines and train enough lab techs fast enough to get us out of this mess. Why didn’t we buy more machines when we had a chance? Because it didn’t look like we’d need them. (Also, even if we had twice as many machines and lab techs, given doubling of cases every 2-3 days, it wouldn’t have mattered. Exponential growth always wins.)

DrH asserted that testing centres were always for symptomatic people, and that goes double now. YOU SHOULD NOT BE GOING TO TESTING CENTRES FOR PRE-TRAVEL OR OTHER SOCIAL TESTING. We need to save testing for those who need it: symptomatic people and people in the health care system (paramedics, doctors, nurses) who need a negative test to go to work.

Not only that, she continued, but we need to save it for the most severe: older or immunocompromised people with more severe symptoms (and HCW).

Rapid antigen tests are being used at testing centres to supplement PCR tests for those less urgent cases (younger, no comorbidities, vaxxed). RATs are also still being used in the places we’ve been using them — congregate housing, schools, outbreaks, remote communities, etc.

Self-management

I’m not sure if DrH or Minister Dix said so explicitly, but contact tracing is now overwhelmed. If you are at a lower risk, you will need to manage your case yourself.

If you have any symptoms, you must assume that you have COVID-19 and isolate:

  • If you are young and vaxxed with no risk factors and mild symptoms, assume you have COVID-19 and stay at home away from others.
  • If you are young and unvaxxed with no other risk factors, you must isolate for ten days.
  • If you have severe symptoms, call 811 or 911 and avail yourself of our healthcare system.

If you have symptoms, you need to call your close contacts. If they are vaccinated, they need to monitor themselves for symptoms for 14 days. Any of your close contacts who are unvaccinated, they need to stay away from others, monitor for symptoms, and isolate for 10 days.

Positivity

The positivity rate is high and climbing in the urban areas. (Northern Health has come down, but they were at stupid-high positivity for quite a long time.)

Green is NH, blue is IslandH, red is VCH, orange is InteriorH, purple is FH.

(Note that this is a seven-day rolling average, so it’s actually worse than it looks because the seven-day rolling average is a lagging indicator.)

With our testing maxxed out, the daily case number really becomes another way of indicating the positivity rate. 🙁

Boosters

They are still sticking to their risk-based plan. 63-64 year-olds got their invites yesterday; 61-62 year-olds will get their invites on Tuesday. Anecdote time: I know a 65 year-old who got their invite six months to the day after their second shot, and (with some hunting) got his booster at a pharmacy three days later. They said that there weren’t lines, there wasn’t chaos, everything was blessedly uneventful. Another friend, a CEV, got their invite (also six months bang-on) and they got their dose at the ICBC clinic in North Van which also does pediatric boosters. They said that it was kind of bedlam in a good kind of way, with lots of little kids running around. 🙂

Transmission

In response to a question, Dr.H said that research has shown that Omicron is much better at infecting the upper airways than Delta and I don’t think she mentioned, but it seems to be not as good at infecting the lungs, which might account for why cases seem to be milder. She said that means that it is much more capable of being spread by aerosols. With Delta, she said, you needed more virus to infect you, so you needed bigger drops. With Omicron, you need less, so ever the tiny little aerosols are much more important, which means filtration is more important.

Q&A

Q: Are you still comfortable with the Canucks game on Monday? A: We are looking at it day-by-day. We’ve instituted some more measures, like masks-at-all-times, capacity reduction… and it’s a much bigger space… but we haven’t decided.

Q: Are a lot of people still getting Delta? A: There’s a lag in WGS, but right now it’s about 50% Omicron. Dr.H didn’t clarify if it’s 50% RIGHT NOW, Christmas Eve based on projections or by S-gene target failure, or if the 50% was on the days that the WGS samples were taken (so several days ago). I’m betting it was 50% several days ago.

Q: There’s a rule that you can have one household plus ten people, does that mean you could have ten people over from ten different households? A: Yeah, you could, but that might not be the smartest thing to do.

Q: What advice do you have for people whose employers require a negative test before they can come back to work? A: <fails to answer question> Right now if you can work from home, do so.

Q: With testing being swamped, are we going to see again that people testing negative will be contacted later than positive-testing? A: All the contacting is automated now — usually you get a text. So that should still be fast.

Q: Why don’t we use med students or other trained people to give boosters and increase our capacity that way? A: We do! If you look at the Order I gave on this, we have <very long list of professions> give immunizations.

Q: Come up, pleeeeeeeease can’t you let gyms open? A: No. Gyms have worked very hard to to the right thing but Omicron is a nasty little bugger and it’s just too dangerous.

Q: Why is the gym closed when the sauna and pool are open? A: Different situations, sorry. (They didn’t explain, but I bet it’s that in a gym you’re emitting a lot of aerosols. In a pool, your mouth is not very far from the surface of the water, so probably your germs don’t go very far before they get captured by the water. When standing, your germs are a long way from the ground.

Q: Why can’t you let people go to the gym when you let people go shopping in close quarters? A: We’ve already made Orders about COVID Safety Plans for retail during sales, you have to wear masks when shopping, and the kind of “transactional” encounters you have in store, where you might pass someone briefly are much less dangerous than situations where you stay in one spot for a long time .

Q: How come restaurant patrons have to be vaccinated but restaurant employees don’t? A: laskfjaklsfj (I didn’t understand DrH’s reply completely, but I think it was a question of jurisdiction: I think she was saying that Pub Health has jurisdiction over consumers and WorkSafeBC has jurisdiction over employees. I will also note that employees have to stay masked at all times, while patrons have to be unmasked to eat.)

Q: Why are we in this chaotic testing situation when we had weeks to prepare? A: Twenty thousand tests per day is our limit. We only have so many machines and so many lab techs, we can’t magically create more. (And even if we had been able to buy 2x machines and hire more techs in those few weeks, it still wouldn’t be enough. Exponential growth will always win over linear growth. Furthermore, I expect there to be global shortages of testing reagents soon.)

Q: Someone told me they were standing in line for three hours and then were told they were not going to get a PCR because they were under 60, that only people over 60 were going to get PCRs, wtf?

Statistics

 +2,441 cases, +4 deaths, +4,936 first doses, +1,672 second doses, +21,551 other doses.

Currently 192 in hospital / 71 in ICU, 10,415 active cases, 222,604 recovered, 1,613 Omicron cases to date.

first dosessecond dosesthird doses
of adults92.2%89.5%19%
of over-12s91.8%89.0%17%
of over-5s87.8%82.8%*
of all BCers85.5%80.6%15.8%

Charts

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