B.C.’s fall COVID-19 pandemic plan includes increased testing, almost 2M influenza vaccines

British Columbia’s pandemic preparedness plan for fall includes regional surge capacity in hospitals, increased testing capacity and a campaign to administer almost two million influenza vaccines, among other measures.

B.C. Premier John Horgan, along with health minister Adrian Dix and Dr. Bonnie Henry, the provincial health officer, presented the plan on Wednesday.

Health officials  say they have prepared the province for COVID-19 scenarios ranging from low to exceptional outbreaks and they are confident the health system can meet the challenges.

The officials say some of the preparations include being able to conduct up to 20,000 daily COVID-19 tests, hiring more than 600 additional contact tracers and purchasing more than 1.9 million doses of flu vaccine.

The officials say the plan will also focus on protecting older people, who are particularly vulnerable to COVID-19, with staff increases at long-term care homes and administering 45,000 high-dose flu shots for seniors.

Health officials say the plan represents responses to what the province has learned about preventing the spread of COVID-19 since March.

The plan is supported by access to an additional $1.6 billion in funding for 2020/21 – approximately $850 million has already been announced in different forms, including funding for increased contact tracing staff, the enhanced rural remote transportation framework, single-site staffing initiative, the surgical restart strategy, and increased spending for personal protective equipment.

Horgan says the funding will also result in hiring an additional 7,000 people to work in the health-care system.

“Our pandemic plan has been working,” he told a news conference. “We need to accelerate. We need to up our game.”

Provincial health officer Dr. Bonnie Henry said B.C. has purchased its highest-ever number of flu vaccines to fight influenza.

“Our fall influenza plan is going to be on a scale we have not yet seen,” she said. “We know how important it is to protect all from influenza.”

Henry said influenza in the Northern Hemisphere usually starts in October and November and peaks in December and January.

Health care access and hospital capacity

The government says its priority is to maintain normal routine access to health care as much as possible while also responding effectively to managing COVID-19.

According to the government, the B.C. health system has the adequate physical capacity to meet COVID-19 hospitalizations demand, while also knowing the province can successfully implement more extreme measures linked to delayed surgeries or admissions if required.

One of the actions for hospitalizations the fall is to have additional surge capacity across key hospitals, so it will be less likely changes to surgical planning and medical admissions would need to be considered. The surge capacity will require a continued focus on hiring, training, and effective deployment of staff.

In addition, there will be a staged approach to regionally managing surges in demand compared to the system-wide reduction in hospital bed occupancy used in March 2020.

This staged approach will start by using assigned COVID-19 bed capacity in nineteen COVID-19 sites with the remaining sites be used for what is expected to be a small number of local cases. The government said this is supported by the work underway to ensure patient transportation and support services in rural areas of the province.

The 19 COVID-19 sites (Province of BC)

And there will be a new hospital at home initiative, with $42 million going to staffing and support costs to care for select patients at home.

The initiative will start at the Victoria General Hospital before rolling out to other B.C. communities.

Testing and public health

Infection prevention and control measures across commercial, work and social settings will minimize pressure on the health system over the fall/winter, the government said.

The provincial government said it is building out testing capacity for the fall/winter to approximately 20,000 tests per day for when there is a higher prevalence of flu and colds in the community with the need to quickly and accurately assess COVID-19 cases. Right now, B.C. is up to an average of up to 6,000 to tests per day.

“We do expect the demand and the need for testing to go up as well, particularly as we go into influenza season,” Henry said, adding the same machines do the testing for COVID-19 and influenza.

There will also be increased contact tracing and case management capacity to effectively suppress transmission through the addition of more than 500 new staff.

And there will be an enhanced fall flu immunization campaign through the purchase of 1,965,000 doses of vaccine, the province said.

The province also said the influenza season should be impacted positively by physical distancing and control measures in place for COVID-19 and immunization.

Henry said health officials have been monitoring influenza seasons in the southern hemisphere and have been seeing more mild flu seasons compared to previous years.

“We want everyone in the population to consider getting the influenza vaccine,” Henry said about B.C.

The influenza vaccines will be available at certain public health clinics, pharmacies and doctor offices.

Henry said very few people are not eligible for a free flu vaccine.

“This year more than ever, we have the availability of vaccine to provide it to them,” Henry said.

“We know that some workplaces provide it. We know that adults who visit long-term care homes, who have elderly people in their home, who have at-risk people in their home, who visit any healthcare facilities are eligible for the vaccine.”

The influence of influenza season on hospital admissions (Province of BC)

The impact of respiratory admissions on bed census (Province of BC)

PPE

The government says there will continue to be efforts to source and strengthen the reliable supply chain for personal protective equipment (PPE) and “build out on-hand capacity” for mid-fall/winter

From March to early September the following PPE has arrived in B.C.:

• Over 6,300,000 N95 or equivalent respirators
• Almost 50,500,000 surgical or procedure masks
• Over 2,600,000 pieces of eye protection, including goggles and face shields
• Over 90,000,000 pairs of gloves
• Almost 8,000,000 gowns

Seniors

The province said there will continue to be infection prevention and control practices across all assisted living (AL) and long terms care facilities (LTC) with funding to hire up to an additional 2000 staff.

The government is also making Fluzone-High Dose immunizations available to all LTC and AL residents as part of the fall immunization strategy with the provision of 45,000 doses of vaccine available.

And there will a recruitment and training strategy for additional health care aides, cleaning and food service staff across the long-term care sector – up to 5000 new staff to add additional capacity.

Patients at higher risk

The province said it will be developing patient care guidelines and practices for COVID-19 patients including rapid referral pathways to higher levels of care (including specialized community services programs) as required.

It will also be developing patient care clinical guidelines and increasing use of virtual care focused on health and safety of older patients and/or individuals more likely to experience a serious form of the illness due to underlying chronic medical (cardiac, diabetes, renal, respiratory, cancer, compromised immune system).
There will be lanning to position the Urgent and Primary Care Clinics and other designated primary care clinics as “acute respiratory illness centres” for the coming fall/winter flu/COVID-19 season as required.

The province will also be providing infection prevention and control practices services to vulnerable populations being housed in provincial shelters and congregate housing during the COVID-19 pandemic.

Watch Premier John Horgan, Minister Adrian Dix and Dr. Bonnie Henry on Sept. 9 below

With files from The Canadian Press

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