want to mess with you guys I don't know you guys already figured it out sorry good morning everyone I want to acknowledge of course we're on the traditional territory of la Kong and speaking people the song he's in the squaw walk First Nations and today we're here to announce the beginning of our opening up of elective surgeries the the phase two of the BC restart plan Koba 19 has changed so much of what we do and how we interact with each other we've worked hard together to flatten the curve and we've made great progress dr.
Henry and Minister Dix have been advising us on that on a regular basis but we can't lose sight of the importance of ensuring that if we're sick we stay home we want to make sure that that the the compromises that we've made to our interactions with other people are not lost those huge sacrifices of course have included as of May 18th 30, 000 elective surgeries that have been cancelled that's 30, 000 people who have been having to endure pain and other suffering as we've worked together to address kovat 19 but because of those sacrifices we've been able to move forward yesterday's plan was a slow and safe restart and it will include guidance from dr.
Henry and other public health officials as we bring in the important changes to how the province will operate within the economy and within our health care system so as we resume elective surgeries we're going to have to ensure that we have safety protocols in place for patients safety protocols in place for surgical teams and of course as we start to discuss how we will bring these elective surgeries back online it is an option for patients to wait until they're more comfortable to answer the healthcare system but every precaution that can be taken has been taken right from the beginning of this pandemic we've been focusing on ensuring that the public interest is fronts of sent in front of mind and that the health of British Columbians is our preoccupation as we enter this new normal we're going to continue to be why our hands keeping a safe distance and of course staying at home if we're sick now is not the time to let down our guard now is not the time to forget the sacrifices that people have made and instead we should remind ourselves that thirty thousand British Columbians have been suffering not just by not seeing their friends not just by not going out to enjoy this splendor of British Columbia but they've been living in pain today we'll start the process of relieving that pain for people who have been suffering because of the the lack of elective surgeries I'll turn the microphone now over to Minister Dix and he'll lay out how the plan will unfold from this point forward thank you very much premier and doctor Henry and I will take you through the presentation it's a shorter presentation than that we providing the technical briefing but all those presentations including our surgical plan will be available online I'd also like to thank Michael March Bank who who authored this plan along with many other people in the healthcare system mr.
mank Marsh Bank is the former president of the Fraser Health Authority from 2014 through 2018 is an outstanding healthcare leader in our province very appreciative of the role that he plays on March 16th 2020 we took a very difficult decision to postpone non-urgent scheduled surgeries and you see this and you see the effect of it the premier spoke of the effectiveness well our commitment to you is this there has been a enormous commitment by healthcare workers in my health care system and the premier by the government to address the health care effects of Cova tonight dr.
Henry showed this and the presentation on Monday about the relative success we've had especially compared to other people and dealing with people who had acquired the care of critical care and had Cova tonight are you it has been an extraordinary effort it has been a 100% effort and our commitment to you is it was the same kind of effort from the healthcare system a hundred percent to address the backlog in surgeries applause bike 90 in the coming months in years all patients needing surgery are at the center of the surgical renewal we all do this the safest way possible for patients and providers will be 100% all in this everyone effort and everyone thanks evolve and the health care system is committed to this this idea the next slide a little bit about the pandemic effect impact on surgery above bomber's our estimated number of lost cases you'll see on the slide is 30, 000 14, 000 of those have their surgeries postponed because we shed all the mid three week increments 16, 000 for the normally scheduled miss period on the weightless so that number as you can see on the right here is 30, 000 298 we've also British Columbia we recognized that we needed to take extraordinary measures to ensure that we could provide safe care both for people who had covered 19 in our healthcare system but also for those who needed health care in other sectors and part of that was the actions that we needed to take to ensure that our surgical teams and people who needed surgery during this unusual time where we're cared for as well so there were new clinical protocols that were developed to manage patients during surgery part of those were making sure that people didn't have any symptoms that they hadn't been in contact but we also recognized that when we had Kovan 19 circulating in our community there would people that would be people that may be carrying it so we needed to treat every surgical patient as if they might have kovat 19:00 and that led to protections such as decreasing the number of people in a room when we're doing procedures like intubation putting the the breathing tube down into someone's throat because we know those are situations that increase the risk of a transfer of the virus these protocols were needed when we were having our increase in community spread here in BC and they were based on evidence and discussed with the clinical expert reference group that we put together here in the province they were informed by Public Health and by the epidemiology of what we were seeing in our community we need to to take a different approach to this so we know and we are working very hard in public health to identify every single person who has coded 19 in our province and that helps us understand where the transmission is occurring and that means that we can safely resume surgeries and we no longer have to assume that everybody has this we can now safely assume that most patients do not have kovat 19 and that allows us to change the protocols and to make them no less safe but certainly a little more streamlined so to be able to enhance and increase our surgeries for those who need it here in BC we have we've now put in place very extensive screening protocols for everybody who comes in for surgery so when you get your call about your upcoming surgical date we you need to continue to self isolate make sure you're not putting yourself at risk by being out in the community by having contact with people that you have not had contact for in the next little while it's going to be incredibly important that we all continue to take those measures but particularly if you have surgery scheduled and then we will be having a detailed screening protocol for everybody at that 24 to 72 hours when you get a pre anaesthetic consult there'll be a screening protocol to make sure that you have not been in contact with anybody that you don't have any symptoms and we have a protocol in place that allows for rapid testing should anybody have symptoms and it be required and then that process will be repeated on your day of surgery so that everybody is confident that we don't have people who are at risk or have risk factors for kovat 19 obviously if there's urgent surgery that's needed those protocols will be sped up and put in place as well so these clinical protocols and the infection prevention and control measures are what we need now to make sure that we can ramp up our surgeries and get people in for the the procedures that they need and keep everybody safe and it depends of course on the work that we continue to do in public health to make sure that we are testing everybody in our community that has symptoms of kovat 19 and that we're rapidly able to do the contact tracing and isolation that's needed to prevent outbreaks and more spread in our communities so the first step of this surgical plan will be to establish system readiness which is the next slide patients will be called are being called and will be called over the next 10 days to confirm they are willing and ready for surgery we know some patients may be concerned with that and we're going to engage with them and their primary care physicians on that question to protect health care workers of course as dr.
Henry has talked about new clinical protocols of managing patients through surgery are being implemented the needed PPE supplies and drugs required for surgeries have been confirmed this is a key part of our readiness and I've been reporting regularly especially on the issue of PPE the beds required to Kharis for surgical patients as well as kovat 19 patients have been confirmed that's part of the planning and that screening programs and pre and post-operative care services are being operationalized this is very important because in addition to surgeries lost the fact that we've done considerably less screening for example fit tests for colorectal cancer for example mammographies and so on we've done less of those in these times and we're going to have to catch up there as well and in some cases we will be discovering things that we would have discovered earlier our surgery our surgery renewal plan beginning this month is going to be a massive renewal it is a hugely ambitious plan that will keep up with new demands for new surgeries and clear the backlog created by Kovan 19 over the next 17 to 24 months the plan has five key steps increasing surgeries increasing essential personnel focusing on patients adding more resources and reporting monthly and in detail on progress next slide the surgeries and essential personnel want to speak to that briefly to increase surgery capacities we will refine and update processes to minimize the 30% productivity loss I spoke of earlier extend daily operating hours including weekends open new or unused operating rooms in the healthcare system and contract with private surgical clinics that agree to follow the Canada Health Act we will train and recruit the healthcare professionals we need to deliver and sustain renewal in the months and years to come that includes in the area of anesthesia and surgeons and other support staff and nurses we'll also and on the next slide talk about patients resources and reporting will continue the local collaboration on prioritization of patients in other words that requires the clinical advice of experts in the system of doctors in the system in particular we'll focus on patients who are urgent had surgeries postponed or are waiting for have been waiting more than twice their clinical benchmarks we will maximize day surgeries such as cataracts which are frequently done outside of the hospital like many programs and services impacted by kovat 19 the delivery of this plan also requires added financial support we believe it will be in the order of 250 million in the first year and we are committing to making the required investment to support renewal the Health Ministry and health authorities are committed to transparently updating British Columbians on the progress of this plan by Health Authority and and by month with regular reports on strategies as they are being implemented so we just want to lay out what the targeted timelines are mark may 7th to 15th contacting all patients who had surgeries postponed may 18th starting non urgent surgeries up again may 31st contracting private facilities to work at maximum capacity in June training recruiting and hiring more staff June 15th running all existing operating rooms at full capacity so that is what we're looking for a month where we will continue to lose ground but start to do scheduled surgeries and then hoping to get to full capacity by June 15 and then from June to October all surgical load locations begin adding capacity by extending operating hours adding weekends and adding new operating rooms as noted and as dr.
Henry has suggested all of this is dependent on on avoiding resurgence of kovat 19 and our plans include plans to address that should it arise so with that I'd like to invite the premier back to the podium to take questions Thanks Adrienne thanks Bonnie and I think Jen you're the writer to reporters on the line please press star one to queue and unmute your phones you won't be audible till we call your name our first question comes from Tonya Fletcher hi there I know in the technical briefing you broke down kind of the target goals for nurse recruitments I'm wondering if you can talk about how many surgeons and anesthesiologists you'll be trying to track down what the goal numbers are there and and how you and where you find plan to find them well the plan with respect to nurse recruitment is approximately 400 nurses it's our hope to hire all the graduating nurses this year and to significantly increase training so that nurses are existing in the system can upgrade skills if that's required and also to hire all of the staff required which will include not only nurses and anesthesiologist and increasing our capacity there but as you know surgeons but also medical office assistants that are required cleaning staff that are required people who are involved in and very importantly in in device reprocessing so it will require a significant investment across the system as we spoke of in the technical briefing that's approximately 400 nurses next question our next question comes from Rishi Basu hi everyone thanks for doing this I just want to go back to patients being called starting today will this call be just to make sure they still want to go forward with the surgery or are they also going to be rebooked and at a specific date what can people expect today well the first call is to touch base for them to let them know that we're starting again to see how they're doing and to engage with them on both there to go forward with surgery and then as we go forward we're gonna start booking surgeries but the we need to talk to the people who have seen their surgeries delayed to begin with and that's what we're gonna start to do today that's a necessary step in restarting the system see about their their both their willingness to go forward and to talk to them about that there will be some people who are naturally reluctant I think you'll have note for our daily briefings that we've gone right now we're at about 4600 emergency room visits a day from the previous average of about 6, 500 so people are reluctant at times to come to hospitals so we have to we have to prepare for that and we have to talk to patients about that our next question is from Mary Griffin oh hi thanks very much um a good question came up in the briefing and I just thought I'd asked again with with so many surgeries on the wait list what why not go with the 24-hour operation of the operating rooms to clear the backlog and also what also came up is it was quoted that it was easy to shut down the electric surgeries but can you give us a sense of just how much of a gargantuan task this is true bring them back up well like everywhere else I think kovat 19 is affecting hospitals like every workplace in BC and so we're having to take steps to deal with what we call productivity losses but the extra time we have to to take to make sure that staff are safe and to make sure that patients are safe so it does take extraordinary effort to relaunch the system the shutting it down Ament for those who had non what's called non urgent scheduled surgeries which is what we delayed it was in some respects easy to shut that down it's easy to say no in a system much harder to get going again because we have cases continuing into the system we have to assess patients for the urgency of the surgery it's an enormous challenge and because we have people on a wait list already and this simply adds to that and presents a real for the system but I think we're up to addressing it we're gonna throw everything we have at this issue because I think the people who have made a real sacrifice and seeing their surgeries delayed those people deserve that with respect to 24/7 you will know that in the case of MRIs for example we've done that around BC over the last couple of years moving I think from two machines going 24/7 to two nine machines going 24/7 to 19 going at least nineteen seven surgeries are a little different we need human beings they need they do need to sleep and so what we've what we're doing and and to prepare and we do have two staff surgeries in a significant way so what we're doing is extending the plan is to extend the hours every day for surgeries and then to look at weekend surgeries so we can increase our capacity this is how we can increase the number of surgeries we can do reduce the the Cova 19 related increase and then we hope continue on to reduce wait times once we get through this coming 17 to 24 months my next question is from Justine hunter I thank you how much of the success of this plan hinges on surgeons and anesthetist and nurses who are willing to expand their hours and give up their summer holidays work weekend and what's the back-up plan if you don't get that buy-in on my way to the legislature today where we are now I ran into a surgeon who is biking and who told me about their commitment to get going how determined they are these are their patients and I think it's and I speak of surgeons I think of nurses I think of people who keep operating rooms clean who perform such an important function they profoundly care about the success of the system they are determined to deal with this backlog and so I think we're going to have enormous buy-in from everyone in the system this is what they do this is their life's work and this is the biggest challenge in terms of surgery that we've faced in our health care system and so we need to be all in on it and I know that our staff who have been extraordinary and it has been a challenging time both for the mental health of people in acute care and across the healthcare system of people who have been on the front lines of kovat 19 but I also know their extraordinary motivation I think together we can we can make enormous progress and that's what we're going to do and we're going to report as they say monthly on how we're doing next we have Vaughn Palmer a question for the premier of what what's been described to us here sounds like a major transformation in the healthcare system from operating hours to staffing to training to changes for productivity and everything there is a funding increase as well but I guess the question I would have is can you see that this transformation which is done to clear the backlog could become a permanent thing in the health care system in British Columbia good question Vaughn we have since 2017 been focusing on trying to increase productivity within the system Adrienne spoke about diagnostic services that were multiplied in our time leading up to the advent of kovat 19 that was a transformative change in determining how many surgeries were required we were creating more opportunities for those surgeries and I remember quite vividly when dr.
Henry and Minister Dix and I started talking about the pandemic plan and the consequences to elective surgeries and the impact that would have on individuals and we resolved then some months ago that we needed to have a plan to make sure that we could try and get to the place we'd worked so hard to get to in January February of 2020 Adrienne just touched upon of on the commitments of healthcare practitioners whether they be care aides whether they be janitorial staff whether they be nurses whether they be admissions clerks all of the people involved in our health care system are committed to the well-being of the people that they serve and and we're going to be redoubling our efforts very ambitious and I think that ambitious can be infectious as well in a positive way when we see success in our personal lives we try to duplicate that day after day and I think the system will want to do that as well we're asking a great deal from people but I believe they're prepared to give it and and we will be doing what we can on the resourcing side Adrienne and Minister the Minister of Finance are in a regular contact about what this will mean over time but we're focused right now on getting back to a place where people can have confidence in our health care system which is in many in many ways the envy of the world certainly in North America it is and we're proud of that I'm fiercely proud of the work that the ministry has done to get us into this place and I'm absolutely confident that we're going to be successful our next question is from Moira wings hi premier thank you my question is a follow-up one on bonds question but you know would we potentially see a scale down after the pandemic related backlog is cleared I know that's a couple of years away but earlier in the Tremezzo briefing it was mentioned that this is kind of an expedition of a five-year surgery plan that was in the works so is that five-year is that a timeline that we would see the sustained or what is that timeline well as the technical briefing suggested this is not something that will be resolved over the course of the summer it will take time and we're committed to it we wouldn't have brought it forward if we didn't believe the system was able to handle the increases and the diversity of solutions we are outside the box in many ways provided we're working within the Canada Health Act we believe that there is capacity and if we challenge that capacity to expand and we work on increasing the number of graduates we have in healthcare professions if we increase the resources available and and that is our commitment we'll be able to achieve these goals our next question comes from Keith Baldry I thanks to this this is a more about reopening than surgeries just getting inundated with calls and emails from albertans wondering in light of the request to stay home and not travel our albertans welcome in British Columbia this summer mr.
Pierre well certainly Albertans are Canadians we have mobility rights as Canadians these are fundamental principles but I know from talking to premier Kenney I know from talking to other primers across the country the objective is the same wherever you may live if you don't need to travel you should not you should stay in your own community we are just now reopening after what has been a difficult and challenging time for British Columbians many people in rural and remote communities are concerned that the the full effect of cope with 19 has not reached their communities and they're fearful that it may arrive that's why we worked minister Dix and I and others to put in place a rural remote and indigenous community strategy so that we have the capacity to bring people to acute care services should they need them and so my recommendation to Albertans is the same as my recommendation to British Columbians stay home enjoy where you live do the best you can to work together as we have been doing to flatten the curve and ensure that as the summer progresses we can have more interaction with our neighbors whether they be albertans or our people from the Maritimes or any other part of Canada but for now it would be better if you stay at home next we have Laura Brom hi I'm just wondering if you mentioned that some surgeries will continue even if the patient has conveyed 19 but in some cases it would be canceled so if it does get cancelled like the person wakes up they have a cough cold whatever would they get pushed to the back of the line or how would it be determined where they end up where and when they can end up getting their surgery yeah I think this is a common occurrence all the time even before covered 19 that people have to be well for their surgeries and so this is an important thing and we you know that's why it's it's important when you have your surgery scheduled to make sure that you're you're staying very close to home that you're not out mixing and mingling if you can help it because we want to make sure everybody is well enough to have their surgeries as scheduled but we do have a provincial process for this so people will be fed back into the queue according to their to their need and and people will be rescheduled so it won't be you'll be back at the bottom of the list it'll be rescheduled as appropriate as part of the whole system so it is incredibly important though that people are careful right now and we don't want to have any more delays so that's a really important piece to bring up and people be careful before you have your scheduled surgeries make sure that we have the screening processes in place so that everybody bit can be confident and cared for safely next we have a question from Rob Shaw premier and mr.
Dixon is hoping you could reflect on I'm sure there are some people on that list of 30, 000 cancel surgeries who are in pain and they're wondering if the decision to make the cancellations the way they were made was really worth it given that British Columbians did step up they flatten the curve and we had a record number of empty beds in hospitals the last couple of months says because the surge didn't emerge like the worst-case scenario suggested it could so I know you both said it was a difficult decision to cancel these surgeries but can you address people who are wondering if it was the right call to do it in the way that you did given the space that we've had the last couple of months it was absolutely the right call you'll recall back in March there's a very different discussion about kovat 19 we saw images every day on television about what had gone on in Italy we were working in the healthcare system and what this has allowed us to do in the health care system is respond at the care level at a I think an extraordinary level of skill and care for people who are dealing with kovat 19:00 and so it was the right decision at the time to ensure that our healthcare system was prepared that the extraordinary anxiety that that system was facing seeing what was happening in places such as Italy and then New York in our health care system was was we were able to undertake that effort with the calm that dr.
Henry Oh was asked for and so I think it was absolutely the right decision that we have to continue to be prudent and I think it's a good opportunity to remind everybody of the sacrifices that have been made particularly by those who have were scheduled for surgeries and have had their surgeries delayed those sacrifices have been profound and why we continue to have to be a hundred percent all in even as circumstances change because our ability to succeed on the surgery plant and so much else of what we're trying to do depends on people's commitment to one another to the ones that they love and to the ones that they don't know this has been our successes of province it was not inevitable it was the result of extraordinary work by public health officials I think in communities I think we'd all say all the people who worked on contact tracing all the people who helped break the links of transmission all of the people that made sacrifices in our community was it worth it you bet it was you bet it was the communities that every ticket rolls juice for do colors says me Vava Newsarama this is young difficile Daniel 8 the number of surgery user vehicle Mohammedanism a oubliette the person effective as a decision who's that o south to supplant or renewed map bruno Velma the last year jury nila Ferran de la manera blueproof la pluie Co possible inference to travaille avec la meme determination to sell canoes a la fête on combat on Covidien earth truly mount the not system de santé a too lazy to I ended up provenance some attache as aplomb yeah I just going back to Rob's question absolutely the right thing to do but we need to put into a context that today is the day after we announced our slow and focus to restart plant the first order of business is to say to those who made a significant sacrifice by having their surgeries cancelled that they're at the top of the priority list for us going forward this was a very difficult decision to make the right decision to make but as we made that we were mindful that these were not just numbers on spreadsheets these were human beings people in many cases been waiting a long long time and we are gonna focus and and the resolve is fairly clear from the technical briefing the commitment that we anticipate from healthcare providers the resources that the Treasury will be providing so that healthcare the fundamental the fundamental principles of health care that tenets of Canadian citizenship that is so important to us is the first order of business absolutely the right decision and this is absolutely the right response our next question comes from Lisa cord ask oh thank you very much you've been very specific in saying that you need 400 surgical nurses and where you will get them but in terms of surgeons and anesthetist how many do you need and where will you get them we're confident to do that I think it's fair to say that over the past decades sometimes the relationships between health authorities and anesthetist and the anesthesiologist sar have been challenging but we've we're making progress with that and we need to recruit there as well and so everybody's committed to this we obviously need to increase our capacity in every area one of the key areas though and has been over the last period is is surgical nurses that's been a challenge over a period of time so that's why we give focus to that today well we're going to require more a medical office assistant more skilled healthcare workers and and obviously surgeons and initiatives I think that I think what's been sometimes a restriction in our health care system is the the amount of operating room time people have not necessarily the number of surgeons so this expansion of operating room time is going to help us as well so it's a combination of that operating room time of the work of the system to prepare people for surgery so that the outcomes are good is gonna require significant investment in post-operative care because that's critical to the success of any surgery so what you're talking about is is major investment in people to make this go forward but it's in all of the areas including including of course nursing next we have a question from Cindy Hartnett well thanks very much um I wanted to clarify what is the percentage of beds that will be left in Cova designated hospitals in case there is a surge is there percentage and can you tell me what the balancing act is between the temptation to do a lot of day surgeries and hips and knees surgeries that can be done quickly and weighing that against complex surgeries that may include multiple days in hospital and extensive follow-up that would you know impose on Kovac beds if you needed them well the key question is the urgency of need and you've seen that during this period we have we have successfully completed across health authorities 17, 000 surgeries urgent surgeries and emergent or emergency surgeries in this time and the priority there are people who required surgeries for things with with lesser with shorter required wait periods to 4 in 6 weeks so the people who needed the care urgently got the care Urgent Li and 17, 000 in the context of what's happened with kovat 19 is important so what you're going to continue to see is the clinicians is the people who are responsible for doing the surgeries setting priorities and that means in part doing surgeries that were able to do for example in the private clinics where we did a between twelve and thirteen thousand surgeries and 2018-19 and increasing that capacity and all of that surgery is day surgery in that case because in none of those places are people able to stay overnight so those are that's all day surgery on the one hand but it's prior izing patients one of the great successes we've had and it represented an effort by members of the legislature extraordinary effort by a skilled surgeon named doctor honey in Vancouver was a surgery called deep brain simulation which takes hours and hours and hours and hours and that's been a priority as well and so we all know that a seven or eight hour surgery counts as one just as a surgery that only takes an hour but we've got to balance off those things and that's our intention – there's no in our processes there's no gaming of the stats we need to do all kinds of surgeries de surgeries of course but also the more serious surgeries who talk about and they're already being given urgency in the system just to speak a little bit about some of the the thinking that we have around what do we do if there's a resurgence and what proportion of beds would be Cova beds etc so we obviously have considered that including looking at critical care so there's some surgeries that people are more likely or will need to be in ICU afterwards so that has an impact on our ability to provide critical care both to people with kovat and people with other things so we are very much looking at that balance and ensuring that in different parts of the province it may mean transporting somebody for surgery to a different area and then as we go into the fall in particular assuming we don't see any resurgence of kovat 19 in the summer and that's what we'll be focusing on of course but in the fall when we start seeing influenza season again and there's a potential for what we're calling a second wave or resurgence of Kovan 19 then we'll be looking again as you know we talked about having 19 kovat hospitals that we had available and ready to go through this period of time we'll be looking more strategically come to fall because we do know more about this virus and we will be ensuring that we have our surveillance and our Public Health detection out there so that we can respond a little bit more nimbly and also with more precision come the fall so it may be that some hospitals will really not all 19 hospitals will need to be available right away for for Cova 19 surge and we'll be able to titrate that in a better way so those are the things obviously it's very complex and those are the types of things that we're thinking through as we move forward we have time for two more questions the first is from Nomi makanda oh good morning um I'm just gonna go through the videos my question has been a Spectre wanted to know what's gonna happen to people from out of province who had been scheduled or specialized surgeries in BC and had them thought we they be allowed to travel here to undergo the surgery premium seventy pound these individuals it is circumstance may of a quark announced a new program not for program this year should be massive ad pal was premium a during an DVD for example a book would mount Kia biblical territoire uncle amoeba technique Oh Canada clear swab your service service to scourge surely surgery on Columbia Brittany apostasia la of a continuum ECMO program illegally limit as you know Ellen neccessity the voyage a don't sever Edwin question on the system limits a ABN entendu lettuce you don't said that upon this to say so Constance my soo Kwang soo don't on Saddam pal say the the Rahman swap program the Geo Sharia elective a a southern you to mount Kyra suave says she really madness SEPA are generally person diesel province 602 debianchi a bit oh you can a all territoire and do you want to repeat that in English I think all right our last question comes from Richard Sussman Jennifer the premier one of the things the education system is seeing both k12 and post-secondary is going to be a huge drop-off in international students and they're already concerns being raised that this drop-off will mean teachers need to be laid off and could potentially other changes because of the decrease in revenues how much this concern you for both levels of schooling and also are you considering and related note salary top offs for essential workers as we've seen from the federal government well firstly with respect to the top-up this is a cost shared program all the provinces have agreed to join with the federal government Minister James is working with the federal government to put in place the plan for British Columbia many of the workers frontline workers in residential care for example where some of the focus of the federal government has been are already well above what the threshold number would be so British Columbia will be developing a plan in concert with the federal government that meets the needs of a broader group of employees but we're grateful to have the federal resources and we're going to be doing our part to address the need in that area when it comes to international students this is at the at the post-secondary level as we see people retooling for the new economy what the world will be like for them going forward we need to ensure that we have a maximum number of spaces in our post-secondary institutions whether it be for skills training whether it be for training to become care aides to go into some other medical field or any number of other areas so we're fairly confident that our post-secondary sector has the capacity to to take in those new students who because of other work that we've done on Adult Basic Education for example and english-language learning will be able to meet the needs of the community right here in British Columbia we also understand the value of foreign students international students coming to our post-secondary institutions that will be working with the university presidents on how how we deploy spaces for that cohort when it comes to the K to 12 system every district is a different approach to international students and the will Minister Fleming and I will have more to say about the K to 12 system in the weeks ahead as we look to the wrap up of this year and prepare for the beginning of the 2021 school year and international students may well have a key role to play in that and that will be determined district by district but I certainly were not contemplating layoffs quite the contrary education is the key to success for individuals and for communities it's the great equalizer in our society we have been committed from the beginning to expand access to education for all British Columbians and we'll continue to do that that's all the time we have today thank you great thanks.