Speaker 1: Hi everyone, thanks for joining. We're gonna get started now. Just a reminder, we have approximately 30 minutes. One question, one follow-up. We have Dr. Moore here today, so I'll turn it over to him for some brief remarks. Good afternoon

Speaker 2: everyone. Bon après-midi à tous. Today there are 409 new cases of COVID-19 in Ontario. There are 197 people in hospital, 132 in intensive care units due to COVID related critical illnesses. Of the patients in our intensive care units, 19 are from out of province. This means the total number of patients from Ontario in intensive care units is 113. And I'm sorry to say that there are three additional deaths have been reported. A total of 31,383 tests were processed yesterday, with a percent of positive tests being 1.3%. Our vaccination rate continues to climb towards our target of 90%. Currently 88% of eligible Ontarians have had one dose, 84.2% have had two doses of a COVID-19 vaccine. In regards to flu shots, as we have been taking steps to protect ourselves from COVID-19, we must also prepare for the upcoming influenza season. While our primary focus has been centering on increasing vaccination rates and decreasing the spread of COVID-19, we cannot lose sight of the flu season, which also has the possibility of creating severe illness and having a significant impact on our healthcare system. Though we cannot predict how serious this flu season may be or when its peak will occur, we know that an annual flu vaccine is the best defense against the flu. To protect the most vulnerable, Ontarians' initial supply of flu vaccine was prioritized for the long-term care setting and hospital-based patients. Flu shots are now available for seniors, children between six months and four years old, individuals who are pregnant, and people with underlying health conditions such as asthma, heart disease, diabetes, and also for all healthcare workers. Free flu shots will then be made available to all Ontarians beginning in November at your doctor's or nurse practitioner's office, public health units, and participating pharmacies for anyone two years of age and older. The experts on the National Advisory Committee on Immunization recommend that COVID-19 vaccines can be given at the same time as the flu vaccine for those who are not fully vaccinated against COVID-19. This provides an important opportunity to protect for both diseases. So if you're getting your flu shot and still have yet to receive your first dose or second dose of the COVID-19 vaccine, now is definitely the time. I also want to take this moment to address the importance of the influenza and COVID-19 vaccines for those trying to become pregnant, who are pregnant, or who are breastfeeding. Getting vaccinated can protect you from infection and reduce the risk of severe disease and complications in pregnancy. I would like to take a moment to address the importance of the vaccines against influenza and COVID-19 for people who are trying to become pregnant, who are pregnant, or who are breastfeeding. Getting vaccinated can protect you from infection and reduce the risk of severe disease and complications during pregnancy. And studies suggest the antibodies that your body develops following vaccination will pass on to your baby, which will keep them safe after birth. You can safely get the influenza and COVID-19 vaccines before becoming pregnant or in any trimester of pregnancy. Please reach out to your trusted health care provider for any questions you may have. They are ready and willing to address the concerns you may have. For Halloween, Halloween weekend is upon us, and I know the young ones are excited. As a reminder, trick-or-treating should take place outdoors as much as possible. Do not overcrowd the doorsteps. Take your turns and keep interactions brief. Make physical distancing as much as possible. And when it comes to your costumes, costume mask is no substitute for a proper face covering, so be creative. Make your face covering a part of your outfit. And it bears repeating that if you're sick, even with mild symptoms, you should be not participating in Halloween festivities. Consider getting tested for COVID-19. Also, a very important reminder is to drive safely this weekend. Be extra cautious if you're driving, and keep your eye out for the trick-or-treaters. Also, a very important reminder, drive carefully at the end of the week. Drive even more carefully, and be careful of Halloween passers-by. Kids are going to be on the street. It will be dark, and too many tragic incidents have occurred on our roads, so please, please drive cautiously and carefully. I would also encourage parents to incorporate reflective stripes into their children's costumes to help ensure that they are visible. I want to again thank Ontarians for their collective efforts in reducing COVID-19 transmission by adhering to public health measures and embracing the COVID-19 vaccine. These efforts have allowed us to release a plan that continues the safe reopening of Ontario by gradually lifting remaining public health and workplace safety measures over the next several months. The plan is to slowly and incrementally lift the measures while providing us with time to monitor the impacts on our hospitals and communities. And in the absence of any concerning trends like increases in hospitalizations or impact on our intensive care units, Ontario will continue to move forward. There's no question that the months ahead will require increased vigilance for each of us as we do our part across our province as we move in the right direction. We can't take our hard-fought progress for granted. We must stay cautious, disciplined, and never underestimate this virus. Together, we want to continue taking the small steps forward and not backwards. Ensemble, continuons un petit pas vers l'avant au lieu d'aller en arrière. Thank you. Merci. I will now take questions. We'll go to the phone lines.

Speaker 1: Just a reminder, one question, one follow-up. Over to the first question, please.

Speaker 3: Your first question comes from Alison Jones with the Canadian Press.

Speaker 4: Please go ahead. Hi, Dr. Moore. As you were mentioning with the reopening plan, we see some incremental lifting of public health restrictions, going to pretty much all restrictions lifted, including mask mandates at the end of March. I'm wondering what you thought about schools. Do you see public health measures lifting in schools in lockstep with this plan, or are you going to

Speaker 2: take a different approach? I think we'll be very conservative in our school settings given that, especially the 5 to 11s, we may not have a high level of immunization at that time. We certainly hope that we'll hear from Health Canada and the National Advisory Committee regarding vaccine for that age group. We want to continue to keep our schools safe and protected, and I think we'll have a very guarded approach regarding any vulnerable populations like our elementary or high school students. So far, our schools have remained very, very safe and have to thank all families, parents, workers in those environment that have adhered to all of the best practices that we put in play. But I think we'll be extra cautious in the school setting as we follow any reduction in public health measures. Follow up? Yes, thank you. Um, I'm also

Speaker 4: wondering when the proof of vaccination requirements start to be lifted in January and the other measures are lifted in March. Are you considering at that time recommending that the government lift any of the workplace mandates like the vaccinator terminate policy in long term care or the current vaccinator test policies in the rest of health and education? That's a really

Speaker 2: good question. We would work with the minister of long term care on any change in directives. That was a directive uniquely from directly from the minister. If we're seeing any change in the vaccination policies that would coincide with reduction in risk across our communities. Clearly, you've heard directly from the premier. This will be data driven will be monitoring the situation very closely. We want to protect those that are in the most vulnerable settings as best we can in these policies that have been put in play, in particular for the long term care sector are exceptionally important and we've done a series of important public health measures there, including just recently providing third doses. And we've had a very good strategy on third doses for the patients in those settings. So we will be very, very cautious and reduction also in vulnerable settings in particular.

Speaker 1: Next question.

Speaker 3: Your next question comes from Erica Bella with Global News. Please go ahead.

Speaker 5: Hey there. Thanks so much for taking my question. So I just wanted to ask around the lifting of restrictions on outdoor capacities that was announced today. You know, some are really questioning the timing of this. Why was this decision to lift capacities on outdoor organized events made after we saw restrictions lift on indoor settings?

Speaker 2: Or settings that we've lifted restrictions if if they are going to not require the same amount of distancing, they still will need a verification process for for those settings. So we do think we've added a layer of safety as we've taken off some of the restrictions by ensuring that it's vaccinated people meeting in those venues. And I think that that's in a very important strategy that we've enabled as we lift restrictions in those settings. Remembering that outdoors is safer than indoors, but adding the extra layer of protection of not having mixing of vaccinated non vaccinated, I think is a very prudent, cautious approach. Follow up.

Speaker 5: Have there been consultations with organizers of large sort of outdoor gatherings, like for example, the Santa Claus parade in Toronto before this announcement was made? Was there any sort of consultation around that? Okay,

Speaker 2: so for parades, yeah, we've heard loud and clear from some of our municipal partners from our public health agencies regarding the parades in particular. We do think outdoor events can go forward safely. We do think that the masking for these environments is appropriate that they we can do distancing as best we can. And given that they're outdoors and our rates across Ontario are steadily decreasing, we certainly hope that at a regional level, they'll make decisions to enable the parades to go forward. Last

Speaker 1: question. Unless someone else joins the queue.

Speaker 3: Your last question comes from Jeff Gray with the Globe and Mail. Please go

Speaker 6: ahead. Oh, thanks. Hi, Dr More. I want to ask about the, um, to the target for vaccination. So the premier mentioned 90% in his comments the other day. Um, and I think there's just a bit of confusion over. We're aiming for 90. We're aiming for as high as we can get. I'm sure. But we're aiming for 90%. Um, is that does the denominator in that case include the whole population, including Children when they're when they're made eligible and health Canada approves that vaccine? Or what's that? What is the target that we're hoping to approach before we can do this? This larger reopening that we're talking about in January vaccination in the

Speaker 2: percentage of the population protected through vaccination is one component of the data elements that will be monitoring. Um, there's a whole series, including the impact on the hospital sector, in particular, the intensive care unit, because that's a limited resource. We have to protect that sector in particular. Um, uh, we looked at initially had a plan of 80% for 12 and overs for the alpha. It's 90 and over for the delta for 12 and up. But you're absolutely right. The higher the level of protection at a population level, the easier it is for us to be able to lift public health measures over time in a cautious way. So right now, I think we're at 77% of the overall population that still leaves one in four of us vulnerable to this virus. Uh, and at a population level, certainly for us to open up, we'd want that level to be much higher and we'd want, uh, to maintain public health measures as best we can until we have a higher population level of vaccination. You either get, um, immunity from natural exposure to this virus, or you get immunity through the vaccination process, and it's that combination of numbers can tell us how safely we can open up. Uh, and we're not. We're not there yet at a population level. Follow up. Thanks.

Speaker 6: Yeah, I mean, uh, I think that's been the source of some of the confusion. If if, um, you know, do you think we will get what number do you think we'll get to realistically? Uh, January at a population level, given there are some people who we've seen from polls and so on that are expected to be reluctant to vaccinate their Children.

Speaker 2: So so we are basically immunizing around 20,000 people a day. And sadly, as you've seen, we're still having infection of 2 to 300, sometimes 400 a day, building natural immunity through exposure. This remains a pandemic of those that haven't been vaccinated. The vast majority of people in our intensive care units in our hospitals or who are getting positive tests are unvaccinated. So we've we've got our last mile strategy, multi component strategy that we're not going to give up on over the next many months. Our public health units are still working diligently in all of our communities across Ontario to try to make the vaccine accessible, available and targeted. So we're not giving up that strategy. We will hear hopefully very soon from Health Canada and the National Advisory Committee regarding the 5 to 11 strategy and when we can unveil that I'm anxious to review the safety data and the effectiveness data. So combined, we will get a larger level of our population protected. But I still see us needing the public health measures through to March 28. So that's the masking and distancing to best protect our communities. And Ontarians have embraced prevention and protection. And as a result, our rates across this province are remaining stable and decreasing slowly. The impact on our hospitals are being decreased slowly and steadily. And I have to thank all Ontarians for first coming forward and getting vaccinated. Second to adhering to the best practices still on hand hygiene, distancing and masking. It's working for us. And we just need to continue to be patient to answer the questions of the remaining 12% eligible now of individuals who I hope come forward still to get vaccinated. We also I'm looking forward to a review of a product called Novavax. It's an additional vaccine, a non mRNA vaccine that may be an additional tool to our armamentarian in Canada to offer additional variety in vaccine types. It's a non mRNA non adenovirus delivery mechanism. It's your more traditional vaccine, and it's shown to have high effectiveness in initial trials that I've seen. So I hope to have another product that we can offer Ontarians to boost our immunity in the

Speaker 1: long term. Last question.

Speaker 3: Your final question comes from Robert Benzie with the Toronto Star. Please

Speaker 7: go. Hello, Dr Moore. I wanted to ask you about the immunization of School Pupils Act and whether how the discussions are going. You'd said in August that you were talking with the Ministry of Education about whether COVID vaccines would be added to, you know, mumps, measles, rubella and polio and so on to attend public school in Ontario. I just wonder where the what's the status of those discussions and next steps. So just for clarity,

Speaker 2: the I. S. P. A. The Immunization Student Pupils Act is that you must report your immune status, and it's not a mandatory vaccination process. It's a mandatory reporting of your immunization status or an educational module for those other antigens. We reviewed the including COVID-19 in the I. S. P. A. And what we found was that would be an additional burden at present to local public health agencies and parents and students. We tried to work with our boards of education, our local public health agencies to ensure that local public health agencies had the lists of students in each school and in each class that that data could be integrated into the Kovacs tool so we'd know their vaccination status. And then it would enable public health to have a rapid case and contact management capacity. It's it is somewhat labor intensive to do that work, but it provides the essential information that the I. S. P. A. Would have on DH. It has enabled us to have improved outbreak management. We're still working on getting those line lists from the boards and ensuring that data quality is good. But that is the process that we've developed that was developed in partnership with the Ministry of Education, Ministry of Health as well as the Information Privacy Commissioner as well as feedback from our boards of health and medical officers of health. So the health units do have that information, and it is being shared between the boards of education and local public health agencies. Follow up

Speaker 7: and this is the last question. So notwithstanding what the what the opposition parties have been calling for here at Queen's Park, it doesn't sound like it's going to be necessary for or mandatory for students or to have COVID vaccines in order to attend school. This is not going to be a compulsory say

Speaker 2: as polio or measles. That's correct. It's not going to be integrated into the I. S. P. A. At present, we have to look at the trends and the ongoing threat of this virus if it persists season after season and is an ongoing threat. At that point, we would review with government the integration of COVID vaccination statisticians into the I. S. P. A. At present, our goal was to improved outbreak management in the school settings and to enable local public health agencies to have the data they need at their fingertips to be able to respond to outbreaks. And that's what we're doing in partnership with the Ministry of Education. Thanks, everyone.