As Ontario's COVID-19 cases keep rising, calls grow for tighter holiday lockdown

COVID-19 is spreading more rapidly in Ontario's biggest cities than at any point in the pandemic, prompting calls to strengthen and expand the province's lockdown measures through the holidays.

The calls come as Ontario's second wave of COVID-19 hits new heights: the average trend of new confirmed cases daily is above 2,000 for the first time, the number of people hospitalized with the coronavirus has surpassed 900, and the cumulative death toll now exceeds 4,000. 

Momentum for tighter restrictions built Thursday morning as the province reported a single-day record of 2,432 new cases.

Also Thursday, the Ontario Hospital Association's board of directors urged the government to impose a four-week lockdown in all public health units where COVID-19 infections are spreading at red-zone levels or higher. It also called for the actual lockdown measures to be "rapidly re-evaluated by independent public health and epidemiological experts to determine if additional, stricter provisions are necessary."

Meanwhile, Ontario Health is telling hospitals to be ready to clear beds within 48 hours for a surge in patients. The education ministry is urging teachers and students to take home anything they may require for remote learning when schools close Friday for the winter break.

And public health officials are pleading with Ontarians not to get together with anyone outside their own household over the holidays for fear the spread of COVID-19 will accelerate.

It's all prompting questions about whether Ontario will impose measures similar to Quebec, which ordered all non-essential stores to close for two weeks after Christmas, all school classes to go online and nearly all office employees to work from home until Jan. 11.

The mayors of Toronto and Mississauga are calling for a lockdown across the Greater Toronto Area. We'll find out if that happens within the next two days. 

On Thursday afternoon, the chief medical officer of health Dr. David Williams is due to hold his twice-weekly briefing. Each Friday, provincial officials, led by Premier Doug Ford, announce any changes to the colour-coded restriction levels in local public health units.

This Friday marks four weeks since Ford announced the 28-day lockdown for Toronto and Peel Region. As the daily case counts in Toronto and Peel have only risen since then, the lockdown is almost certain to be extended through the Christmas and New Year holiday.

The real question is whether the government will strengthen the restrictions in its version of lockdown. 

Changing the lockdown measures is the subject of "active discussion" with the province, said Peel Region's medical officer of health, Dr Lawrence Loh, in a Wednesday news conference. 

"We have to go back to the behaviour we adopted in the spring," Toronto Mayor John Tory said at the city's COVID-19 briefing on Wednesday as the city reported a single-day record 850 new cases of COVID-19. 

"We don't want to look back at Christmas 2020 ashamed that we collectively didn't do the right thing in this region." 

York Region and Windsor-Essex are also in lockdown. Nearly all of the rest of southern Ontario's largest cities, with the exception of Ottawa, are in red zones. That includes Hamilton, London, Kitchener-Waterloo, Guelph, Oakville, Oshawa and Barrie. 

"We certainly have to do more than we're doing right now," said Dr. Andrew Morris, an infectious diseases physician at Toronto's Sinai Health and the University Health Network. 

"What we really need is determined, effective, clear messaging that we have a problem right now and we need to address it right now," Morris said in an interview with CBC News. "Almost everything is secondary to control of the infection for the time being."

He said it's crucial both to boost people's motivation to follow public health guidelines and to help people who feel unable to miss work if they're sick or who can't easily self-isolate if they contract COVID-19.    

Despite hundreds of additional beds funded by the provincial government, hospital capacity is hitting a crunch in the red and lockdown zones, according to hospital officials.

The fear is that the nearly 2,000 new cases a day happening right now will result in hundreds more hospital patients each week as January arrives, a time of year when Ontario's hospitals are typically at their fullest. 

"We know that our next few weeks in the hospital sector are going to be tough," said Dr. Chris Simpson, a cardiologist and vice-dean of the Queen's University Faculty of Health sciences, recently appointed executive vice president (medical) at Ontario Health. 

While Simpson believes hospitals would benefit from tighter public health restrictions, he said there will be a delay before the incoming patient numbers start to slow down. 

"Even if you were to shut everything down from Niagara to Oshawa today, we're still going to see rising hospitalizations. We're still going to see rising ICU utilization and rising deaths in Ontario for perhaps weeks until we started to see the impact," he said.

Front-line doctors are also looking to the province for action to tackle the growing pace of hospitalizations.   

The province's warning to hospitals to brace for a surge in COVID-19 patients needs to be taken seriously, said Dr. Nadia Alam, a family physician and a former president of the Ontario Medical Association.  

Asked Wednesday on CBC News Network whether a stronger, wider lockdown is necessary, Alam replied: "If that's what we need to do in Ontario, then, yes, I'm a proponent of it, even though I hate saying it. My patients need to work, my patients need to be able to afford their mortgages and their food and all of that. But if that's what we need to keep our health-care system going, then that is what we need."

Dr. Shajan Ahmed, an emergency room physician at Toronto's University Health Network, said Ontario's political leaders face "a very difficult decision" about widening and strengthening the lockdown because they also need to take into account the social and economic impacts. 

"From a health care standpoint, absolutely we would prefer lockdowns," Ahmed said in an interview with CBC News. "We would prefer measures that would help curb this surge that we're seeing right now,"