Ontario is reporting a record 700 new cases of COVID-19, a significant increase that has now prompted the Ontario Hospital Association to call for the return of Stage 2 restrictions.

It’s the highest daily count ever recorded in Ontario, surpassing the 640 cases confirmed on April 24.

It should, however, be noted that the province was testing far fewer people this spring so it is possible that the numbers from back then may have been an underrepresentation of just how prevalent the virus was in the community at the time.

For example, the previous high of 640 cases was based on the completion of more than 12,000 individual tests, translating into a positive percentage of five per cent. The 700 cases confirmed on Monday came on more than 41,000 tests. That translates into a positive percentage of about 1.7 per cent.

The positive percentage in Ontario previously went as low as 0.4 per cent in August but has now been on the rise for weeks, even amid a significant expansion testing that has seen the province process at least 40,000 tests on each of the last four days.

“We know that we are in the second wave and we know that it will be worse than the first wave but what we don’t know yet is how bad the second wave will be,” Premier Doug Ford acknowledged during a briefing at Queen’s Park on Monday afternoon. “The reality is that is up to each of us. Together our collective actions will decide whether we face a wave or a tsunami.”

Three out of four new cases are in GTA

Ontario went an entire week with its daily counts of new infections under 100 as recently as early August but since then the numbers have steadily increased and we are now back where we were during the peak of the first wave in April.

The 700 new cases confirmed on Monday represents a substantial increase on the 491 cases confirmed one day prior, which itself represented a near-five month high.

Officials say that the rise could be partly explained by the clearing of a backlog of tests that were waiting to be processed over the weekend.

That said the seven-day rolling average still stands at 461.

That number previously peaked at 570 in April and went as low as 85 last month.

Of the new cases confirmed on Monday, roughly three-quarters of them were in the Greater Toronto Area (526 cases), continuing a recent trend in which the virus appears to be increasingly clustered in urban areas.

Toronto alone had 344 cases while Peel Region had 104 cases, York Region had 56 cases, Durham Region had seven cases and Halton Region had 15 cases.

Ottawa also continues to be a hotspot of infection, adding another 89 cases over the last 24 hours.

Twelve of Ontario’s 34 public health units, meanwhile, reported no new cases at all.

Speaking with reporters at Monday’s briefing, Ontario Chief Medical Officer of Health Dr. David Williams said that the province is clearly on “the slow upward curve” of a second wave of infections.

He said that right now the modeling suggests that it is more of an “undulating wave” in which infections gradually increase as they did in the spring but he acknowledged that there is always the risk of “a tsunami-type” wave, in which there is a sudden spike in cases.

“We have to assume that it could be a lot worse than the first wave especially if it is the second scenario where it is more of a tsunami one. So far it doesn’t seem to be going that way and we would like to think that we can keep on top of this and ask the public to really hunker down and stay at the task and see if we can flatten the curve like we did the first time,” he said. “People have gotten very casual I think at the end of the summer and in the early fall and we have seen that effect but I think if everybody refocuses we can turn this around.”

Hospitalizations on the rise

While hospitalizations have so far remained well off the peaks seen in April when 1,043 people were receiving treatment, the latest data suggests that they too are on the rise.

There are now 128 COVID-19 patients in Ontario hospitals, which is about triple the number seen at points last month.

Of those patients, 29 are in intensive care units and 17 of them are breathing with the help of a ventilator.

There also appears to be an uptick in outbreaks in long-term care homes, where so many of the COVID-19 related fatalities earlier in the pandemic were concentrated.

On Monday, the province reported another four outbreaks at long-term care homes, bringing the total number of active outbreaks in those settings to 36.

There are also now two homes in Toronto with more than five resident cases, a threshold that hadn’t been reached by any of the city’s long-term care facilities for months.

“If we compare this to the first wave of the pandemic it is actually a steeper rise in the curve which is very, very troubling,” infectious disease specialist Dr. Abdu Sharkawy told CP24 earlier on Monday morning. “I think people need to recognize that just because we don’t have an enormous number of hospitalizations and ICU admissions right now that can change and it can change without a lot of notice and as we await flu season any day now that could really spell trouble for our healthcare system.”

Ontario Hospital Association calls for more restrictions in GTA, Ottawa

The Ford government has taken several actions to address the recent rise in cases, including a recent decision to prohibit the sale of alcohol after 11 p.m. and reduce the maximum size of allowable social gatherings to 10 people indoors and 25 outdoors.

In a statement released following the publication of Monday’s numbers, the Ontario Hospital Association called on the premier to go one step further and immediately reinstate Stage 2 restrictions across the GTA and in Ottawa.

Under Stage 2, bars and restaurants were limited to take-out and patio service only and a host of other businesses, including gyms and movie theatres, were prohibited from operating entirely.

“Ontario hospitals have been the anchor of Ontario’s pandemic response, opening assessment centres, conducting laboratory testing and deploying staff to assist in long-term care but they are gravely concerned that the current rate of spread will mean that hospitals will be unable to fulfill these roles while delivering life-saving care,” OHA President and CEO Anthony Dale warned in the statement. “Without public health measures in place to limit opportunities for disease transmission, Ontario will soon see higher numbers of hospitalizations, admissions to intensive care units and more deaths.”

Dale acknowledged in his statement that a return to Stage 2 would come “at a serious cost to thousands of businesses and their employees” but he said that “emerging evidence clearly illustrates that indoor settings like bars and restaurants have become significant drivers of rising COVID-19 cases.”

He said that while a move to limit the hours of those establishments “may have a small impact on transmission,” the province simply can’t afford “to wait and find out.”

For his part, Ford said that “everything is on the table” but he did not commit to a rollback to Stage 2.

Williams also spoke of a need to be more “surgical” in the issuing of new public health restrictions, noting that the province isn’t likely to follow the same staging system it used in restarting the province’s economy this past spring and summer.

“We are looking at different metrics and different ways of reviewing it because it is presenting itself differently and it is presenting itself differently in different parts of the province,” he said.

Other highlights from the data:

  • There was one more death confirmed over the last 24 hours, bringing the total number of fatalities so far to 2,840.
  • The number of cases confirmed on Monday more than doubled the number of new recoveries (331). There are now 4,564 active cases province-wide.
  • The total number of lab-confirmed cases since the pandemic began has now surpassed 50,000 (50,531).
  • Nearly half of all new cases over the last 24 hours (317) involved people between the ages of 20 and 39. Just 15 of the 700 new cases belonged to the oldest demographic tracked by the province (80 and above)
  • There were eight new cases reported among long-term care home residents and five new cases reported among long-term care home staff.