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Students wait to cross the street at Tomken Road Middle School as Ontario prepares for its third province wide lockdown during the COVID-19 pandemic in Mississauga, Ont., on April 1, 2021.Nathan Denette/The Canadian Press

Local health officials in three of the largest regions in Ontario say the government hasn’t taken the necessary measures to slow a spike of COVID-19 cases, with at least one region shuttering its schools as hospitals warn the province is on the verge of catastrophe.

The medical officers of health in Toronto, Ottawa and Peel Region made their plea as the province is facing increasing pressure to revamp its vaccine plan to reach more essential workers in hard-hit neighbourhoods.

In a letter released publicly on Monday, the local officials call for a provincewide stay-at-home order to “reverse the surge” of significantly more contagious COVID-19 variants that are sending younger people to hospital. The letter, sent to Ontario’s Chief Medical Officer of Health David Williams on Sunday, was released just days after the government announced what it calls a “shutdown,” which leaves most retailers open and makes few changes to the restrictions in already locked-down areas such as Toronto and Peel.

The letter recommends the closing of non-essential retail and businesses, as well as provincial travel restrictions, paid sick days and for schools to move online if “outbreaks are significant” and capacity to manage is “stretched.” The Ontario Medical Association is also calling for more restrictions, including a stay-at-home order whereby people would only leave home for essential purposes such as medical appointments, grocery shopping and outdoor exercise.

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Alexandra Hilkene, a spokeswoman for Health Minister Christine Elliott, said it will take time for the public-health measures introduced last week under the province’s “emergency brake,” to take effect, even though the only major change for Toronto and Peel is closing outdoor patios.

“Our government will continue [to] act on the advice of the Chief Medical Officer of Health who will review the science, data and trends along with collaborating with local medical officers of health and our team of expert health officials on if and when public health measures can be loosened or strengthened,” she said in a statement.

On Monday, Peel Public Health was the latest health unit to use its authority to close its schools to in-person learning. Schools will be closed for at least two weeks, starting Tuesday, although the second week is the scheduled April break for staff and students.

Lawrence Loh, medical officer of health for Peel, which includes the cities of Mississauga and Brampton, said he believes schools are safe if public-health measures are followed, but the region needs a “cooling-off period” while community cases continue to rise.

“We know that we’re also at such high rates of transmission that we’re seeing more and more introductions into our school settings and our ability to respond is becoming increasingly strapped,” Dr. Loh said in an interview. “It should prompt maybe some reconsideration about some of the other measures that may be in place.”

Dr. Loh has previously used his powers to order additional restrictions in Peel on top of what the province put in place, including banning wedding receptions and large celebratory gatherings in businesses last November.

In March, Dr. Loh also ordered Amazon Canada to cancel all shifts at its facility in Brampton, Ont., after hundreds of workers tested positive for COVID-19 in recent weeks.

Schools in Thunder Bay and Sudbury have been closed to in-person learning since March and students are learning remotely. The Wellington-Dufferin-Guelph health unit also said on Monday that area school would temporarily shift to remote learning, starting Wednesday.

Toronto Public Health, meanwhile, said on Monday that it would not be shifting its schools to remote learning, but the decision will be revisited on a daily basis. However, the health unit recommended temporarily closing a numbers of schools on Monday, including 11 Toronto public schools, to investigate COVID-19 cases. Six other Toronto District School Board schools were previously closed by the public-health unit. Boards can close a school if there’s not enough staff in the building to supervise students but local public-health units manage closings resulting from outbreaks.

In Ottawa, Vera Etches, the local medical officer of health, said on social media on Monday that her team is reviewing COVID-19 data in schools “to advise on an approach to take for schools” in the region.

Education Minister Stephen Lecce has insisted that schools are safe, even as more than a quarter of schools have at least one COVID-19 case – a number that has kept increasing in recent days. Mr. Lecce has said that he would announce additional safety measures when students return to school after the April break.

Many parents across the province are wrestling with the decision to send their children to school amid rising COVID-19 infections. Some are choosing to keep them home, acknowledging that the ability to work from home allows them to do so.

Natasha Poushinsky, a parent in Ottawa, said that she felt she had “no option” but to keep her children home this week. The government has said schools should stay open for the mental and social well-being of children, but Ms. Poushinsky said a bigger responsibility is also keeping her children safe. She said she wants to see vaccinations prioritized for teachers and school staff, and for the government to introduce rapid antigen testing in schools.

“Our measures [in schools] were sloppy and slapdash in the first phases of the pandemic. With the variant … it is not the worth the risk,” she said.

The rise in cases has also led to calls for Ontario to retool its vaccination strategy to reach more people in neighbourhoods with high infection rates. Data released last week by the non-profit Institute for Clinical Evaluative Sciences (ICES) showed that parts of the province with the highest rates of coronavirus infection, hospital admission and death had the lowest vaccination rates.

Medical experts have been calling on the province to bolster its outreach to marginalized communities and vaccinate more essential workers under 50.

“There is literally no excuse not to open vaccination up to all teachers and essential workers today. Today. Any further deaths in these groups with so many available vaccines unadministered is simply negligent,” said Shady Ashamalla, a surgical oncologist at Sunnybrook Health Sciences Centre’s Odette Cancer Centre in Toronto.

Brampton Mayor Patrick Brown said instead of closing elementary schools, the province should shutter food-processing plants, big box stores, crowded factories and Amazon warehouses, where hundreds of employees have been sickened by COVID-19. He called on the province to vaccinate educators and essential workers, many of whom won’t be reached for weeks or months in the next phase of the immunization plan. “Same old approach isn’t working,” Mr. Brown said on social media.

Toronto Mayor John Tory said Monday the city is looking at offering vaccinations at high-risk workplaces, while the eligibility age has been dropped to 50 at many hospital-based vaccination centres and community clinics in the city’s high-risk neighbourhoods. Ontario is expected to release an update to its vaccine rollout on Tuesday, expanding on its plan to reach communities where many essential workers reside.

Calls for more restrictions are growing as the number of COVID-19 patients in Ontario’s intensive-care units continues to climb.

The total stood at an all-time high of 482 patients as of midnight Sunday, according to Critical Care Services Ontario, after 44 new COVID-19 patients were admitted to ICUs within the previous 24 hours.

Back in the fall, when the second wave was taking off, experts advising the provincial government said 350 coronavirus patients in the ICU was the threshold beyond which it would become “impossible” for the health care system to support non-COVID medical care. The province now has a pandemic-related surgical backlog of more than 245,000 procedures.

Ontario’s COVID-19 Science Advisory Table, led by independent academics and physicians, projected last week that the number of COVID-19 patients in ICUs would hit 800 by the third week of April – even if vaccinations ramped up and the province imposed a four-week stay-at-home order.

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