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People line up, physically distanced, at a mass vaccination centre during the COVID-19 pandemic in Mississauga, Ont., on May 10, 2021.Nathan Denette/The Canadian Press

Ontario should not relax its stay-at-home order until its daily count of COVID-19 cases sinks “well below” 1,000 – about a third of current levels – and stays there, the province’s Chief Medical Officer of Health said Monday.

David Williams made the comments as the Ontario government looks set to extend its current order, which was due to end May 20. The province is trying to keep more-contagious new variants of COVID-19 at bay while its vaccine rollout, criticized by some as confusing, gathers pace.

“I haven’t got a definite metric right now,” Dr. Williams told reporters. “It certainly will be well below 1,000.”

Ontario Health Minister Christine Elliott said Monday that the daily case numbers and ICU admissions, while declining, are “still too high” to lift the stay-at-home order, which includes bans on gatherings, outdoor sports, eating at restaurants and has left non-essential businesses shut.

“The medical experts have been very clear that we need to stay the course for right now,” Ms. Elliott told reporters at Queen’s Park, adding that there needs to be a “significant drop” in cases before restrictions are loosened.

Ms. Elliott said cabinet has yet to receive final advice from Dr. Williams and other medical experts, expected later this week, on extending the order.

Ontario recorded 2,716 cases on Monday, its lowest tally since April 1, although the number of tests it conducted was much lower than usual and case counts are often lower early in the week.

The province’s daily count of new infections has been declining steadily, down from a third-wave high of 4,812 on April 16. Ontario last had fewer than 1,000 new cases a day in early March. It has not had a sustained week of new infection tallies below that level since October.

Dr. Williams said after the second wave, cases only sank to around the 1,000 mark for a few days before climbing again. This time, he said, he would like them to get to a lower level and stay there for a longer period of time before reopening the province.

He also said he would like to see the number of COVID-19 patients in intensive-care units across Ontario – declining but still at a crisis level of 828 – come down closer to 150 to 200, to potentially allow hospitals to lift a ban a non-emergency surgeries and to start tackling the growing backlog.

Dr. Williams said the key difference now is the pace of vaccinations, which he said could see close to 70 per cent of adults with at least the protection of a first dose by the end of the month. He also said his goal was to reopen slowly, to avoid a fourth wave and another round of shutdowns.

Meanwhile, the association representing Ontario’s local public-health agencies sent a letter to Premier Doug Ford last Friday that strongly recommends extending the stay-at-home order and other restrictions beyond May 20.

The group, which includes Paul Roumeliotis, the Medical Officer of Health for Eastern Ontario and chair of the Council of Ontario Medical Officers of Health, noted that the number of people in intensive-care units remains far higher than at the peak of the second wave.

“Any move to relax restrictions now would without a doubt reverse the modest downward trends we have observed over the past two weeks,” the letter reads.

Ryan Mallough, the director of Ontario provincial affairs for the Canadian Federation of Independent Business, said any lockdown extension should also come with new funding to help business survive. He pointed to Manitoba’s government, which announced Monday a new round of grants up to $5,000 to make up for new restrictions.

“They tend to offer support right off the bat, whereas here it’s just kind of wait and see,” Mr. Mallough said.

Toronto’s Medical Officer of Health, Eileen de Villa, said projections suggest that if current levels of contact between people are maintained, there will be approximately 400 daily cases in the city by June 1. But if Ontario opens up and transmission increases by as little as 20 per cent, she said, case counts would instead rise to 800 a day in Toronto alone by early June.

Dr. de Villa said there was “little likelihood” of things changing before the stay-at-home order’s current expiry date.

Meanwhile, Ontario is looking into how it could speed up second vaccine doses for older seniors, after the province recently moved to eliminate the four-month delay for urban Indigenous adults and high-risk health care workers.

Nathan Stall, a geriatrician and assistant scientific director for the province’s COVID-19 Science Advisory Table, said adults 80 and over have the highest rates of hospital admissions and deaths from COVID-19 after receiving a single vaccine dose. With an increase in supply, he said older populations should now be prioritized for second doses.

“They continue to be the people who are dying the most in our province,” he said. “Older adults are also very, very fearful and sheltered and in some respects have been the most impacted by restrictive public health measures.”

With a report from Oliver Moore

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