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Bartender Victoria Colombe fills a drink for customers while working at Door Fifty Five bar and restaurant during the COVID-19 pandemic in the Port Credit neighbourhood of Mississauga, Ont., on Oct. 9, 2020.

Nathan Denette/The Canadian Press

Ontario is expanding restrictions into another Toronto-area region in a bid to stop the spread of COVID-19 and avoid widespread lockdowns, as Premier Doug Ford faces increasing pressure to balance health care with the needs of the economy.

Mr. Ford, who revealed there has been rigorous debate over the issue in his own cabinet and Progressive Conservative caucus, announced Friday that York Region will move to a “modified Stage 2” for at least 28 days starting at 12:01 a.m. on Monday.

York – which includes the municipalities of Markham, Vaughan, Richmond Hill and Newmarket – will join the hotspots of Toronto, Peel and Ottawa in closing indoor dining, gyms, cinemas and casinos, as well as limiting team sports and reducing capacity limits at event spaces to 10 people indoors and 25 outdoors. The first three hotspot regions were subject to those restrictions last Friday.

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Mr. Ford cited concerning trends in York Region, including a rapid increase in the rate of infection, growing positive rates and high critical-care admissions to hospitals.

“We just have to stop the spread,” Mr. Ford said on Friday at an unrelated announcement in Mississauga. "You have no idea how much I hate doing this.”

Mr. Ford and Health Minister Christine Elliott said the government is eyeing similar restrictions in Halton Region, west of Toronto, which has also seen a rise in community outbreaks.

Burlington MPP Jane McKenna, whose riding is in Halton, said the purpose of restrictions in hotspots is to limit the spread of the virus, and urged people not to travel to other regions.

“None of us want to see additional restrictions here in Halton,” she said. “This is people’s lives and livelihoods that we’re talking about.”

Progressive Conservative MPPs who represent affected areas told The Globe and Mail they are hearing a variety of opinions in their ridings, but said the government has to protect its most vulnerable. “People … who have never in their life felt depression, are telling me they’re starting to understand what it means to be depressed," said MPP Gila Martow, who represents Thornhill in York Region. “I think that people are realizing that this is sort of going to be a slightly long, drawn-out process.”

Mr. Ford has repeatedly stressed that he is trying to balance COVID-19 restrictions with their devastating effect on the economy and particularly small-business people. But he also says he is following the advice of his Chief Medical Officer of Health, David Williams, and the panel of select local medical officers of health that provide confidential advice to Dr. Williams, known as the public-health-measures table.

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Experts outside government – including prominent epidemiologists and critical-care doctors – have criticized Mr. Ford, Dr. Williams and the panel, saying they are dragging their feet on reinstating new restrictions in virus hot-zones. The government waited a week after a public plea from Toronto’s Medical Officer of Health Eileen de Villa for a ban on indoor dining in restaurants and bars.

But local medical officers of health from other regions on the advisory table say it is also important for them to weigh economic and social factors. Some on the seven-member panel have told The Globe in recent days that their vocal critics often fail to consider economic and practical factors.

“I am sick and tired of hearing, to be honest with you, a lot of other physicians out there, speaking their mind,” said Paul Roumeliotis, Medical Officer of Health for the Eastern Ontario Health Unit. “… They aren’t on the ground and don’t know what we are facing. It’s beyond math. There’s a qualitative art and science to this. You’ve got to balance it. There’s a lot of grey zones."

Opposition NDP Leader Andrea Horwath said she agrees a balance needs to be struck between public-health measures and the economy. But Mr. Ford, she said, was doing too little to help businesses hit hard by the recent closings. She said the Premier’s recent announcement of $300-million for affected businesses is not enough.

“Mr. Ford has done squat when it comes to stepping up and assuring those businesses that, for example, government will subsidize them for the covering of their rent,” Ms. Horwath said.

Ontario reported 712 new cases of COVID-19 on Friday, along with nine new deaths related to the novel coronavirus. Of the new cases, 213 are in Toronto, 135 are in Peel Region, 108 are in Ottawa and 62 are in York Region, down from 127 the previous day.

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