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Notices indicate which doors are to be used for entry and exit at the Iceland Arena in Mississauga, Ont., which is dealing with restrictions brought on by the spread of COVID-19.

Fred Lum/The Globe and Mail

Restaurants and bars in Peel Region will be allowed to offer limited indoor service and gyms can reopen, Ontario Premier Doug Ford announced on Friday, in a move that hospitals are calling reckless as COVID-19 infections shoot upward.

Peel’s Medical Officer of Health appealed to the government earlier on Friday to keep indoor restaurant service and fitness centres closed for at least another week because cases are rising rapidly and hospitals are strained.

Instead, Mr. Ford said Peel would move on Saturday into the province’s second-strictest category for COVID-19 restrictions under a new framework for reopenings unveiled this week. This allows restaurants and bars in Peel, west of Toronto, to reopen for indoor food and drink, and gyms to operate, both with a maximum of 10 people at a time, and other limitations. Peel Region is the only public health unit in the province moving into this category, which is called “control” and identified by the colour red.

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Mr. Ford said that while cases in the region, and especially the city of Brampton, are “out of control,” his cabinet consulted with stakeholders and the opening aligns with the new guidelines.

“You have everyone giving you advice and I think it was a fair compromise,” Mr. Ford said. “I don’t want to close these folks down.”

Anthony Dale, president and chief executive officer of the Ontario Hospital Association, called for the decision to be reversed.

“Given the powerful evidence of spread of the COVID-19 virus in the region … the decision to proceed with reopening is reckless and must be reversed immediately given the risks it poses to area hospitals,” he said in a statement on Friday.

Brooks Fallis, medical director and division head of critical care for Peel Region’s William Osler Health System network of hospitals, said reopening indoor food and drink service and gyms with the rapid spread of the virus and local hospitals over capacity will make things worse.

“Premier Ford is risking lives and the sustainability of the local health care system,” Dr. Fallis said. “It’s shocking and disingenuous that our Premier would declare that he’s looking out for the health and safety of Ontarians. He’s certainly not looking out for the safety of the people of Peel.”

Peel Region’s Medical Officer of Health, Lawrence Loh, pleaded with the province in a letter on Friday not to loosen restrictions, warning of “serious implications” for hospitals. However, the mayors of Peel’s biggest cities, Mississauga and Brampton, supported the reopening, saying social gatherings and large workplaces – not restaurants and gyms – were major drivers of the spread.

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The CEO of Paramount Fine Foods, Mohamad Fakih, said restaurants in Peel stocked up to reopen this weekend, only to learn at the last minute that they will be limited to 10 people. “Money down the drain when businesses are all trying to survive for a few more months,” he said on Twitter.

Dr. Loh said in an interview that he appreciated the province did not move the region into a more permissive category, which would have been “an unmitigated disaster.” He said spread in Peel is also linked to large workplaces where employees don’t have sick leave and feel pressure to work, as well as social gatherings, and called on residents to limit close contacts.

“The reality is that when you get to a certain level of transmission, any increase in in-person contact and interaction starts to drive up potential risk and also cases,” he said.

Peel, Toronto, York Region and Ottawa were put into what was called “modified Stage 2” restrictions last month, with a ban on indoor dining in restaurants and bars.

As of Saturday, Ottawa and York Region will move into the orange, “restrict” category, which allows 50 people to be in restaurants (with an earlier closing time of 10 p.m.) and gyms, while Toronto will remain in modified Stage 2 at least until Nov. 14.

Ontario on Friday reported 1,003 new cases of COVID-19, including 300 in Toronto, 280 in Peel and 125 in York. Brampton now has a positive-test rate of 11 per cent, and its weekly rate of new cases is 170 per 100,000 people.

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Peel Region, which also includes Mississauga and Caledon, has a weekly rate of 103 cases per 100,000 people. Under the new guidelines, a weekly rate of 100 cases and a positive rate of 10 per cent require more stringent restrictions.

Andrew Morris, medical director of the antimicrobial stewardship program at Sinai Health System and University Health Network in Toronto, said the province’s new framework will not contain the virus in Peel – or elsewhere.

He and other experts say the thresholds for stricter action – such as a 10 per cent test positivity rate for the “control” category – are much too high.

“This is a real public-health challenge when the politicians want to move one way and public health wants to move another way,” Dr. Morris said.

Brampton Mayor Patrick Brown said his city has not had a case of COVID-19 in a dining setting. “It’s tough for me to explain to restaurants why they are being penalized,” he said.

He called for the federal government to install an isolation centre in Brampton for those in precarious employment. He said Peel is also working on stricter enforcement of restrictions on social gatherings, fearing Diwali celebrations in the South Asian community will lead to an increase in cases.

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