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People on their way to work wait for the Steeles West bus at the intersection of Jane and Steeles in Toronto on the first morning of the Ontario-wide stay-at-home order on April 8, 2021.

Yader Guzman/The Globe and Mail

A retail marketing firm. An Amazon warehouse. A maker of sports uniforms. A metal polishing firm. All of these workplaces remain open in Canada’s largest city – and all had more than 20 COVID-19 cases among their workers in recent weeks, according to data analysis by The Globe and Mail.

As Ontario sets new records for increases in COVID-19 cases, hospitalizations and people in ICUs – all driven by the spread of more infectious variants – some medical experts say further restrictions, in areas such as manufacturing and construction, are now warranted.

Brooks Fallis works in critical care in Toronto. He’s never been this busy. On his last shift, he brought nine people into the ICU and put six of them on ventilators. In his previous shift, he saw 20 patients with severe cases of COVID-19. Of those, 14 were workplace-related – either directly from a workplace exposure, or from a family member who was exposed while working in sectors such as manufacturing and distribution.

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For indoor environments where people work at close quarters, it’s time to “take a really good look at what is truly essential, just for the next four to six weeks, and close everything that’s not truly, truly essential for our society, to get through this,” said Dr. Fallis, a critical care and internal medicine physician in Toronto and Peel regions. “It would save a lot of lives.”

It would also speed the pace of recovery, he said. “We’re better off to go as deep as we possibly can with the restrictions right now, to really drop cases as fast as possible. Because things like getting schools reopened again or getting restaurant patios reopened ... are dependent on cases coming down.”

Across Canada, COVID-19 cases have hit a record high in recent days, with increases across the country; pressures on the health care system are most acute in Ontario. The new rate of cases per capita now exceeds that of the U.S.

All provinces continue to allow most construction, manufacturing and logistics companies to keep operating. With the prevalence of more contagious variants – causing more severe infections and now comprising more than 60 per cent of cases in Ontario – what worked in prior lockdowns to limit cases will not be as effective this time. Stricter short-term measures may be needed. Just as Quebec enacted stringent restrictions last spring when its cases were skyrocketing in the first wave, Ontario may also need to limit non-essential activity in some industrial areas.

“Right now there is just so much stress [in the health-care system] that even a single case that’s preventable, that could lead to an ICU stay, is one that we would absolutely try to avoid,” said Zain Chagla, infectious diseases physician at St. Joe’s Hamilton and associate professor at McMaster University.

Though some areas – such as food or medicine production, or road maintenance – need to keep running, Dr. Chagla says “there are probably industries that are open now, in manufacturing, that probably could be put on the shelf. The places we worry about are larger manufacturing facilities, where people can’t physically distance or they’re at risk of transmission.”

In Ontario, most public-health units do not disclose workplace outbreaks by employer name, making it difficult to discern the full extent of on-the-job transmissions. Two public-health units, however – Toronto and Hamilton – do publish case counts and outbreaks by employer.

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In Toronto, the most cases among outbreaks from mid-March to mid-April were at Array Marketing, a marketing firm, which had 53 cases, according to City of Toronto data compiled by The Globe. Among others with the highest case counts in the past month are Athletic Knit, a sports uniform maker (26 cases), an Amazon warehouse (25 cases) and 159SW Condominium, a construction project developed by the Alterra Group (21 cases). It’s not just the workers testing positive; increasingly, each case holds the risk of spreading to family members as well.

Alterra Group said nearly all of the cases were among contractors. It had paused work at the site, and is now resuming with limited access. “We need vaccines,” David Wineberg, vice president of construction, said in an e-mail. “The workers have been deemed essential.”

In Hamilton, an hour west of Toronto, the most cases in the past four weeks have been at a logistics firm (32 cases), a nursery and garden centre (30 cases) and a construction site (22), according to the city’s list, aggregated by The Globe.

And in Peel region, a massive warehouse and logistics hub west of Toronto hit hard by COVID-19, thousands of people must commute and go in to work. Brampton Mayor Patrick Brown is urgently calling for more vaccines. “If we are unable to get vaccines for essential workplaces and factories, then we should definitely consider closing them during the surge,” he told The Globe.

Under Ontario rules, most manufacturing, construction and logistics remain open. There is precedent for stricter measures in Canada: In the first wave, Quebec closed all non-essential manufacturing and construction, while Ontario limited some construction.

Other provinces are recognizing workplaces are playing a role in transmissions. B.C. enacted new measures last week to expedite workplace closing orders; if three or more people contract the virus in non-essential workplaces, public health can close the facility for at least 10 days. “Workplaces continue to be sustained areas of transmission, clusters and outbreaks,” the province said in a press release. “These have strained public health resources.”

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Workers head to the commercial bakery in North York where they work the overnight shift ahead of the Ontario-wide stay-at-home order on April 7, 2021.

YADER GUZMAN/The Globe and Mail

For those essential workers who must remain on the job, both Dr. Fallis and Dr. Chagla say more measures are needed to support them – including paid sick leave, more rapid testing in workplaces and paid time off for vaccination, something only offered so far in Saskatchewan. They may also need better access to PPE, such as higher-quality masks, Dr. Fallis said.

For those still on the job, “this is an extremely stressful time,” said Tim Deelstra of the United Food and Commercial Workers Locals 175 and 633, which represents workers in meat-packing, health care, retail and factories. The recent lockdowns and stay at home orders “are not an option for the majority of our members. So it does cause anxiety, and they are looking for as much security as they can.”

This means higher priority for vaccines, he said. Among his union’s members are Cargill workers in London, Ont. – where 82 workers have just tested positive, causing the chicken-processing plant to shut down. Earlier access to vaccines may have prevented this outbreak, he said.

“If we want cases to drop quickly, we’re going to have to go deeper with the restrictions that we have,” Dr. Fallis says. “And it’s that non-essential industry, manufacturing, distribution, construction that stands out as really untouched from the current restrictive rules.”

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