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Frontline workers arrive at an immunization site in Toronto on Jan. 18, 2021.Fred Lum/The Globe and Mail

The two Ontario regions hit hardest by the COVID-19 pandemic are balking at the province’s plans to gradually reopen the economy and raising the prospect that the government should delay loosening restrictions in their areas.

Representatives in Toronto and Peel Region, which includes Mississauga and Brampton, say the transition from stay-at-home orders to the province’s colour-coded framework guiding business reopenings has the potential to spiral out of control with the rise of faster-spreading, more contagious variants. Although most of the province re-entered the framework on Tuesday, public-health units in Toronto, Peel, York Region and North Bay Parry Sound are scheduled to return to it as early as next Monday – though the government can choose to keep the stay-at-home orders in place.

Even as case counts, hospitalizations and deaths continue to fall across the province, officials have warned of a third wave if variants take off and public-health measures are lifted. With schools now reopened across the province, some health officers say the province should wait two to four weeks until further loosening restrictions.

Lawrence Loh, Medical Officer of Health for Peel, which has the highest rates of transmission in the province, said his region has seen a 20-fold increase in coronavirus variant cases since last week, rising from five to 100.

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“I’m very concerned about the tenuous situation that we find ourselves in. I think many people have been lulled into a false sense of security with the declining numbers,” Dr. Loh said in an interview. “We would certainly welcome some consideration as to whether it is appropriate at this time to re-enter the provincial reopening framework.”

Dr. Loh said if pushed by the province, the region should enter the grey “lockdown” zone, which keeps many restrictions in place but allows retail stores to open at 25-per-cent capacity. Dr. Loh said he will continue to advocate for adequate paid sick leave, adding that in 25 per cent of the region’s cases between August and the end of January, people reported going into work with a COVID-19 symptom.

“Paid sick days save lives. Paid sick days reduce transmission,” Dr. Loh said.

Councillor Joe Cressy, chair of Toronto’s board of health, said that the combination of school reopenings and circulating COVID variants means “a cautious approach is certainly warranted.” He called for a co-ordinated response across the region.

“We are in active conversations with our regional counterparts and the province on what additional [public-health] measures may be required and the timeline for re-opening,” he said.

Premier Doug Ford defended his government’s reopening plans on Tuesday, which have faced criticism from Ontario’s own scientific advisers. He said Ontario still has Canada’s strictest pandemic rules, and that the province wouldn’t hesitate to return to stricter regional lockdowns if cases rise.

But he said for the four remaining regions, it will be up to the province’s Chief Medical Officer of Health, David Williams, and the local medical officers of health to recommend what restrictions stay in place after Feb. 22, adding that local medical officers of health are also free to make their own local health orders as they see fit.

“We aren’t reopening the province yet – we’re transitioning,” the Premier told the Legislature, which reopened on Tuesday for its spring session.

The Premier also said Ontario wouldn’t “double-dip” on the sickness benefit offered by Ottawa, which has been criticized as insufficient, complex and too slow to benefit essential workers.

Meanwhile in York Region, the sprawling suburban area that shares boundaries with both Peel and Toronto, local politicians and the medical officer of health have asked to be classified in the province’s “red/control” level of restrictions, a step down from “grey/lockdown.” In the red zone, restaurants can reopen for indoor dining as well as indoor fitness facilities, but with a capacity limit of 10 people.

Karim Kurji, the region’s Medical Officer of Health, said York’s case numbers have flattened after a steady decline in recent weeks. And while the British variant remains a “wild card,” he said it is currently being held at bay by the aggressive tracking and isolating of contacts of confirmed cases. There are about 60 current active cases of the British variant in York Region, he said, and it does not appear to be spreading as rapidly as he feared just a few weeks ago.

“We think that the variants are in check at the moment,” Dr. Kurji said, crediting more stringent border measures and public compliance with health guidelines for helping to keep the more contagious strain under control.

But even as some restrictions in York Region are lifted, he said residents still need to stay at home as much as possible while maintaining two metres of physical distance from others if they do go out.

Charles Gardner, Medical Officer of Health for the Simcoe Muskoka District Health Unit, whose region moved to the “red” level on Tuesday, said the province is taking a risk with its plans to lift the stay-at-home orders. The new, more transmissible variants of the coronavirus will become more prevalent fairly quickly, Dr. Gardner told reporters.

“I would advise the province that they be fully prepared to put back in place the stay-at-home order and the shutdown with the onset of a third wave, if not sooner,” he said.

To date, 153 cases in the Simcoe Muskoka region have tested positive for the variant of concern first detected in Britain. The variant is behind a devastating outbreak at the Roberta Place long-term care home in Barrie, where 70 residents have died.

With a report from Karen Howlett in Toronto

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