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Nurses administer rapid COVID-19 tests at a construction site in Toronto on Feb. 18, 2021.Frank Gunn/The Canadian Press

Ontario has stalled its planned reopening and decided to extend stay-at-home orders for Toronto and neighbouring Peel Region, as new modelling from federal officials warns that more contagious variants of COVID-19 could prompt Canada’s cases to skyrocket to 20,000 new infections a day.

The projections released Friday morning by the Public Health Agency of Canada warn that if the highly contagious variants first found in Britain, South Africa and Brazil are allowed to flourish without further restrictions, they could trigger a deadly third wave before mass vaccinations are set to launch in earnest in April.

“With more contagious variants spreading, further lifting of the public-health measures will cause the epidemic to resurge rapidly and strongly,” Chief Public Health Officer Theresa Tam said, adding that even current restrictions will not be enough to stop a third wave, which can only be avoided by tightening rules.

The latest predictions were made after Ontario had already started loosening its lockdown regime in most of the province and returned its students to classrooms, even in the face of similar warnings from its own scientific advisers of the variants’ threat. Quebec, Alberta and Manitoba have also lifted restrictions and reopened many businesses.

But Ontario announced Friday that it was delaying the planned lifting of its remaining stay-at-home orders in Toronto, Peel and North Bay Parry Sound, which has experienced a large variant outbreak. The government made the decision at a cabinet meeting Friday morning, following the advice, Premier Doug Ford said, of local health officials.

Local medical officers of health in Toronto and Peel, Ontario’s hardest-hit areas, went public this week with pleas to be allowed to remain under the province’s strict stay-at-home orders for at least two more weeks, instead of starting to reopen on Monday as the province planned. The move means non-essential retailers must stay closed, and that restaurants must offer only takeout or delivery.

However, York Region, which shares boundaries and a higher-than-average infection rate with both Toronto and Peel, will move into the province’s lower “red/control” level of restrictions, which allows for shopping at non-essential stores and dining inside restaurants, but with strict capacity limits.

Local politicians and York Medical Officer of Health Karim Kurji had requested the move. Dr. Kurji said the variants are being kept in check by aggressive contact tracing, enforcement of the pandemic rules such as the capacity limits for businesses, and new border controls.

He said the assumptions behind the federal modelling are based on the experiences of other countries and may not apply in Canada. York, he said, has had the variants since January, and has not yet seen any explosive growth.

“We are not seeing any signs of alarm. So at this point, I don’t think we would be headed toward the third wave,” Dr. Kurji said.

Over the past week Canada as a whole has averaged 2,886 daily new cases. Projections released Friday show that if the variants take off with just current restrictions in place, Canada could see 10,000 cases a day by the end of March. If public-health measures were lifted, the modelling shows a near vertical climb in case counts, putting Canada on track for more than 20,000 daily new cases by mid-March.

Dr. Tam cautioned that the modelling shows options for what could happen and is not a crystal ball. However, she warned that Canada’s vaccination campaign has not yet protected enough people, and that even countries that have inoculated more of their citizens have brought in tighter controls to curb the spread of the variants.

She also cautioned against opening other parts of the economy close to the same time as schools, as Ontario is now doing, suggesting the province should wait three weeks to see the effect the return of students to classes has on infections.

Toronto Councillor Joe Cressy, who chairs the city’s board of health, said the province “made the right call” in heeding pleas for a delay from Peel and Toronto.

“This two-week delay is critical if we’re going to effectively monitor these alarming variants and have a chance at preventing a third, and a more severe lockdown later,” he said.

Lawrence Loh, Medical Officer of Health for Peel, warned that the two-week extension may itself need to be extended, depending on how the variants spread.

“I hope two weeks is all it is, but at the same time, if the trends are not favourable, if our hospital capacity remains challenged, if the variants continue to grow rapidly, we would have to reassess,” he said. “We’ll have to make the call when we get closer to that date.”

Ontario also released an updated vaccine distribution plan on Friday. Retired general Rick Hillier, chair of Ontario’s vaccine distribution task force, said the province expects to start vaccinating people over 80 – and who live outside long-term care homes – by mid-March. But Ontario likely won’t get to people in their 60s and 70s until at least April and May, Mr. Hillier said, depending on the flow of vaccines from Ottawa.

Irfan Dhalla, a physician and vice-president with the Unity Health Toronto network of hospitals, called it a good decision to keep the stay-at-home order in Toronto and Peel. He also praised the move by the province to accelerate plans to vaccinate people 80 and up.

“We may need to buy a little more time still, but definitely feeling hopeful today,” he wrote on social media.

Ontario’s steady slowdown in the growth of new cases appeared to falter on Friday, as the province reported 1,150 new infections, back above the 1,000-case threshold for a second day. But the percentage of people getting tested whose samples were positive hit a low not seen since October, at 2.1 per cent. There were 47 deaths in the province.

With a report from Oliver Moore

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