Ontario reported 649 new cases of COVID-19 on Sunday, with one more death and four new hospitalizations recorded.
A total of 3,005 people have died of COVID-19 in Ontario. There are 217 people in hospital with the virus. Fifty-one are in intensive care units and 32 of those are on ventilators.
The numbers of people in intensive care units and on ventilators both increased by three since Saturday.
Peel Region led the way in terms of having the largest number of daily cases per public health unit, according to Ontario Health Minister Christine Elliott.
Peel Region had 157 cases, while Toronto had 140, York Region had 87 and Ottawa had 54.
Elliott said in a tweet that 705 additional cases of the novel coronavirus have been marked as resolved on Sunday.
The province's network of labs completed 44,138 tests since the last daily report. There is still a backlog of 45,837 tests.
Ontario has had a total of 59,139 COVID-19 cases since the pandemic began. A total of 50,427 cases are considered resolved.
In its daily summary of cases in Ontario, the health ministry said of Sunday's hospitalization numbers: "As we often observe on weekends, a number of hospitals (approximately 35) did not submit data to the Daily Bed Census for October 9. We anticipate the number of hospitalized patients may increase when reporting compliance increases."
58 Ontario long-term care homes have active outbreaks
And in long-term care homes, the number of outbreaks remains at 58. The number of confirmed active cases among staff members is 197, an increase of 10 from Saturday.
The number of confirmed active cases among residents is 146, a decrease of four since Saturday.
Vermont Square long-term care home in Toronto has 46 active cases involving residents, while Fairview Nursing Home has 43 active cases involving residents.
The latest case count comes after infectious disease experts warned a week ago that artificially lower case counts were to be expected after the government made COVID-19 testing by appointment only.
As well, last Sunday and Monday, many assessment centres were closed as they prepared to change to testing by appointment. Walk-in testing across the province ended on Oct. 3, which means people who want to get tested have to book an appointment by phone or online.
Dr. Sumon Chakrabarti, an infectious disease specialist at Trillium Health Partners in Mississauga, for example, said case counts were likely to be "unreliable" in Ontario following the change.
Other experts have said Ontarians should consider a variety of statistics, including deaths, hospitalizations and positivity rates, to get a clearer picture of what's happening.
Province won't post new numbers on Monday
The Ontario health ministry, meanwhile, has said it will not post updated COVID-19 case counts on Thanksgiving Monday. Instead the ministry will post Monday's numbers on Tuesday alongside Tuesday's numbers.
Also, Dr. David Williams, Ontario's chief medical officer of health, and Dr. Barbara Yaffe, Ontario's associate chief medical officer of health, will speak to reporters as part of a news briefing on Tuesday at 3 p.m.
Some 'having a really hard time' booking a test, doctor says
Dr. Andrew Boozary, a primary care physician and executive director of Population Health and Social Medicine at the University Health Network, said the move to testing by appointment only last Tuesday has created some challenges. People need a phone, WiFi access and a time slot that works for them, he said.
"Unfortunately with such a shift, you can have unintended consequences. I think what we're really seeing is some patients, even some of our own colleagues here at the hospital and other settings, having a really hard time being able to book," he told CBC News on Sunday.
Boozary said some communities face a digital divide when it comes to testing by appointment only.
"I think COVID-19 has exacerbated long-standing inequalities and we've seen long-standing access issues. It's the same people and communities that have been under-resourced that continue to have challenges in accessing the testing and now even more so than ever," he said.
Boozary said the province needs to work with community agencies to continue to provide mobile testing in areas where there are relatively high case counts.
Toronto, in particular, has seen "great examples" in the northwest areas of the city, where Black Creek and Rexdale Community Health Centres have run mobile testing centres, he said.
"I think we need to partner with communities who know how to best deliver the care and supports to people who need them," he said.
"The online booking system can work really well for certain individuals who are able to get access to it. There's also the need for community supports to make sure we're not worsening this divide. Those solutions and innovations have already been out there. We just need to support them more."
COVID-19 test site inspired by Disney crowd control
Just outside Ottawa, meanwhile, the lead doctor at a COVID-19 testing centre says she may have found a solution to the province's testing woes: a same-day appointment system inspired by crowd control at Disney amusement parks.
Dr. Suzanne Rutherford — a big Disney fan who's visited their theme parks with her children — worked at several COVID-19 testing centres in Ottawa before being put in charge of the North Grenville COVID-19 assessment centre in Kemptville, Ont., in late September.
The centre opened at a time when the province's testing system was under major stress, with people waiting outside test centres for hours at a time.
"I often sat there and thought, 'What we need is the Disney FastPass system,'" Rutherford said in an interview with CBC Radio.
"There's really no other place in the world that manages crowds and lineups better than Disney."
Rutherford modelled the appointment system at the North Grenville testing site on the FastPass system, which allows people to reserve times at Disney attractions and then wait in lines shorter than regular ones.
Anyone who thinks he or she qualifies for a COVID-19 test is first assessed by staff upon arrival at the Kemptville Campus Education and Community Centre. Then people eligible under provincial criteria are given a window of time to show up at the actual testing centre to get tested.
Rutherford said having people register in-person avoids the pitfalls of phone and online appointment systems and the inconvenience of waiting outside. Instead, people are encouraged to leave and come back, or wait in their cars, in the time between registration and the actual test.
"I really wanted people to be able to access the Kemptville assessment centre equitably," Rutherford said.