Saskatchewan's chief medical health officer Dr. Saqib Shahab says time is not on the province's side when it comes to getting COVID-19 under control.
"Right now, time is of the essence. We have a week or two at most to make specific decisions that are quite significant."
Saskatchewan currently has the third highest per-capita rate of COVID-19 hospitalizations in the country, and has been flipping between third and fourth when it comes to active case rate.
On Thursday, Shahab released the province's latest modelling of where COVID-19 cases could go, based on how well the public follows measures introduced and public health advice.
In a "best-case scenario," the government's model said Saskatchewan will nearly double its total number of COVID-19 cases over the next six months.
To date, there have been 5,651 known COVID-19 cases in Saskatchewan.
The worst case scenario in the modelling would see 469,000 cases over the next six months.
This week, the government implemented a mandatory mask rule for indoor public spaces province-wide. It also reduced private gathering limits to 5 from 10 and said it is consulting with the hospitality, worship and sports sectors about further restrictions.
Shahab spoke with CBC's The Morning Edition host Stefani Langenegger Friday morning. He said the public must follow the current guidelines.
He said people should reduce their activities by "more than half."
For example, if you are going for groceries twice a week, go only once, he said. Shahab also suggested visiting your favourite restaurant less frequently.
He said hospitality, retail, offices, worship and sports all need to "recalibrate" their safety measures as well.
When asked why bars and restaurants remain open to customers, Shahab said temporary closures have been implemented in other parts of Canada and may not be necessary here if transmissions of COVID-19 can be slowed.
"If we can slow things down by up to 50 to 75 per cent, but still keep these sectors open, then at this point I would suggest that's a better route, but we will have to see."
Shahab said a restaurant that has 12 tables may need to reduce to four to keep patrons safe.
"It's a mistake to say 'shut everything down for an extended period of time,' because obviously that will get cases down, but there are some, I would have said unintended consequences, but there are some known consequences of that," he said.
"It's a balance. Public health advice cannot be disassociated from impacts on society and economy."
Shahab said if cases continue to go up, restrictions will have to get tighter.
On Thursday, Minister of Health Paul Merriman said the province is trying to strike a balance between restrictions and keeping people employed.
"With a complete shutdown, it's very challenging for people to deal with that twice in one year, so we're continually adjusting our restrictions and our guidelines."
Merriman said the frequent changes to guidelines in the last several days are due to the increasing cases and hospitalizations.
"I can't tell you what's going to happen in the future, but I can tell you this if everyone adheres to guidelines that are set out we have got a better chance of maintaining what we have now or opening things back up versus going the other direction," he said.
Merriman strongly recommended the public not entertain visitors from outside their households.
Asked about why the guidelines restrict home gatherings, but not public gathering limits or places like bars or restaurants, Shahab said cases of transmissions in uncontrolled environments like a home setting contributed to the decision.
"Not one sector is responsible for all the cases, but all of them are contributing about 10 to 20 cases a day."
He said if those sectors can be "slowed down" to three to five cases a day, the province would be under 60 new cases and that would be a manageable figure.
"If we can't get there in a week or two then we will have to pause."
Shahab said recreational sports like hockey, where masks aren't being worn during competition, may also require a "slow down."
Shahab says he and government are 'aligned'
The chief medical health officer position in Saskatchewan is not an independent office. Shahab and his officials are under the Ministry of Health umbrella.
There have been questions about this arrangement, which is similar to other provinces, but Shahab said Friday the government has not been refusing his recommendations.
Shahab said he and the government have "been moving in an aligned fashion." He said there is "vigorous" discussion within branches of the government about the recommendations and regulations.
"When I speak, I speak directly to the public. You can't have a chief medical health officer who is totally separated from all the government machinery."
"I issue recommendations and suggest regulatory changes, but the government has to implement them," Shahab said.
Merriman said the province consults with Shahab and his team before issuing new guidelines.
When asked if the recommendations by Shahab to see fewer people and go out less were contradictory to having certain sectors remain open, Merriman said no.
"We are not making guideline recommendations without Dr. Shahab and his team having a close look at what we are doing," Merriman said.