Toronto's top doctor called for "immediate action" by the province Friday to stop the spread of COVID-19 as the city faces the risk of "exponential growth" of novel coronavirus infections.
Ontario reported a record-high number of new cases, with 323 out of the total 732 in the city of Toronto. From Sept. 1 to Sept. 29, the city's seven-day moving average of new cases has risen from 40 to 84 to 239 — an almost six-fold increase.
"We have seen in other places what happens when COVID-19 gains the upper hand. Without quick action to implement further public health measures, there is an acute risk the virus will continue to spread widely, causing serious illness, stressing the health care system and further straining Toronto's economy," de Villa said in the release.
The recommendations include calling on the public to leave their homes only for essential trips including work, education, healthcare appointments and exercise, with up to two people from outside a household allowed to provide social support for those living alone.
De Villa said her push for the province to undertake her temporary recommendations is to "drive overall case counts down."
"These number won't reverse on their own," she said. "They will only increase without action. This is the threat we face and this is why I am asking the province for support to do more."
De Villa's recommendations also include prohibiting indoor dining and indoor sports and recreation, and requiring large venues to submit plans showing how they will comply with public health measures, such as through physically distanced seating and methods to collect information from patrons.
For now, the proposals remain as recommendations, Mayor John Tory confirmed at a news conference Friday afternoon.
"We've taken all the steps we can ... within our legal authorities," said Tory.
Province enacts some tighter restrictions
At an earlier news conference Friday, provincial officials announced a set of "targeted" measures for Toronto, Ottawa and Peel Region — areas it called "hot zones" for the virus.
Those measures include limiting indoor occupancy at restaurants and bars to a maximum of 100 patrons (Toronto has already moved to limit capacity to 75 patrons) and restricting group exercise in gyms and fitness settings to 10 people.
De Villa threw her full support behind the province's new restrictions, but made clear she felt more actions could be taken.
"I am in agreement with the province's course of action," she said. "However, I am convinced there is more that can be done."
She stressed that her proposals are meant to "prevent" the need to take more stringent measures.
"What I don't want is a return to a lockdown like we saw last spring," she said. "I do not believe that is necessary."
Implementing these proposals herself exceeds her authority, de Villa says
At Friday's city news conference, de Villa was asked by reporters whether it was within her legal power to enact the recommendations for Toronto herself.
She said while she does have some authority under the Health Protection and Promotion Act, she has received legal counsel suggesting it would be "unprecedented" for a medical officer of health to "enact such broad changes.
"Such action likely exceeds my authority and may render me personally liable."
Instead, de Villa said she hopes the province will implement her proposals or shift the authority to her to enact them herself.
"If I had the power to do this, I would have done it," she said.
"It's just this simple: I'm asking the province to do it or to give me the power to do it. And if they give me that power, I will absolutely take the necessary measures to do what needs to be done to protect the health of this city."
With a sharp rise in the number of COVID-19 cases, the city has already made some changes of its own. City council voted unanimously this week to change protocols at restaurants and bars across the city, reduce the number of patrons from 100 to 75 and reduce the number of people at a table from 10 to six, among other changes.
Toronto is facing 169 active outbreaks in the community and congregate settings, such as child care, work places and long-term care homes.