Toronto's medical officer of health is recommending a list of new restrictions today to try and get the spread of COVID-19 under control in the city, and it includes asking residents to only leave the house for essential reasons.

Dr. Eileen de Villa wrote to Ontario's chief medical officer of health to strongly urge the province to introduce her recommended new measures for a period of 28 days — which also includes ending indoor dining, stopping indoor exercise classes and adding new rules for large venues — though they've yet to agree to do so as of Friday afternoon.

Still, similarly to what was asked of Toronto residents during the first wave of COVID-19, Dr. de Villa is recommending that residents try to leave the house as infrequently as possible  — limiting trips to just essential reasons. 

Today I made new recommendations to residents & the Province to break the dangerous chain of #COVID19 transmission & reduce the risk of further illness, stressing the health care system & further straining our economy. Read my statement: https://t.co/8b8Oj80Lgi

— Dr. Eileen de Villa (@epdevilla) October 2, 2020

Work, education, exercise and fitness, healthcare appointments and the purchase of food would all be considered essential reasons for leaving the house, according to Dr. de Villa, and up to two individuals from outside a household would also be permitted to provide social support if someone lives alone.

Speaking during the city's COVID-19 briefing this afternoon, Dr. de Villa said she's recommending these new public health measures to try and avoid a complete lockdown like we saw in the spring.

"What I don't want is a return to a lockdown like we saw last spring. I do not believe that is necessary," she said. "My proposals are meant to prevent the conditions that would force a large-scale lockdown."

Cases of COVID-19 in Toronto have been on the rise for several weeks now, with the seven-day moving average of new daily cases surging from 40 to 236 between Sept. 1 and 29.

As of 2 pm on Oct. 1 there are 20,180 cases (311 new since Sept. 30), 72 people are in hospital (3 new), 1,262 deaths (2 new) & 16,672 people recovered (236 new). Today's totals include 73 cases, 78 deaths & 8 hospitalizations added due to data cleaning. https://t.co/PxiTuazCjh pic.twitter.com/EEy7NzbwCc

— Toronto Public Health (@TOPublicHealth) October 2, 2020

As a result of the spike, the province has reduced gathering limits, introduced an 11 p.m. last call for bars and restaurants, introduced a province-wide mandatory mask policy, changed the rules for gyms and fitness classes, and made COVID-19 assessment centres appointment only.  

But the city says it's simply not enough, especially for a large and dense city like Toronto. Dr. de Villa, however, does not have the authority to enact any of these recommended measures on her own. 

Due to her limited authority under Section 22 of the Health Protection and Promotion Act, she has requested that Dr. David Williams use his legislative powers to either enact these changes himself or consider making the necessary changes to provide her with the authority to take these actions as quickly as possible.

"Drawing on experience from other jurisdictions, as well as our own successful experience in Ontario in controlling COVID-19 transmission during Wave 1," wrote Dr. de Villa in the letter to Dr. Williams.

"I recommend that individuals only leave their homes for essential activities, such as work, education, fitness, healthcare appointments, and to purchase food, with flexibility for up to two individuals from outside their household to provide social support if an individual lives alone."

Joe Cressy, city councillor and board of health chair, meanwhile released a statement expressing his support for Dr. de Villa's recommendations Friday afternoon.

"Based on the current situation, our Medical Officer of Health has recommended a comprehensive plan. It's Toronto's version of a modified Phase 2 Re-opening approach – a 28-day pause on activities that have fostered transmission," said Cressy in a statement. 

"These measures are necessary to save lives and keep our schools open. They are necessary to preserve the stability of our healthcare system.

They are necessary to make sure our children can continue to learn, and that child care centres can stay open so that parents are able to work. And they are necessary to prevent a complete lockdown, which will likely become necessary if we don't act now."