Just a little less than a week before Toronto's time under shutdown and stay-at-home orders is set to expire, the city's top doctor says she's never been more concerned about the threat of COVID-19. 

Speaking during the city's press briefing Wednesday afternoon, Medical Officer of Health Dr. Eileen de Villa said she has written to the province asking that lockdown measures be extended and that Toronto's transition into the colour-coded framework be delayed until at least March 9.

"I have never been as worried about the future as I am today," she told reporters earlier this afternoon. "A week ago, there were 33 confirmed cases of COVID-19 variants in Toronto. Today, we have 56."

Dr. de Villa explained that there are actually more than five times that number being confirmed in the labs right now, as 283 new cases have screened positive as variants of concern and lab work is currently underway to confirm this and find out which ones. 

"The variants of concern mean we face a deceptively dangerous situation," she said, adding that while present case numbers may not seem too bad, "today's variant count is the tip of an iceberg."

"By the time the confirmed case counts are big enough to shock us, it will be too late to do anything," she continued. "We will be in a third wave as bad as anything we've been through thus far."

In Germany, for example, de Villa said the porportion of cases found to be variants of concern is doubling every two weeks. 

And in the U.K., the new variant began circulating last September, she said, and while daily case counts were averaging around 15,000 in mid-November, they reached a peak of 50,000 a day in mid-December.

"That is what happens with exponential growth, and exponential growth is what Toronto faces," she warned. "Suddenly case counts leap, and the opportunity to prevent it is gone."

As a result, de Villa said she and Dr. Lawrence C. Loh, Medical Officer of Health for Peel Region, penned a letter to Ontario's Chief Medical Officer of Health Dr. David Williams this past weekend asking that measures be extended for at least two more weeks in Toronto and Peel, at which point indicators would be reassessed once again to determine if the regions are ready to transition to the framework.

An excerpt from the letter reads as follows:

In reviewing recent mobility data, it is clear that only when the Province-wide Shutdown began on December 26th, followed by the Provincial Stay-at-Home Order and Emergency Declaration on January 14th did we see a significant decline in mobility. Even in the absence of changes to public health measures, data has recently started to show an increase in mobility that could result in more contacts which, in turn, increases risk of transmission. Reopening in any degree influences public perception of risk and may give a false sense of security that the risk is no longer present.

With this as background, we are requesting that the Province delay assessing our regions' readiness to move into the Framework until March 9th at the earliest. Until that time, we recommend both Peel and Toronto remain in the 'Shutdown Zone' under O. Reg. 363/20 and that the region-specific Stay-at-Home Orders (O. Reg. 73/21 and O. Reg. 89/21) remain in place. This delay will allow Peel and Toronto to monitor VOC growth and support the safe re-opening of schools.

We recognize the importance of balancing economic recovery with protecting the health of the population. We also acknowledge that the Province has instituted an "emergency brake" provision that allows the local Medical Officer of Health to reinstate maximum restrictions if their jurisdiction experiences rapid acceleration in COVID-19 transmission or if its health care system risks becoming overwhelmed. However, it is important to recognize the weariness the public is experiencing, particularly those who have been most impacted by COVID-19. We believe that the public will be far less accepting of a return to a third lockdown than the gradual and progressive lifting of the existing one.

Mayor John Tory reiterated de Villa's recommendations Wednesday, saying the more transmissible and dangerous variants have already been found in long-term care homes, homeless shelters, hospitals and meat packing plants, just to name a few. 

He added that the priority is to ensure schools can remain open safely while also avoiding having to shut the city down again just as the weather warms up and patios reopen.

"Despite the huge dislocation the pandemic has caused for people and for businesses, the worst mistake we could make right now is to ignore the advice of our medical experts and begin to reopen too quickly," he said. 

"We absolutely do not want to find ourselves opening things up, even slightly, and then having to close down again just a few weeks from now."

And in her final remarks of the day, de Villa did not hold back from expressing the urgency and seriousness of the current situation.

"As a public health physician, I've never been as concerned about the threat of COVID-19 to your health as I am now. Not at any other point in the pandemic. I am obligated to make it that clear," she said.

"I would love to be able to tell you that we are at a point where restrictions can substantially lift. I look forward to that day," she continued.

"Today, it is better to delay reopening and stage reopening gradually when we have certainty that the time is right. Better to wait until we know more than to put everyone through the yo-yo of closing, reopening and closing again and again."