Officials expressed growing concern Wednesday over highly transmissible new COVID-19 variants taking hold in Canada's biggest cities and in First Nation reserves across the country.
Toronto's mayor, top doctor and emergency management boss announced they want the metropolis to remain under Ontario's toughest restrictions until at least March 9, two weeks longer than planned.
"I have never been as worried about the future as I am today," said medical officer of health Dr. Eileen de Villa.
She said there are 56 cases with variants of concern -- predominantly the one first identified in the United Kingdom -- in Toronto, up from 33 a week ago.
Another 283 cases have screened positive for being variants of concern and lab work is underway to make the final confirmation, de Villa added.
She said the city faces a "deceptively dangerous situation," as overall daily case counts have been trending lower lately.
"Today's variant count is the tip of an iceberg," de Villa said.
"By the time the confirmed case counts are big enough to shock us, it will be too late to do anything. We will be in a third wave as bad as anything we've been through thus far."
The top doctor in Peel Region, a COVID-19 hot spot west of Toronto, joined de Villa in asking Ontario's chief medical officer of health for a two-week extension to the tougher rules.
Ontario recorded 847 new infections Wednesday, along with 10 more deaths and 23 fewer people in hospital than the day before.
New modelling out of Quebec suggests a more contagious COVID-19 variant could dominate in the Montreal area in a matter of weeks.
As of Wednesday, there were 16 confirmed variant cases in Quebec, including 13 cases of the U.K. mutation, and another 135 suspected cases.
Quebec added 14 more deaths from past dates, but no new ones, in its update. It reported 800 new infections and five fewer COVID-19 patients in hospital than a day earlier.
In Ottawa, Indigenous Services Minister Marc Miller said he fears the prospect of variants taking hold in First Nation communities, where residents often live in overcrowded homes and have worse health outcomes due to several socio-economic factors.
"I don't think I can be any more concerned," Miller said.
Miller said that, as of Tuesday, there had been more than 19,000 confirmed COVID-19 cases on First Nation reserves, nearly 1,400 of which were active.
Active cases are one-quarter what they were a month ago, but Miller said "these numbers continue to be alarming."
He said the Prairie provinces, in particular, have had "really scary spikes."
"It is no secret that the opening up of the economies at the end of the summer created that catalyst," Miller said.
"The science is showing that we're still very much at risk as a country and none more so than Indigenous communities, who have really, really fought and continue to fight overwhelming odds.
"The best way to see a third wave is to ignore the science."
New recommendations from the National Advisory Committee say all adults in Indigenous communities should receive a COVID-19 vaccine in the second stage of the immunization campaign to start this spring.
Miller said vaccinations have started in 400 Indigenous communities. More than 83,000 doses had been administered as of Tuesday.
Miller said vaccines have been delivered to about a quarter of the adult population in First Nations, Inuit and territorial communities, a rate that is six times higher than that of the general population.
A shipment of the Pfizer-BioNTech vaccine was delayed because of heavy snowfall earlier this week that temporarily closed operations of the shipping company UPS in Kentucky. Canada's doses of that vaccine are made in Belgium but are routed through the UPS air hub in Kentucky.
Heath Canada said provinces could expect to receive shipments of the Pfizer-BioNTech product at least a day behind schedule, but all 400,000 doses should be in Canada by Friday.
In Newfoundland and Labrador, which is under strict measures to curb the spread of the novel coronavirus, there were 44 new confirmed cases and 21 presumptive ones.
Manitoba had 75 new cases and one additional death. The province also said 27 tickets were issued last week to people accused of breaking public health orders -- more than half of which were for not wearing a mask in an indoor public place.
Saskatchewan reported 124 new infections and five additional deaths. Alberta officials said there were 277 new cases and seven deaths, and a total of 225 cases with variants were detected.
In B.C., there were 427 new cases and three more deaths. The province said 176,015 doses of COVID-19 vaccine have been administered, and of those 26,030 are second shots.
This report by The Canadian Press was first published Feb. 17, 2021.