The Ford government drastically raised its own thresholds for when to implement harsher COVID-19 restrictions as case counts continued to surge in early November, contradicting both its own earlier guidance and prevailing wisdom in the medical community.

As Ford and his cabinet and health command table were formulating a new five-tier framework for COVID-19 measures in late October, they first decided that any region with more than 40 new cases per 100,000 people and a test positivity rate greater than 2.5 per cent be put in the red “control” category, the highest level of public health restrictions before a complete lockdown.

But according to confidential provincial documents obtained by CTV News Toronto, they raised the threshold for exiting the lower orange “restrict” category and moving to the red “control” category in early November, from 40 cases to 100 new cases per 100,000 – a 250 per cent increase, and the test positivity rate from 2.5 per cent to 10 per cent – a 400 per cent increase.

They also increased the effective reproduction number (Rt) to be allowed in the lower orange “restrict” category from 1 to 1.2.

Indoor dining, gym activity, karaoke singing, movie theatres and casinos are permitted to operate in this orange “restrict” category.

Ontario Premier Doug Ford said Thursday afternoon that the suggestion cabinet raised restriction thresholds was “inaccurate” and that cabinet merely signed off on what was proposed by the Chief Medical Officer of Health, Dr. David Williams.

“This framework was given to us through Dr. Williams and his team and we went forward with it. That doesn’t mean… we can’t change this. Nothing in this pandemic is concrete,” Ford said.

He added that Dr. Williams has 70 doctors advising him, “telling him this, that and the other thing,” and Williams sought “balance” with the new framework.

COVID-19 tiers

Peel Region and soon, Toronto, now occupy the red category, with additional measures imposed by each region’s local medical officer of health.

The updated thresholds were widely panned by most epidemiologists, the Ontario Medical Association and went against even what Premier Doug Ford himself had said previously, where any region with a positivity rate of more than 2.5 per cent hit the province’s own “high alert” range for concern.

The higher thresholds were implemented as Peel Region’s major hospital networks said they could no longer accept any more COVID-19 patients and had transferred at least 20 hospital patients to other parts of the province.

The increase in the test positivity threshold even contradicted World Health Organization guidance, which states that a sustained test positivity of above five per cent should mean a jurisdiction should not relax public health measures.

The documents appear to support a report in the Toronto Star which suggested that the indicators adopted by the province were much higher than those proposed by members of its own health table and Public Health Ontario.

Ontario’s Health Minister Christine Elliott said the government considered a “wide variety” of factors before putting the plan into action.

“There were several numbers that were suggested to us but then there was also a consideration made of the issues on the other side with respect to mental health, the significant anxiety and depression levels that we were seeing that we also had to think about in making some of these recommendations,” Elliott said speaking to CTV News Toronto on Thursday.

“That is what was reflected in the final framework that was brought forward to me for consideration and that I then referred to cabinet without any revisions.”

Elliott argued that the framework presented by the Ontario government prevents the possibility of “prolonged, deeper periods of lockdown,” but stopped short of saying whether or not the proposed benchmarks would be changed in the face of record-breaking numbers.

“We are learning. So if we need to make changes we will but at the moment we are relying on the framework for decisions going forward.”

COVID-19

Public Health Ontario said Thursday it stood behind the comments one of its doctors made to the Toronto Star, which first reported the story, regarding relaxing of thresholds in the province's COVID-19 response framework, against the advice it provided to the Ford government.

Ford said the Toronto Star story amounted to one “doctor voicing her opinion,” and not the view of all of Public Health Ontario’s staff.

Dr. Williams said Thursday afternoon that Public Health Ontario staff had input on “numbers and metrics” contained in the framework.

“(The numbers) were ones that they had their input on, and we had those numbers put out,” he said when asked who changed the thresholds in the framework.

Michael Garron Hospital Physician Dr. Michael Warner said he feels the changes were made to help businesses stay open in more parts of the province.

“I think he moved the goalpost to allow for economic reopening in the short term and that is not a wise long term decision,” he told CP24. “It will lead to further lockdowns and further insecurity for all the businesses that are closed or on the verge of closing because the pandemic is out of control."

Official Opposition Leader Andrea Horwath said the changes amount to Ford and Elliott lying to the people of the province.

“Mr. Ford and Ms. Elliott lied, and decided to gamble with people’s lives. Now, we are headed towards a public health and economic catastrophe.”

She proposed targeted two-week lockdowns of everything but hospitals and schools in hard-hit areas, something Ford said Thursday he would not entertain.

Liberal Leader Steven Del Duca said the increased thresholds threatened vulnerable populations.

“Doug Ford ignored the advice of Ontario’s top doctors and then lied to us about it. His lie has led to skyrocketing COVID cases and a new wave of tragedy in our nursing homes.”

Ontario reported 1,575 new cases of COVID-19 on Thursday, its highest daily count yet.

Ninety-nine people have died of novel coronavirus infection in the province in the past seven days.

-- With files from CTV News Toronto's Colin D'Mello and Phil Tsekouras