Toronto’s top public health official is urging residents to limit their contact with people outside their immediate household as the city reported its highest daily number of COVID-19 cases since the pandemic began.

During the city’s coronavirus briefing on Monday, Dr. Eileen de Villa said the concept of bubbles or social circles of up to 10 people was a sensible and effective approach last spring to help establish contact and reduce isolation during the lockdown.

Those in the bubble, which may include those outside the immediate household, are allowed not to keep their distance.

However, with businesses and schools reopening and the continuing surge of COVID-19 cases fall and, the doctor said, “times have changed.”

“We have to acknowledge that the extent of the infection spread. And the nature of city life means that the concept of the bubble or the social circle no longer reflects the circumstances in which we live,” de Villa said.

“That is what you need to think about before you make a decision to go anywhere. Where you go in the city is less important than what you do when you are there.”

Toronto Public Health announced 381 new cases on Monday, which is the highest daily count recorded to date in the city since the beginning of the pandemic.

It brought Toronto’s COVID-19 total to 19,033. Of those cases, 3,000 infections were recorded in September, de Villa noted.

The doctor asked residents to continue following public health measures, especially keeping distance with people they don’t live with to protect themselves from the disease.

The Ontario Hospital Association called on the province on Monday to reinstate Stage 2 restrictions across the Greater Toronto Area, and Ottawa as COVID-19 cases continue to surge.

When asked about it during the city’s coronavirus briefing, de Villa said it should be put into consideration what are the social and economic effects of another lockdown.

“The challenge is one of establishing the best balance between COVID-19 control measures and ensuring that people have access to the things that actually promote and sustain and maintain health,” de Villa said.

De Villa also proposed further restrictions on restaurants and bars, which she will present to city council later this week for approval.