An Ontario health unit said Monday it would reinstate capacity limits and other public health rules amid a surge of COVID-19 cases, while another mulled a similar move.

Algoma Public Health said cases are rising, particularly in the northern city of Sault Ste. Marie, Ont., and measures are needed to prevent more infections and protect the health system.

“I continue to urge all Algoma residents to take immediate action to stop this surge of transmission, and help protect the vulnerable members of our community, and preserve our health care capacity,” Dr. Jennifer Loo, the area's medical officer of health, said in a written statement.

“Stay home if you have any symptoms, cut down on gatherings and encounters where you have unmasked, face-to-face close contact with people you don't live with, and please get fully immunized and help others to do so.”

Loo has ordered businesses in the Sault Ste. Marie area to reinstate by Wednesday capacity limits lifted by the provincial government last month. Masks must also be worn indoors and outdoors at businesses and organized events where people can't keep two metres apart.

Loo also issued an order requiring people with confirmed or suspected COVID-19, or identified close contacts of an infected person, to isolate or be fined up to $5,000 per day.

Another rule was amended requiring organized sports participants aged 12 and older to be vaccinated against COVID-19 or have a medical exemption.

The health unit said COVID-19 activity is currently “the highest that it has ever been since the beginning of the pandemic,” with 155 active cases as of Sunday and a rate of 121 cases per 100,000 people.

It said all communities covered by the health unit are at risk due to regular travel and residents of all ages have been affected, with particular strain on the local hospital.

Sault Area Hospital CEO Ila Watson said the surge in hospital admissions that's anticipated to continue “may lead to the cancellation of elective surgeries and procedures.”

Eighty-six per cent of eligible people in the Algoma health unit were considered fully vaccinated as of Monday, according to provincial data.

Last week, the public health unit covering Sudbury, Ont., also reinstated capacity limits based on an unprecedented surge in cases.

That uptick had affected 80 school, daycare and bus cohorts as of Monday, with 45 cohorts dismissed over the weekend, according to the region's top doctor.

Dr. Penny Sutcliffe also said Monday that the province and neighbouring health units were providing assistance with contact tracing.

“We are following up on approximately 1,500 contacts of cases in our area right now,” Sutcliffe said in a video update Monday. “That is tremendous.”

Elsewhere in the province, the Southwestern public health unit was also considering adopting new measures as of Monday.

The medical officer of health for the counties of Oxford and Elgin said the positivity rate in daily COVID-19 tests in her unit was continuing to climb every week, reaching about 5.1 per cent recently.

“Our (epidemic) curve is definitely on the upswing,” Dr. Joyce Lock said in an interview. “We continue to see cases in our region which are at a higher rate that has been has been reported for the rest of Ontario.”

Lock said her team is looking at the local data to see what additional measures can help in stopping the spread of the virus and reducing the pressure on local hospitals.

St. Thomas Elgin General Hospital, one of three hospitals in the region, said it's facing a dire situation, with the highest number of patients requiring critical care since the start of the pandemic.

“We have reached our capacity to care for critically ill patients and our hospital is operating above capacity - both of which are the direct result of COVID-19,” Dr. Waleed Chehadi, chief of staff at the hospital, said in a written statement.

“COVID -19 admissions have risen significantly over the course of the week and are expected to continue to rise over the next several weeks. The reality of this means patients will need to be transferred to other hospitals and receiving care outside of the community.”

As of Sunday, 87 per cent those eligible to receive a COVID-19 vaccine in the Southwestern Public Health unit had received at least one dose and 84.1 per cent had received two doses.

Premier Doug Ford has said he wants to avoid bringing in broad lockdowns again and if any eased public health measures need to be brought back in, that will be done in a localized way.

Chief Medical Officer of Health Dr. Kieran Moore recently reiterated that, saying the battle against COVID-19 will now be fought with local measures.

“At a provincial level, I honestly don't see us stepping backwards,” he said last week as the province announced pause on further reopening.

Nightclubs, strip clubs, sex clubs and bathhouses were due to ease capacity limits this week but those limits will now be in place for at least another month.

This report by The Canadian Press was first published Nov. 15, 2021.