My biggest concern in Toronto at present: the public doesn't understand the acuity of the situation, and are therefore understandably upset at current developments. So I will try and outline my understanding of the current situation:

Testing: we have a 7-day average of about 240 cases/day. This is an underestimate of the number of tests, because of a) backlog, b) system challenges that are dissuading people from being tested, c) over-weighing of younger cases, which makes asymptomatic cases more likely.

Regardless, our testing system is overwhelmed, and so we have no gauge on our gas tank.
The number of cases has totally exhausted @TOPublicHealth capacity. https://twitter.com/kellygrant1/status/1312443142554042369?s=20. So not only no gas gauge, but we also don't have a map for where we are going.

On top of this, b/c our society has been pretty unfettered and free, most cases have had > 20 people who they were in close enough contact with in the days prior to being tested/symptomatic. This is a major challenge for not only contact tracing but, more importantly, for growth.

As the growth of cases increases, it means possibly an "essential" worker is out of commission. Or they are introducing it into a nursing home. Which is a big deal, because we now have 45 nursing homes in ON in outbreak. https://twitter.com/NathanStall/status/1312400683417718788?s=20

This is a big deal because many patients who are in hospital are waiting to be transferred to a LTC bed. That list is growing, and will grow exponentially. That will further strain hospitals, which is already at the breaking point in Ottawa, and we are at 90% capacity in TO.

As @covid19mc showed the past week https://twitter.com/covid19mc/status/1309481361313599489?s=20 growth of cases and the ↑ strain on hospitals will mean surgeries and other non-emergent healthcare will suffer, as everything backs up further. Who will provide all this care? Same workers who are getting infected.

Additionally, as these cases rise, we have more schools in outbreak mode. This will mean more kids at home, and their parents (read "some who are healthcare workers or teachers") at home.

This is why we are at a critical time in our city's (and province's) history. Even if most infected don't go into hospital or die, the effect on the entire system is massively profound, and cannot be ignored. Israel and European cities like Madrid have discovered this already.

@fordnation @JohnTory and other leaders have a choice: leave it to the public--who feel that the issues are only about civil liberties--or make tough decisions because it is about our civic health. @IrfanDhalla @BogochIsaac @DFisman @DavidJuurlink @picardonhealth @TorontoIDDoc