As the number of new cases in Toronto reaches unprecedented levels, the city is preparing to announce its preferred approach to reopening, originally set for Saturday.

, the city’s medical officer of health, said Monday that as the pandemic drags on she fears residents will start to see alarming case counts — 504 new cases reported Monday — as normal, but she urged people to remain vigilant as she and other city officials promised to detail next steps on Tuesday.

De Villa said there had been almost 1,350 cases over the last three days, what she called “the most concerning I’ve seen here in Toronto since the pandemic started.”

“Five hundred confirmed cases in one day is not a number that can be ignored or rationalized. We’re in a high-risk situation. It is not time to panic, but it is time to act.”

But de Villa would not say Monday whether she would recommend indoor dining or gym classes be allowed, or impose further measures on those and other activities as has been done in Peel Region. But she did suggest that relaxing the rules is not in order.

“I believe that if we’d seen these numbers in April, or May or even August we all would have found the case counts extremely worrisome. I don’t think the current case counts point us towards relaxing the roadblocks we’re putting up in front of the virus,” she said at a Monday press briefing. “The extra time we asked for shows that we have not reached that point yet.”

The province earlier announced a colour-coded framework for reopening that saw restrictions lifted in many areas this weekend despite a rise in cases. Toronto was omitted from the new stages after city officials asked for another week to assess the situation locally.

Under the new provincial rules, which are set to come into effect on Saturday, Toronto would fall into the “orange” or “restrict” category, which includes allowing up to 50 people dining indoors and 50 people at gyms.

City officials said Monday they continue to seek further legal and public advice.

“Every option is actively being considered so that we can assure ourselves that we are making the best decision,” de Villa said.

promised “strong, responsible” action based on the best available advice in public health and law, and that conversations with the province remain “constructive.”

As Brampton saw cases continuing to spike, Dr. Lawrence Loh, Peel Region’s medical officer of health, issued new directives on Saturday that impose restrictions on residents and businesses beyond the province’s new framework.

“Concerningly, in the past week area hospitals have begun to reach capacity as a direct consequence of a surge in COVID-19 admissions,” the letter from Loh reads. “This means any further growth of the COVID-19 pandemic in our community will overwhelm our efforts to keep our community safe, ensure access to hospital and health-care services and prevent mortality.”

Despite warnings from the Ontario Hospital Association about health system capacity, Peel joined other areas in reopening this weekend as the only region in the “red” or “control” category under the province’s newly announced “Keeping Ontario Safe and Open” framework.

The red category amounts to a modified stage 2, but one that is different than what is currently in place in Toronto. It allows up to 10 people to dine indoors and 10-person gym classes.

Loh’s letter said the new provincial framework “may result in a small but material reopening of certain high-risk businesses” which he said needed to be countered with additional measures to prevent risk of spread. That includes, for example, directing all wedding celebrations in businesses be prohibited and specific new measures for group gym classes, though they continue to be discouraged.

He also issued advice to residents — which is not enforceable — to not gather outside their household, asked bars and restaurants to limit seating to those within the same household only and recommended religious groups move services online.

Speaking to reporters Monday, Premier Doug Ford reiterated confidence in the province’s plan, calling it a “very good framework.”

He said his government continues to collaborate with Tory and de Villa.

“We’re going to communicate and make sure that we’re all on the same page at the end of the day,” Ford said. “Dr. de Villa has the authority and the power to change things if she’s not comfortable.”

The city and province have previously disagreed over who has the ultimate authority to impose sweeping measures, which caused a week-long standoff earlier this fall when de Villa urged Ford’s government to return Toronto to stage 2 under the old rules.

Natalia Kusendova, the PC MPP for Mississauga Centre, posted a video to her Twitter account on Sunday singling out Dr. Loh and making it clear the government was not responsible for imposing additional measures on religious services or other activities.

Asked about Loh’s directives on Monday, Ford said he respected Loh’s advice.

“I support what he has done and we’re going to move forward with the guidelines that he’s recommending.”

Jennifer Pagliaro is a Toronto-based reporter covering city hall and municipal politics for the Star. Follow her on Twitter: