TORONTO -- The CEOs of three major hospital networks in York Region are warning that the health-care system in the municipality is at a "tipping point” due to rising COVID-19 cases.

In a joint statement issued Tuesday, the CEOs of Mackenzie Health, Markham Stouffville Hospital, and South Lake Regional Health Centre said they are concerned that a significant increase in cases could impact the hospitals’ ability to carry out regular services.

“We have reached a tipping point in our efforts to manage COVID-19-related volumes at our hospitals — Mackenzie Health, Markham Stouffville Hospital and South Lake Regional Health Centre,” the statement reads. “After seeing a significant increase over the last week in the number of COVID-19 patients admitted to our hospital, we are concerned about how this may impact access to care like scheduled surgeries for all patients across our communities.”

While Toronto and Peel Region entered the grey lockdown category in the province’s tiered framework on Nov. 23, officials in York Region asked the province to leave the region in the less restrictive "red zone.” In doing so, they cited the fact that hospitals in the region were coping well as a strong indicator that York Region didn't need further restrictions.

York Region Public Health reported 193 news cases of COVID-19 on Tuesday. The region currently has 1,234 active cases, including 65 people who are hospitalized, with 10 in the ICU.

The latest data from the province indicates that York Region had a seven-day rolling average of 107.6 COVID-19 cases per 100,000 people for the period ending Dec. 4, an increase of 17.6 per cent from the previous week.

That compares to 119.9 cases per 100,000 people in Toronto over the same period, an 11.4 per cent increase from the previous week in Toronto.

Kurji: indicators for region ‘not looking too good’

Speaking with CP24 on Sunday, York Region’s Medical Officer of Health Dr. Karim Kurji acknowledged that hospitals in the region “are getting increasingly challenged,” however he said he is “not hearing the sort of crisis calls” that hospitals in Toronto and Peel were putting out ahead of their lockdowns.

He also said that he did not believe that a lockdown would help bring cases down because the region has not seen a strong link between retail, restaurants and gyms and case increases.

However speaking with CP24 again Tuesday evening, Kurji said a lockdown for York Region may be inevitable.

“We're also in discussions with the Chief Medical Officer of health, as we normally do every week, with respect to whether York Region should go into lockdown or not,” he said. “And at this point in time, our various metrics do not seem to be boding well for us. So we are on a path which may very well lead us to a lockdown, depending on the various processes and various monitoring that goes into making these decisions.”

Kurji suggested that the increased number of COVID-19 patients in York Region hospitals could be the results of people from outside the region seeking care there.

“The hospitals have been increasingly challenged as they have actually been taking patients from across the GTA,” he said. “So while our own York Region hospital patients, you know, may not have contributed as much to the workload compared to others around us, it is imperative that people follow the public health guidelines very stringently.”

Kurji did not say how many hospitalized COVID-19 patients are from outside the region. It’s also not clear how many York Region residents are hospitalized in neighbouring Toronto, where a number of hospitals are a closer drive for Markham or Vaughan residents than those in their own municipalities.

Vaughan Mayor Maurizio Bevilacqua and Markham Mayor Frank Scarpitti, whose cities border Toronto, have often repeated the rationale that a lockdown is not necessary because hospitals in the region are coping. However they have expressed concern that visitors from neighbouring municipalities in the highly interconnected GTA might travel to York Region to shop or use gyms.

While the letter from the hospital CEOs did not call for lockdown restrictions on the region, it did plead with the community to do its part in following public health guidance to avoid further spread of the virus.

“Our staff, physicians and volunteers are doing everything they can to continue providing exemplary care to patients and their families, but the mounting pressure from COVID-19 is taking a toll on many. For them and for everyone, as a community we must do better,” the letter reads.

“We are asking that you always wear a mask in public and when you cannot physically distance, and avoid social gatherings. We know that the greatest potential for this virus to spread is when people interact in groups of any size so in order to slow the spread, we must avoid these interactions.”