TORONTO -- Ontario is in for "troubling times" if the province doesn't change course to help curb the rapid surge in COVID-19 cases, an infectious disease doctor warns.

Doctor Isaac Bogoch told CTV News Toronto on Monday that while strict lockdowns and stay-at-home orders aren't the only option for lowering cases, the province will have to consider more dramatic action if the healthcare system becomes stretched beyond capacity during the third wave.

"We're seeing a pretty significant rise in cases over a short period of time," Bogoch said. "Intensive care units are filling up again."

Bogoch said that some COVID-19 patients being treated in Toronto hospitals are already being moved to other areas of the province to free up space in intensive care.

According to provincial data, the highest number of patients being treated at the same time in Ontario intensive care units was back on Jan. 19, when 400 people were receiving treatment.

On that same date, Ontario was under a province-wide lockdown and a stay-at-home order was in effect.

More than two months later, as Ontario continues to push forward with reopening, there are now 382 people in intensive care. 

One week ago that number was at 298. 

"We're in for some troubling times if we don’t change course,” Bogoch said. 

What should Ontario do first?

Bogoch believes there are measures Ontario should take before resorting back to lockdown.

"I think several things need to be done simultaneously," he said. "It's never too late to start looking at the drivers of infection in your community and we have to deal with the upstream drivers of infection."

Bogoch said dealing with what drives infections takes commitment and money, but it's ultimately worth it. 

"There are certain policies that can help. For example, things like paid sick leave."

Bogoch said that better COVID-19 screening, testing and financial support are needed to help protect Ontarians and reduce case numbers.

He also believes that strongly promoting outdoor activity will help bring cases down. 

"We know the outdoors is just way, way safer compared to indoor settings," Bogoch said.

COVID-19 hospital

He believes that government's need to get creative and even "bend the rules," in a temporary manner, so that businesses can operate as much as possible outdoors.

"I would allow businesses to really take over sidewalks, streets, public places and public parks,” he said. "For the spring, I think it would be a very reasonable thing to move as many things outdoor as possible, and have a lot of tolerance for businesses moving into an outdoor environment."

"It's only temporary, only for a few months until we really ramp up vaccinations to protect a greater proportion of the community."

Lockdown is the last resort

If cases and hospitalizations continue to climb, Ontario will have to seriously consider bringing back a lockdown and stay-at-home order, Bogoch said. 

"You can't have your healthcare system stretched beyond capacity. We have to avoid that at all costs," he said. 

Bogoch said places around the world like New York and Italy have seen the "tremendous negative repercussions" an overstretched healthcare system has on citizens. 

He said it would result in the unnecessary deaths of not only COVID-19 patients but also an unacceptable number of fatalities in people with other conditions. 

He said while he understands the tremendous economic and physiological impact of lockdown, once the healthcare system is overstretched the government has to consider a shutdown. 

"You really don’t have many other options at your disposal that can rapidly lower case numbers," he said. "Unfortunately, that will have to be entertained if we continue along this path."

"You can't ignore it."

Bogoch isn't the only expert sounding the alarm over the worsening situation in Ontario hospitals.

Last week, President and CEO of the Ontario Hospital Association Anthony Dale said that the province's critical care system is reaching a "saturation point."

Dale said that hospital capacity is already "well beyond the threshold after which hospitals can operate normally."

"In the third wave, we are facing a different kind of pandemic," Dale said. "Patients are arriving at the hospital younger and sicker then in the previous waves."

"The health system will face punishing conditions in the weeks to come."

As COVID-19 cases have increased, the Ontario government has continued to relax restrictions. 

Nearly all non-essential businesses are allowed to operate in the province, regardless of if a region is in lockdown. 

Last week, the Ontario government said that outdoor fitness classes would be allowed to resume for regions in the grey zone. 

Hair salons will also be allowed to reopen on April 12.

Ontario did adjust its "emergency brake" system on Friday to allow the government to impose the public health measures found in the previously lifted province-wide shutdown.

This means that if a region reports a "rapid acceleration" in COVID-19 cases, or if its health system is at risk of becoming overwhelmed, all non-essential businesses can be shuttered by the province’s top doctor, in consultation with local medical officers of health.