An Ontario cancer surgeon is sounding the alarm over hospital capacity, warning that the province’s record high COVID-19 case count has placed the healthcare system at a “tipping point” and relaxed provincial restrictions could once again lead to overwhelmed emergency rooms.

Dr. Shady Ashamalla, head of general surgery at Sunnybrook Health Sciences Centre, told CTV News Toronto that hospitals are currently in a “sweet spot” where critical surgeries are being performed, while space for COVID-19 patients is still being maintained. 

But Ashamalla warns that the growth of cases during the pandemic’s second wave has led to anxiety among his patients, who recall the cancellation of surgeries during the first wave. 

“Our phone is ringing off the hook with people very anxious to have their surgery done immediately because they’re terrified that two, three, four weeks from now they won’t be able to get their operation,” Ashamalla said. 

Their fears, Ashamalla said, are based in reality as the province’s positivity rates and reproductive number remain at concerning levels. 

“Day over day we are getting worse. The seven day trends are getting worse,” Dr. Ashamalla told CTV News Toronto. “And for the government to allow indoor activity without a mask, we know that increases transmission [which] comes with an increased hospitalization rate -- and we know we can’t sustain these numbers forever.”

Already, the William Osler Health System -- which encompasses hospitals in Etobicoke and Brampton -- are at capacity and have begun transferring patients to other regional hospitals, which have also approached capacity.

Our @THP_hospital is at capacity. Please help stop the spread of the virus. https://t.co/4GrqyFyEfn

— Bonnie Crombie ���� (@BonnieCrombie) November 7, 2020

There are currently 374 novel-coronavirus patients in the province’s hospitals, far below the 1,043 patients who were hospitalized during the peak of the first wave. 

Over the weekend, the Ford government implemented a new colour-coded COVID-19 chart, which loosened restrictions on hotspot regions such as Peel Region, York Region and Ottawa.

Under the new framework, the most stringent measures would still allow for indoor dining, the usage of gyms and the re-opening of casinos -- albeit with strict capacity limits. 

The framework has been heavily criticized for it’s pandemic benchmarks which some infectious disease specialists and public health experts have argued will allow the virus to spread uncontrollably before triggering public health measures. 

Ashamalla says while the government’s drive to avoid a full lockdown is the “right idea” he also believes some of the benchmarks -- including the requirement that a region should carry a 10 per cent positivity rate before being designated a “red zone” -- are too high. 

“That's an astronomical number, that is a disaster number -- 10 per cent,” Ashamalla said. “It's like setting your smoke alarm to go off only when your house is on fire.”

On Friday, Premier Ford defended the new framework as “preventative maintenance” and said it was designed to avoid “an inferno” of COVID-19 by blanketing hard hit regions with additional support. 

“When we see issues, to jump in there, to put more contact tracers in there, add more pop up [testing] centers in the hot areas,” Ford said.

As a cancer surgeon, however, Dr. Ashamalla wants to avoid the postponement of surgeries and said the government should clamp down on indoor activities where patrons are allowed to remove their masks.

“When someone has cancer, if you don’t take it out with surgery that has a hundred per cent mortality,” Ashamalla said. “It’s very difficult to tell people we are prioritizing indoor dining over taking out their cancers.”

“It’s a very difficult conversation to have.”