Public health officials in Waterloo Region are again reminding people not to gather with people outside of their immediate household.

The region recorded more than 180 new cases on Wednesday, a new record increase.

They say climbing numbers are likely a consequence of people's behaviour over the holidays, since cases typically reflect interactions from two weeks ago.

Medical Officer of Health Dr. Hsiu-Li Wang spoke at a regional Board of Health meeting on Wednesday, saying the region needs to remain in lockdown as cases continue to climb. Those cases are putting a significant strain on the health-care system,.

Delayed indicators like hospitalizations, ICU admissions and deaths will likely all increase in the coming weeks.

People should only leave their homes for essential purposes like work, school, groceries, medical appointments and exercise.

Dr. Wang said cases could get even higher.

"While the provincial shutdown is necessary, we cannot rely on the shutdown measures alone," she said. "We each have a role to play."

Many people said they did avoid gatherings over the holidays.

Dr. Wang said workplace exposures and outbreaks continue to be a cause for concern. She emphasized workers should be paid for sick leave.

“Those who don’t have access to paid sick time may be more likely to attend work when they have symptoms of COVID-19 or need to self-isolate,” Dr. Wang said in a news release. “Research shows that access to paid sick time can help reduce the spread of influenza-like illnesses in the workplace.”

"Consistently data has shown that some of our most vulnerable citizens are most susceptible to COVID-19, but they are typically least able to afford to stay home without pay if they fall ill," Kitchener Mayor Berry Vrbanovic said.

The board will be urging the province to provide more support on that front.

Coun. Sean Strickland called for an action plan to stop the spread of COVID-19 in workplaces, saying many people may not be gathering socially, but are going into work and having contact with people there.

"It's a mixed message: keep your bubble small but still go to work," Strickland said.

Dr. Wang said about 85 per cent of workplace outbreaks have occurred in November and December, but added the outbreaks don't tell the full story.

"For example, on Jan. 5, we had 10 workplace outbreaks but there were a total of 145 workplaces where at least one employee had tested positive, 75 of which have two ore more employees who have tested positive," she said.

The sectors with the most outbreaks are manufacturing and industrial, food and beverage services, sport and fitness settings, food processing, and trades and construction.

He suggested tools like rapid testing in workplaces.

Dr. Wang said that's being tested the provincial level right now.

Councillors also discussed whether or not to name more workplaces with outbreaks, pointing out other jurisdictions that do. Others said that's not fair.

Dr. Wang said the current policy is based on the risk to the general public or the need to find people who may have been exposed.