The president of the Ontario Hospital Association says hospitals have been directed to “ramp down” all elective surgeries and non-emergency activities starting Monday amid the third wave of the COVID-19 pandemic.

“A major redeployment of staff and resources is required to provide care for a large wave of COVID patients requiring hospitalization,” Anthony Dale tweeted.

In a memo dated on Thursday, Matthew Anderson, Ontario Health’s president and CEO, said effective Monday, April 12 at 12:01 a.m. hospitals are instructed to ramp down on non-urgent activities, including surgeries.

“Given increasing case counts and widespread community transmission across many parts of the province, we are facing mounting and extreme pressure on our critical care capacity,” the memo read.

The memo noted the scale back does not apply to the Northern Ontario Health Region but cautions the region should be prepared to do so in the near future if needed.

Hospitals that specialize in pediatric patients were also advised to not ramp down any capacity and continue with plans to care for children and youth.

“These are very difficult and challenging times for all Ontarians, and we understand that deferring scheduled care will have an impact on patients and their families and caregivers,” the memo read.

As of Friday, there are 541 patients in Ontario’s ICUs with COVID-19 according to Critical Care Services Ontario’s daily report — the highest number seen in the entire pandemic. Patients admitted to ICUs in the province have surged in the last couple weeks.

The province also reported more than 4,200 new COVID-19 cases on Friday, the second highest increase in a case count since the pandemic began.

“This situation is extraordinarily serious and we ask for patience and support from the people of Ontario as hospitals grapple with this historic crisis,” Dale said. “Ensuring equitable access to critical care services is our paramount priority.”

Following the scale back directive, another physician Dr. Naheed Dosani said he has received calls from concerned patients living at home with serious illnesses who are “understandably upset that their surgeries/procedures will be canceled.”

The memo from Ontario Health prompted the College of Physicians and Surgeons of Ontario to issue a statement of support for doctors citing provincial consideration to enact critical care triage protocol.

“We firmly believe physicians need to be supported if they are required to make extraordinary decisions about which of their patients will be offered critical care resources that are in short supply,” Nancy Whitmore, CEO of the college said in her statement.

“Once the critical care triage tool is initiated by the command tables of the province, we are supportive of physicians acting in accordance with this protocol even when doing so requires departing from our policy expectations.”

Whitmore said these are extraordinary times requiring extraordinary decision-making. Despite no official word on triage from the province, the college said it would provide clarity and support to Ontarian physicians if the protocol is enacted.

In an email to Global News, Dr. Mary Grant, a radiologist in Ontario, said the college’s letter about possible critical care triage was upsetting to receive and she is urging the public to do their part in these “unprecedented times.”

“We all believe that the public needs to be made aware of our reality in the medical world,” Grant wrote. “We need public buy-in for this stay at home order, we need those who are eligible to get vaccinated, and we need folks avoiding activities for the short while that could result in trauma (need for an ICU bed).”

Premier Doug Ford declared a third state of emergency and implemented a stay-at-home order in effect for the next four weeks as the province struggles to bring down rising COVID-19 infection rates and hospitalizations.

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