TORONTO -- As the medical officer of health for a region in Ontario hard-hit by the pandemic, Dr. Lawrence Loh has spent more than a year making difficult decisions and enacting strict measures in a quest to curb the spread of COVID-19.

The Region of Peel in Ontario has faced a punishing third wave with a positivity rate of 18.5 per cent as of Thursday morning, nearly three times higher than the province as a whole.

Dr. Loh, who has been in his role since March 2020 when the pandemic began, attributes the region’s high case counts to the types of industries located there.

“Peel has had a significant challenge with work that cannot be done from home,” he told CTV’s Your Morning on Thursday. “We have a large manufacturing, warehousing and distributing sector that has grown up around Pearson airport.”

Because of the essential nature of the work, Loh said a lot of these businesses have not been affected by provincial closures and shutdowns. What’s more, he said, many of the workers in these industries come from racialized or new immigrant communities and they are precariously employed to begin with, which means they’re less likely to miss work if they’re feeling unwell.

“The result is, that’s the perfect storm for interactions, for precautions that may not necessarily be foolproof, and therefore high rates of transmission,” he said.

In response to the spread, Loh has directed Peel Public Health to issue some of the strictest measures in the province throughout the pandemic. They have included bans on large wedding parties, shutting down bars and restaurants, closing non-essential businesses, shuttering schools, suspending crowded bus routes, and even temporarily closing down an Amazon warehouse.

More recently, Loh went further than the province’s restrictions when he ordered that any workplace in the region with five or more recent COVID-19 cases must shut down for 10 days.

Loh defended these tactics by arguing that the case counts would be even higher if they didn’t take them.

“The reality is that a disease that spreads from person-to-person really relies on contacted interaction in order to transmit and so the measures that you described that were necessary in our community's unique situation really helped to reduce discretionary contacts,” he said.

In addition to limiting potential contacts, Loh said the region has been focused on delivering vaccines to as many people as possible.

“As of today… All Peel adults over the age of 18 can now book in via the provincial system into our mass vaccination clinics, which have done 600,000 doses and continue to offer almost 18,000 doses a day across the system,” he said.

Loh said they also have booking and transportation networks to assist people in travelling to vaccination sites, as well as pop-up and mobile vaccination clinics that are administering doses in specific areas and workplaces.

As Ontario’s province-wide stay-at-home order is set to expire on May 20, Loh said he needs to see how effective the recent restrictions have been and how many people have been vaccinated in the region before he decides whether to request an extension.

“I think we're very optimistic. We've been here before here in the region of Peel. We're starting to see the curve bend, but of course, it’s very preliminary as a trend,” he said. “We really need people to stick to the measures, get their shot, and hopefully we'll be able to see more of a decrease coming down the other side.”

Loh also stressed that if the situation does improve in the coming weeks, any reopening shouldn’t be rushed.

“Any sort of opening would need to be gradual because that similarly is what got us, I think, get into some trouble with this third wave and we know that from international experience, opening gradually after increasing your vaccination coverage rates is ultimately the way to get out of this for good,” he said.