TORONTO -- Quebec has the most number of active cases of COVID-19 per capita -- nearly three times as many as Ontario, followed by Manitoba and Alberta, as a second wave of infections surges across most non-Atlantic provinces.

Three months after the number of new cases in Canada fell to its lowest levels since March, several provinces have hit record new daily cases and are experiencing an overall spike in infections that exceed or is close to exceeding the numbers seen this past spring.

A snapshot of where provinces stand since mid-July shows Quebec, Manitoba, and Alberta leading in the number of reported active cases per 100,000 people by a substantial margin.

Quebec had 8,492 active cases, or 99.3 cases per 100,000, on Oct. 8 (the most recent complete data available for all of Canada), an increase of 450 per cent from mid-July when that figure stood at 18 per 100,000. It is nearly triple that of Ontario, which reported 5,442 active cases, or 36.9 infections per 100,000, on Thursday. Quebec’s seven-day average number of new cases sat at 1,110, or 13 new infections per 100,000, its highest level since the start of the pandemic.

Montreal, Quebec City and many regions in between are now designated “red zones” by the province. Tougher measures, including the closure of restaurants and bars, and high school mask requirements, are set to kick in within those areas in the coming days.

Manitoba has the second-highest number of active infections, at almost two-thirds of Quebec on a per capita basis. The prairie province once had the lowest number of cases among non-Atlantic provinces, with less than one case per 100,000 for much of April through July. It reported zero new cases for nearly two weeks in the first half of July, before the number of infections began rising.

The province saw its first spike in late August, following several outbreaks, clustered primarily around Winnipeg, Brandon, and several Hutterite communities. The second spike came at the end of September, with Winnipeg -- where the bulk of the active cases are located -- seeing a test positivity rate of three per cent, according to the province’s chief provincial public health officer, Dr. Brent Roussin. Test positivity is a percentage of the tests that come back positive. With 863 active cases on Thursday, or 62.6 per 100,000 residents, Manitoba has seen the most dramatic rise in infections per capita.

Alberta, which had almost the same number of infections as Quebec in mid-July on a population basis, now has half the number of active cases as Quebec. Still, Alberta has far more cases per capita than many other parts of Canada with nearly 47.4 active cases per 100,000 people, or 2,097 residents who were positive on Oct. 8. That same day, Alberta reported a record 364 new cases, prompting chief medical officer Dr. Deena Hinshaw to introduce voluntary measures in Edmonton encouraging masks, and limits to gathering sizes and cohorts.

Ontario, which reported a record number of new cases for the second straight day on Friday, had 5,442 active infections on Oct. 8, or 36.9 cases per 100,000 residents. Toronto, in particular, has seen a concerning surge in cases, prompting public health officials to urge the province to tighten restrictions again. Some pockets of the city are seeing 10 per cent of tests coming back positive, according to a report by The Toronto Star, and hospitalizations are once again climbing.

“We are at 100 per cent critical care bed capacity in my hospital today. Multiple others in GTA are over 90 per cent. PLEASE don't make it a SuperSpreader weekend. Make it simple, small, and safe,” CTV News infectious disease specialist Dr. Abdu Sharkawy tweeted on Thursday.

Eighty percent of the total number of cases being reported in recent weeks are coming from Ontario and Quebec.

“Both provinces have also observed a rise in the number of hospitalized cases over the past several weeks raising concerns about straining health system capacity if the upward trend continues,” Canada’s chief public health officer, Dr. Theresa Tam, said in a statement Thursday.

The last time CTVNews.ca examined a regional breakdown was on July 17 after provinces began slowly reopening their economies and when an uptick in infections in some provinces hinted at what was to come. At the time, Alberta had the most number of active COVID-19 cases per capita in Canada, roughly double that of Ontario.

SNAPSHOT OF THE REST OF CANADA

In British Columbia, there were 1,394 active cases, or 27.2 per 100,000 residents on Oct 8; in Saskatchewan, 143 residents, or 12.1 per 100,000, were currently infected. The Atlantic provinces and the territories managed to avoid a major outbreak for much of the last six months, reporting zero to less than half a dozen active cases in each region.

New Brunswick, which had reported fewer than five new cases a day between June 9 and Oct. 6, confirmed 17 new cases on Wednesday, its highest tally ever. The cases were tied to an outbreak at a special care home in Moncton.

Overall testing per capita has also increased significantly since the last snapshot. Quebec tested 350 people per 100,000, compared with 175 in mid-July; Ontario tested almost 329 residents per 100,000, up from about 211. Alberta tested 222 people per 100,000, up from 107, while British Columbia tested more than 237 people per 100,000, up from 61.

An average of 71,000le have been tested daily over the last week, said Tam, with 2.5 per cent of those testing positive.

But in some of the busiest regions in Canada, like Ontario, there has been a backlog in processing these tests, prompting the provincial government to send some of them to the United States. In Toronto, many testing centres were no longer accepting walk-ins amid long lines and wait times that lasted hours.

On a per capita basis, there are now 48.6 active cases per 100,000 people in Canada, up from 10.7 in mid-July. At that time, the seven-day daily average number of new infections per 100,000 was less than 1.The national average now stands at more than 2,000, or close to six cases per 100,000 people, surpassing the previous peak in May. Health officials worry that if case numbers keep climbing, infections will once again spread to vulnerable segments of the population.

Graphics by Mahima Singh

With files from Phil Tsekouras in Toronto, Danton Unger in Winnipeg, Diego Romero in Edmonton, and The Canadian Press