KITCHENER -- After weeks of stabilizing COVID-19 case counts in Waterloo Region, new cases spiked over the weekend.

The region added 59 new cases on Saturday and 58 on Sunday.

It was the first time since March 11 the region reported more than 50 new COVID-19 cases in a day. The last time there were more than 50 new cases on two straight days was back in February, when the region reported 69 more cases on Feb. 24 and 77 on Feb. 25.

Speaking at the region's COVID-19 update on Friday, Medical Officer of Health Dr. Hsiu-Li Wang said the area was moving towards orange tier restriction levels, but said provincial officials look for stability for a period of about two weeks before deciding to move a region into a lower level of the colour-coded COVID-19 framework. Waterloo Region is currently in the red tier.

"The province generally looks for stability of indicators for a couple of weeks before moving an area to a lower level," Dr. Wang said Friday.

Dr. Wang also confirmed Friday the number of cases associated with a large cluster following social gatherings at the start of the month has doubled in size from 23 confirmed cases to 56 confirmed cases and two probable cases.

Regional officials urged people not to gather over Easter.

"We have seen what can happen and how quickly one case can lead to dozens when public health measures are not practiced consistently," Dr. Wang said Friday. "For all upcoming holidays or celebrations, celebrate only with those in your immediate household and gather virtually with all others. This is critically important to slow the spread of the virus and maintain the progress we have made to date."

Here's a look at the epidemiological indicators for moving between tiers in Ontario.

Green "prevent" tier:

  • Weekly incidence rate of less than 10 cases per 100,000 people
  • Less than 0.5 per cent positivity
  • Reproductive number less than 1.0

Yellow "protect" tier:

  • Weekly incidence rate between 10 and 24.9 cases per 100,000 people
  • 0.5 to 1.2 per cent positivity
  • Reproductive number around 1.0

Orange "restrict" tier:

  • Weekly incidence rate between 25 and 39.9 cases per 100,000 people
  • 1.3 to 2.4 per cent positivity
  • Reproductive number between 1.0 and 1.1

Red "control" tier:

  • Weekly incidence rate of more than 40 cases per 100,000 people
  • 2.5 per cent positivity or higher
  • Reproductive number of 1.2 or higher

Grey "lockdown" tier:

  • Adverse trends following a move into the red tier, including increasing weekly cases and positivity

On Friday, Dr. Wang said Waterloo Region had a weekly incidence rate of 38 per 100,000 people, which would put the area on the higher end of the orange "restrict" tier. As of Friday, the region had a 2.3 per cent positivity rate and a reproductive number of 1.0.

Waterloo Region has been in the red tier since the stay-at-home order was lifted in February.

The region reported 39 new COVID-19 cases on Monday, along with another death related to the disease.

As case counts rise, hospitals across Ontario have been asked to hold back 15 per cent of their acute care bed capacity in case space is needed.

"I think Ontario Health is doing a great job in coordinating our system response and we are treating it as an entire system," said Stephen Street, President and CEO of North Wellington Health Care. "A bed here versus a bed in Peterborough or Ottawa, we're all working tighter and right now it states locally to help each other meet capacity."

Street said Brampton has seen an influx from Peel Region.

"From time to time, they will be needing our capacity," he said. "Everyone is just working together to find that balance between maintaining that capacity and meeting the demands to catch on some procedures that have been delayed due to wave one and wave two cancellations."

Wellington-Dufferin-Guelph reported a combined 61 cases over the weekend, representing numbers from Friday, Saturday and Sunday. That keeps the area's trends in the orange tier.

Guelph General Hospital confirmed there are no COVID-19 patients in the ICU and they haven't had any recent requests from other regions to take in COVID-19 patients.

Waterloo Region has 24 people in the hospital, including six in the ICU.