KITCHENER -- Region of Waterloo Public Health reported 68 new cases of COVID-19 on Thursday, a drop compared to the 90 cases reported the day before.

Thursday's update brings the total number of lab-confirmed cases in the region to 4,739 since the pandemic began. The total includes 4,118 resolved cases and 139 deaths.

That leaves 478 active cases in the region. Of those, 38 people were in hospital, the region's online dashboard showed Thursday. Ten of the hospitalized patients were being cared for in the ICU.

The number of hospitalizations is room for concern, Waerloo Region's top doctor said on Wednesday.

"Our health-care system is under a very heavy strain," Medical Officer of Health Dr. Hsiu-Li Wang said while speaking to regional council on Wednesday night.

She warned residents to prepare for the possibility of a lockdown.

Dr. Wang said hospitals will likely be overwhelmed if case counts aren't brought down. She said the Region of Waterloo is following similar trends as other communities that have already moved into the grey lockdown tier.

On Thursday morning, the Ontario Hospital Association called for the province to impose a lockdown in areas that were currently in the red zone, including Waterloo Region and Wellington-Dufferin-Guelph. But speaking during his daily news conference, Premier Doug Ford said he wouldn't make any "snap decisions" on lockdowns.

The number of outbreaks also dropped slightly in the region on Thursday, from 31 to 29. One outbreak at a congregate setting was declared over, as were two other outbreaks: one at KidsAbility and one at BrightPath child-care centre.

At the same time, public health officials reported that an outbreak had been declared at Hillcrest Public School in Cambridge after two cases there were identified in the same cohort.

That outbreak was announced on Thursday morning.

The latest updates come hours after the region's top doctor warned residents to prepare for the possibility of a lockdown.

This is a developing news story. Check back for more details.