KITCHENER -- Waterloo Region's top doctor warned Wednesday that the Region of Waterloo is facing the "real possibility" of a lockdown as COVID-19 continues to spread.

During a Board of Health meeting, Medical Officer of Health Dr. Hsiu-Li Wang called the situation "serious," saying that the region's red "control" zone indicators have worsened since it made the move.

There are no specific criteria for a move from red to lockdown laid out in the province's Framework for Reopening.

Instead, there are a number of factors to keep an eye on, including an increasing weekly case incidence or test positivity rate, especially in people over 70, increasing outbreaks among vulnerable populations and the risk of the hospital or ICU capacity being overwhelmed.

These indicators are generally assessed based on the prior two weeks, but trends are rapidly getting worse, a region can be escalated more quickly, as the region saw with its rapid move from yellow to red.

WHAT A LOCKDOWN WOULD MEAN FOR WATERLOO REGION

The biggest immediate change would be that organized indoor events or gatherings would be banned, except for with people who live in the same household. Virtual and drive-in gatherings would still be permitted.

A maximum of 10 people would be able to gather outside as long as they could maintain physical distancing, but Waterloo Region residents would be encouraged to only leave their homes for essential purposes like work, groceries, exercise and medical appointments.

Restaurants would be forced to close both indoor and outdoor service, reverting back to take-out, drive-thru and delivery methods. Facilities for indoor or outdoor sports and recreational fitness activities would be closed, with very few exceptions. Ice rinks, ski hills and snow trails would still be open with some restrictions in place.

In-store shopping at retail stores would be banned, meaning those businesses would have to go back to curbside pickup or delivery methods, as was seen in the earlier stages of the pandemic.

The same would go for stores inside malls, the province's website shows. The mall itself would be open, meaning people could come in to access food courts for takeaway, pharmacies and dentists. Malls will also be allowed to establish indoor pickup points for those who are buying from stores within.

In-person retail shopping would not be allowed in malls.

There would be exceptions for supermarkets, grocery, hardware and convenience stores, alcohol vendors, pharmacies and safety stores. Those stores would have a 50 per cent capacity limit.

Farmers' and holiday markets would be open with some restrictions, while garden centres and car sales would be allowed to have people indoors by appointment.

Personal care services and casinos would have to close under a lockdown.

All information is based on the province's COVID-19 response framework.

HOW LIKELY IS IT TO HAPPEN?

As Dr. Wang mentioned, the region's indicators are getting worse.

A weekly incidence rate of 40 per 100,000 or more is the baseline for the move to the red "control" zone, as is a positivity rate of 2.5 per cent or more.

Waterloo Region's estimated population last year was 617,870. There were 518 cases reported in Waterloo Region from Nov. 25 to Dec. 1, which would put the weekly incidence rate per 100,000 at almost 84.

Those numbers are subject to change as the region updates previous days' totals when they receive the latest information.

As for its positivity rate, the region's online COVID-19 dashboard shows its seven-day rolling average is at about four per cent.

A doctor at the forefront of critical care said Wednesday that nearly all of the region's hospitals with critical care units are working at or above capacity.

There have been more than 3,700 cases of COVID-19 in Waterloo Region to date. Of those, over 500 are still active in the region.

RESIDENTS RESPOND TO POSSIBILITY

Some residents who spoke to CTV News Kitchener said they think the region should move into a lockdown now to "take control" of the spread and prevent people from gathering.

"People are not listening, they're not following the rules," one person said. "Once you open up again and then they start gathering in crowds and more crowds and then you're back."

Others, however, feel the restrictions have been in place for too long.

"I don't think it's right for the mental state of anyone in this region or any region," a resident said. "I feel bad for small restaurant businesses and small stores."

People also said they would adapt to a move into lockdown, as they have been all year.