The city is investigating its first reported cases of COVID-19 in a homeless shelter, a long-term care facility — and a paramedic.

Toronto Public Health made the announcement Friday afternoon.

As of Friday at 1 p.m., there were a total 161 reported cases of COVID-19 in Toronto and 10 people in hospital, Dr. Eileen de Villa, the city’s medical officer of health, said at city hall. The total number of reported cases increased by 33 since Thursday.

De Villa said she is now completely confident there is evidence of community transmission in Toronto, in addition to travel-related cases.

“My team is actively investigating all possible contacts to assess potential health risks and will follow up directly with those who require further action,” de Villa said of the new cases.

The city says it is working to contain an outbreak at the Seven Oaks long-term care facility operated by the city in Scarborough, where a resident tested earlier this week is now confirmed to have COVID-19.

Outbreak protocols have been triggered, which includes isolating all affected floor residents. It’s not clear how many others have been tested at this point, but de Villa said if others develop symptoms they would be tested. De Villa would not say if the infected person had been removed from the facility.

“I am 100 per cent confident that my staff are working well with the long-term care home providers to ensure that every measure is being taken,” she said.

The city has also been preparing for the possible spread of the virus in the city’s shelter population and made significant changes this week. It has opened five additional sites and a separate shelter space for those being tested for COVID-19. There is another site that was secured Friday for shelter clients to recover from COVID-19, officials said.

The person experiencing homelessness who tested positive was in the city’s shelter system and de Villa said they were working with the Fred Victor Centre — which operates several emergency shelters, respites and drop-ins and other programs in the city.

De Villa said all protocols were in place, including screening of clients, at the shelter when the affected person was checked in. She said other people connected to the shelter are under investigation.

Toronto Public Health said it is following up with the facility where the person was staying to ensure the proper protocols are in place, including enhanced cleaning and disinfection.

The affected client was staying in the separate isolation facility while awaiting their test results, said Mary-Anne Bedard, who heads the city’s shelter, support and housing division.

Bedard said they continue to assess what she called an “evolving” situation and will change their response to temporarily scale up the number of available shelter spaces to allow for appropriate distancing as needed.

“We will take whatever steps we have to take to keep people safe,” Mayor John Tory told reporters earlier on Friday when asked whether further measures — like making hotel floors or student dormitories available — could help space out the homeless population given the permanent shelter system is already at capacity.

Toronto Paramedic Services Chief Gord McEachen says they were contacted March 19 by that paramedic and that the member had been in touch with Toronto Public Health and were following its advice, including remaining in self-isolation.

It’s not clear where the paramedic worked or when they were last on shift. City officials did not confirm how they are believed to have contracted the virus and whether it was travel or community related. It’s also not clear if any other paramedics or others are in self-isolation as a result.

McEachen said they’re not concerned about the level of service they will be able to provide ongoing.

A press release noted that paramedics are “highly trained” and provided with personal protection equipment, including masks and gloves. Pre-shift screening has been implemented at all Toronto Paramedic Services’ facilities, the release said, including mandatory assessment and temperature reading.

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On Friday, De Villa urged anyone returning from March break to follow public health recommendations as officials brace for an increase in cases.

“If you were returning from travel, you must stay home for 14 days even if you do not have symptoms of illness,” said de Villa. “We’re asking you to do this to protect yourselves, your families and our community.”

People travelling are likely to have gone through areas where COVID-19 is circulating, she added.

She asked friends and family of those people returning from travel to encourage them to stay home and offer to drop off groceries and supplies they may need.