Ottawa could have between 11,000 and 34,000 cases of COVID-19 right now, the city's medical officer of health said Wednesday.

Those figures are in stark contrast to the 429 confirmed cases announced by Ottawa Public Health (OPH) on Wednesday, but Dr. Vera Etches has been saying for weeks thousands more residents are likely undiagnosed.

The discrepancy is partly due of the limited criteria for testing suspected cases, Etches said.

Wednesday's update included one new death and 29 new recoveries.

Etches said projections show the city should be able to keep the number of cases relatively stable while hospitals build their intensive care capacity — if residents continue to practise physical distancing.

Without strict physical distancing, the pandemic won't peak in Ottawa until mid-summer or even early fall, Etches warned.

(The Ottawa Hospital)

With 50 per cent distancing — in other words, if only half of the city's residents practise proper physical distancing — there could be up to 4,000 deaths by October, and that doesn't include people who die outside hospital, the latest projections show.

Under that grim scenario, shown above in blue, Ottawa's hospitals would see 50 deaths a day from COVID-19, and would no longer be able to handle the volume of severe cases requiring intensive care.

At 60 per cent distancing, shown in orange, the city could see up to 2,000 hospital deaths.

With 70 per cent distancing, shown in green, Ottawa could hold the death toll to 200 and delay the pandemic's peak until February 2021.

In a presentation to council by phone on Wednesday, Vera Etches, Ottawa’s chief medical officer of health, said there could be as many as 34,000 cases in the city, though physical distancing measures will help hospitals manage the number of patients. 1:36

Etches said currently, about 85 per cent of residents polled report they're practising physical distancing. The projections come from a collaboration between OPH, The Ottawa Hospital and the University of Ottawa.

Expanding testing criteria

Etches said OPH is handling the current demand for testing well, and could soon expand eligibility to include people who live with health-care workers, and others providing essential services, such as grocery store employees.

She did not say when that could happen.

The wider region of eastern Ontario and western Quebec has 800 confirmed cases. There have been 13 COVID-19-related deaths in the region, seven of them in Ottawa.

.<a href="https://twitter.com/ottawahealth?ref_src=twsrc%5Etfw">@ottawahealth</a>, in collaboration with the Champlain Health Regional Incident Command, is working to ensure those who need testing are tested. Details are being confirmed and will be updated on our website when finalized. We are working to optimize our existing testing resources <a href="https://t.co/aHikGMqKrr">pic.twitter.com/aHikGMqKrr</a> —@VeraEtches

OPH was reporting just 194 cases last Wednesday. The public health agency tracks cases primarily based on when patients first experienced symptoms rather than on the date they tested positive, which accounts for certain discrepancies in its figures.