Two residents of a city-run long-term care home have died after contracting COVID-19, Toronto’s medical officer of health said Wednesday.

Both residents lived at the Seven Oaks long-term care home in Scarborough where public health officials earlier reported an outbreak. One resident and a health-care worker were earlier reported to have confirmed positive cases of COVID-19.

On Wednesday, Toronto Public Health said of the 249 residents at Seven Oaks, nine are confirmed to have the virus and four others are “presumed” cases. There are also four staff confirmed positive for COVID-19.

In long-term care homes, a COVID-19 outbreak is declared when there are 2 or more cases of COVID-19 in the home. In long-term care homes outbreaks, once 4 residents have been tested on the same unit/floor, it is assumed that any additional residents on that unit/floor who develop the same symptoms also have the same type of infection and that it is circulating. If additional residents become symptomatic on other units, testing will begin on that unit as well.

Another person, an “elderly” man with pre-existing health conditions who was tested at North York General Hospital, has also died, Dr. Eileen de Villa said.

“I offer my sincere condolences to the family and friends of these individuals on their loss,” de Villa said at city hall on Wednesday afternoon. “This virus is spreading in our city and this is why I continue to urge everyone to please stay home. When you don’t stay home, you are putting our most vulnerable residents at risk — our parents, our grandparents, people with compromised immune systems and people with chronic health conditions.”

That brings the total number of deaths in Toronto related to COVID-19 to four. The first-reported death was on March 22. A man in his 70s who had travelled to the U.K. died the previous day in Trillium Health Partners Hospital in Mississauga.

There were 319 confirmed cases of COVID-19 in Toronto, de Villa said — an increase of 39 cases from Tuesday. Of those, 22 patients were hospitalized. And 16 per cent of all cases can be attributed to community spread, she said.

“An outbreak within the context of a long-term care home is always concerning whether we’re talking about COVID-19 or any other infection,” de Villa said about Seven Oaks. She reiterated there are protocols in place to manage the situation — including enhanced monitoring, isolating residents in their rooms and increased cleaning.

Protocols also restrict those health-care workers with shifts at multiple long-term care homes to travel between them if one of those homes is experiencing an outbreak, de Villa said.

“I can assure you that we are absolutely working in concert with the team at Seven Oaks and we are implementing all the measures,” she said. “Everything that is expected, and that’s required and that’s meant to prevent the further spread of infection is being done.”

For all long-term care homes, staff who call in sick are also being asked specifically about symptoms and being offered testing for COVID-19, she said.

Another long-term care home in Toronto has also reported a confirmed case of COVID-19.

The president and CEO of Kensington Health, John Yip, advised families of the case at Kensington Gardens care home on Wednesday. It’s unclear if the case involves a resident or a staff member, but an email from Yip identified the affected area as being the western wing of the third floor at the 45 Brunswick Ave. building.

“Our team has taken swift action to halt the spread of the virus through rigorous infection management practices and procedures,” the email said. “Kensington is working in close partnership with Toronto Public Health and Ontario Health to ensure every possible step is taken to protect the health and safety of our residents.”

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Yip said anyone with respiratory symptoms or fever on the affected floor would be tested and residents had been isolated. He said every resident is already being screened daily, including a temperature check.

The facility is home to 350 residents, the Kensington Health website says.

While there continues to be travel-related cases, de Villa said Wednesday they anticipated the number of cases resulting from community spread would increase and she expects it will continue to do so.