TORONTO -- Dr. Eileen de Villa says March 23, 2020, will forever be etched in her memory as it was the day that she made the unprecedented step to advise Mayor John Tory to declare a state of emergency due to the coronavirus crisis.

One month into the state of emergency, city officials on Thursday reflected on the declaration that they said changed the lives of Toronto’s three-million residents.

“I distinctly remember the day that everything changed for all of us. The day that I knew I needed to ask each and every one of you to take extreme actions to protect our city’s health,” de Villa said.

“I knew I needed to focus on my patient as your medical officer of health," she said. “My patient is our whole city.”

COVID-19 cases have risen since the state of emergency was enacted. There were only 304 cases in the city a month ago. But, since then, more than 4,000 cases have been reported.

Toronto Public Health said Thursday there are now 4,347 COVID-19 cases. Of those cases, 293 are in hospital with 106 in the intensive care unit.

The city has recorded 222 deaths.

De Villa said the number of COVID-19 cases in Toronto is lower than originally expected.

Tory said the sacrifices residents made over the past month appears to be paying off after models projected earlier this week that Toronto is flattening the curve.

Despite some who continue to break COVID-19 restrictions, the mayor said most residents have embraced public health guidelines, adding that he has heard about many acts of kindness during the pandemic.

“It’s been incredible to witness how our great city has responded to COVID-19. How we have focused on what’s important and that in particular includes protecting and helping many of our most vulnerable people but protecting the health of everyone,” Tory said.

The mayor acknowledged that the city is paying a hefty price tag due to the COVID-19 measures. The city had previously said the pandemic would cost at least $1.5 billion.

Tory said the city would need the help of other levels of government to recover. He said he is supportive of a request for a $10 billion to $15 billion backstop for Canadian cities.

“None of these decisions were taken lightly, and I made them all based on the advice of our public health officials led by Dr. de Villa,” he said.

Tory encouraged residents to continue to adhere to physical distancing guidelines, which have saved thousands of lives.

When asked when the order will be lifted, Tory said he does not know.

The mayor said the city will work in collaboration with the province to come up with a plan that is effective and organized but also is sensitive to the needs of public health.

“A large number of the people that will determine the date when it comes are the three million people who live in the city of Toronto,” he said.

“Because by adhering to self-distancing and to self-isolation and to the staying at home and to the shopping once a week, guidelines and requirements set out by public health, they will expedite that when that day comes.”

Toronto’s long-term care homes report more deaths

Looking back, De Villa said the declaration helped to curb the spread of the virus in the community, adding that the measures were needed to keep hospitals and health-care workers from being overwhelmed.

“I remember looking at the evidence, our local situation and what was happening in the rest of the world, and I knew we had to act immediately because it is my job to protect your health,” De Villa said.

However, de Villa said residents should continue to focus on maintaining physical distancing to win the battle against the virus.

She said cases and deaths in long-term care homes in the city continue to occur.

The city’s Seniors Services and Long-Term Care General Manager Paul Raftis said there are three additional deaths at Seven Oaks long-term care home, bringing the COVID-19 death toll at the facility to 32.

He said 108 residents have now tested positive for the virus since an outbreak was first reported last month.

“Our deepest condolences go out to the family and friends of those who have passed away,” Raftis said. “We’re working very closely with Toronto Public Health and the ministry to ensure that we have implemented full recommendations and guidelines.”

Raftis said his team continues to work around the clock to limit the spread of the virus in long-term care homes. He said they are aiming to test more residents.

Since April 13, The Mon Sheong Home for the Aged, also known as D’Arcy Home, reported 15 more coronavirus deaths.

According to the facility’s website, 23 residents at the home have died of the virus as of Thursday morning. The deceased are among the 50 residents who have tested positive for the virus. Additionally, 16 staff members have contracted the virus.

Other city-operated long-term care homes with COVID-19 positive residents include Kipling Acres, Lakeshore Lodge, and Castleview Wychwood Towers.

On Thursday, Eatonville Care Centre, the site of one of the city’s largest outbreaks of COVID-19, confirmed a 37th resident have died from the virus.