COVID-19 assessment and testing centres have been approved for Hamilton and are expected to open in the coming days.

The weekend saw five more confirmed cases of COVID-19 in Hamilton and Halton, including a three-month-old baby, bringing the total to eight.

This week, Hamilton's hospitals are also expected to get approval to do their own coronavirus testing for patients and staff, which would cut the response time to four hours or less.

The response to the COVID-19 crisis evolved rapidly over the weekend as Ontario had the country's largest single increase of confirmed cases in one day, jumping to 145 at 5:30 p.m. Sunday from 103 the day before.

"We are holding our breath waiting to see how this evolves," said Dr. Barry Lumb, physician-in-chief at Hamilton Health Sciences (HHS). "It is so hard to know how Canada will be compared to around the world."

The city closed recreation centres, arenas, libraries and other facilities Sunday as the chief public health officer of Canada warned our window is narrowing to flatten the curve to ensure hospitals are not overwhelmed by a surge of COVID-19 patients.

"This is our chance right here and right now," said Dr. Theresa Tam in a media conference. "We need to act now and act together." Tam said she has spoken with all provincial chief medical officers of health and each are considering following Quebec's lead in asking non-essential businesses to close.

Ontario has already shuttered public schools for two weeks after March break and suspended jury trials. Roughly 75 per cent of Hamilton's child care spaces won't be open. McMaster University and Mohawk College ended in-person classes and exams while local sporting and entertainment events have been cancelled.

"This is the key to it," Dr. David Russell, interim chief of staff at St. Joseph's Healthcare, said about curtailing ways for people to gather. "You see dramatically lower case rates and fatality rates," he said.

Like most hospitals in Ontario, HHS and St. Joseph's have more patients than funded beds the majority of the time, so they could be easily overtaken by COVID-19 patients.

"This is obviously an issue for every institution in Ontario that is overcrowded," said Lumb. "We are aggressively looking at every opportunity we can to expand if we need to."

Late Sunday, Minister of Health Christine Elliott asked hospitals to ramp down elective surgeries, which is something Hamilton's hospitals were already considering.

"As this evolves we will be re-evaluating our ability to provide elective care," Lumb said. "That literally will be an hour to hour conversation depending on the burden of work."

Hamilton's medical officer of health Dr. Elizabeth Richardson strongly advised against international travel Saturday, warning you may not be able to get home when you plan. Her comments came on the eve of March break on the same day that federal Foreign Affairs urged Canadians to get home while commercial flights are still available and asked those returning to self-isolate for 14 days.

So far, early indications are that all of this area's cases are travel-related, however they still are under investigation.

Hamilton has a total of five confirmed cases now and Halton has two, plus there is one case that overlaps both areas.

Hamilton's cases include the baby, a couple in their 60s who went on a Caribbean cruise, a 52-year-old man who returned from New York and there is no information yet on the last case.

Halton's new case Saturday was a woman in her 50s who had been in Los Angeles. The other is an Oakville woman in her 40s who travelled to Colorado and took two WestJet flights to and from Costa Rica while symptomatic.

The first confirmed case of COVID-19 in Hamilton and Halton was a 32-year-old radiation oncologist who lives in Burlington and works at Juravinski Cancer Centre. She treated 11 patients and worked with nine staff before discovering she got coronavirus during a trip to Hawaii.

The arrival of COVID-19 in this area March 11 sparked worry in the community with St. Joseph's seeing an all-time high of 201 visits at its King Campus urgent care centre March 12.

More than 2,500 people had called Hamilton's coronavirus hotline by Saturday — 984 of them were between Friday morning and Saturday morning. The hotline is 905-546-2424 ext. 7970, phscovid19@hamilton.ca or hamilton.ca/coronavirus.

"In terms of risk it is unlikely that anybody in Hamilton is going to be exposed or infected to COVID-19," said Richardson Saturday. However, "Residents do need to be mindful that the situation is evolving rapidly."

COVID-19 assessment and testing centres are expected to open in the coming days with St. Joseph's confirming the King campus will be one of the sites and HHS saying another will be at its West End Clinic urgent care centre. These assessment centres are intended only for people referred by public health or family doctors.

Russell said the Hamilton Regional Laboratory Medicine Program is expected to get approval this week to include COVID-19 as part of its standard testing. It can turn the results around in three to four hours and has the capacity to do 500 tests a day.