MONTREAL -- Montreal has reached the plateau of the COVID-19 outbreak but must be careful to ward off a second peak, the city's public health director said on Thursday.

Mylene Drouin said data showed the city has reached a peak but added that circumstances such as a change in the criteria needed for testing means they are no longer using new cases of the disease as a metric.

“What we're looking at is admissions to hospital or intensive care, which are indicators that are more reliable to estimate the peak,” she said. “It's more stable as an indicator and doesn't depend on screening criteria.”

To that end, she said the city had seen 76 new hospital admissions for COVID-19, with six new admissions to intensive care in 24 hours.

Drouin warned that the peak for hospitalizations and deaths is still to come, saying those can take more than a week to arrive after a plateau in transmission.

The announcement came as Drouin and Mayor Valerie Plante unveiled the latest numbers for the city. Those included 90 deaths, bringing the city's total up to 332, as well as a total of 7,281 cases, an increase of 451.

Drouin said the data on new cases was skewed, with 200 of those new cases being people who had been in contact with others who tested positive, hadn't been tested themselves and were already self-isolating. She said another 600 such cases still need to be integrated into the data.

The data for deaths was similarly skewed by the fact that many occurred in the city's long-term care facilities, which often don't send death certificates to authorities immediately.

Despite the plateau, Plante said there is still no timeline for beginning to reopen non-essential businesses.

“While we understand the interest to reopen certain businesses, what we want is to bring together the winning conditions so deconfinement is safe,” she said. 

Drouin addressed the province's new policy of allowing caregivers into the beleaguered long-term care facilities, saying it will have to be introduced slowly within the city. She specified that caregivers must be known by the CHSLD system as someone who gives regular care. 

“We can't do this in the same way as other regions where there's a lower level of cases in CHSLDs,” she said. 

Of Montreal's public facilities, 73 per cent have experienced a COVID-19 outbreak, while 23 per cent of private residences have had an outbreak. 

Before a caregiver can begin working in a CHSLD, Drouin said they must receive training on personal protective equipment and must give consent to take on the risk of possibly contracting COVID-19. Caregivers will not be permitted to work in CHSLDs that have been designated “hot zones,” with many active COVID-19 cases. 

“This will be done in a couple of days because right now our priority is to integrate new healthcare workers coming from hospitals who also have to be prepared,” she said, adding that CHSLDs will be contact with families of residents to give recommendations to their specific situations. 

Drouin insisted the city is well-stocked up on protective gear itself, but that priority must be given to medical personnel being sent to reinforce the staff at affected long-term care facilities. 

“It's not that they're not ready,” she said. “But to prepare the introduction of caregivers, they have to make sure it's only in cold zones, we have to make sure there's training, have to have staff to welcome caregivers and give instructions and we're short of staff. We have to make sure we have the protective equipment. This is not preparation that can be done in 12 hours. Our priority is introducing healthcare workers but as soon as that's done, the (regional health board) CIUSSS will introduce caregivers. We all want them to help us, but we have to make sure it's done properly.”

Drouin said caregivers don't necessarily have to test negative for COVID-19 to be allowed into a long-term care facility for work, but stressed that those who display symptoms or are in contact with people who show symptoms will not be allowed to work. 

Plante announced the expansion of a pilot project aimed at the elderly. The initiative would see seniors receiving automated phone calls explaining that should they have concerns about food, medication or a health need, they should contact 211, where they will be guided to community groups or CLSCs.

Plante asked Montrealers to be aware that while some scams do target the elderly by phone, they should listen to the calls to the end.

“It's not fishing and it's important to listen to the entire message to hear about the resources that are available,” she said.

Plante also announced $75,000 to help the city's taxi industry protect its drivers and clients from COVID-19, with the money going towards additional plexiglass barriers for cabs, as well as hygienic products for drivers and passengers.