TORONTO -- A provincewide pause on non-urgent surgeries has been lifted and hospitals will now be permitted to “gradually” resume the procedures if they have the capacity for them.

The directive was first put in place on April 20 as hospitals struggled to keep up with an influx of COVID-19 patients and began transferring some people far away in a bid to free up capacity.

But in a letter to healthcare providers on Wednesday, Chief Medical Officer of Health Dr. David Williams said that new cases, hospitalizations and intensive care admissions now “appear to be trending downward,” setting the stage for a cautious resumption of elective surgeries and procedures “in some areas of the province.”

A spokesperson for the Ministry of Health later clarified that the “resumption will not be uniform across the province,” as it is “dependent on hospital capacity.”

That could mean that elective care will remain on hold in many Greater Toronto Area hospitals that are continuing to treat high numbers of COVID-19 patients.

“As we gradually and cautiously resume non-urgent and non-emergent care, we will continue to closely monitor COVID-19 cases, hospitalizations and critical care capacity and will respond rapidly should we see a worsening of the situation,” Williams said in the letter. “We will work with our health system partners to take the necessary measures where needed to ensure all Ontarians continue to have access to critical health care services.”

The number of people in hospital with COVID-19 peaked at 2,360 on April 20 but has been steadily declining since then and now stands at 1,401.

Intensive care units remain under immense strain as there are still 735 people with COVID-19 taking up beds. That number, however, is down from 900 earlier this month.

The resumption of some elective procedures will at least slow the growth of a surgical backlog that has already surpassed 250,000 procedures.

The Financial Accountability Office has estimated that the backlog will reach 419,200 procedures by the end of September and will likely take the province three-and-a-half years to clear at a cost of $1.3 billion.

There are also growing concerns about the potential collateral damage that could result from the delay of important surgeries and procedures.

In his letter, Williams said that the decision to suspend elective care was a difficult one to make but was “done in an effort to ensure that our health resources could be focused where they were most urgently needed”

“Such measures are never taken lightly, and we recognize the impact they have had on patients waiting for their scheduled surgeries and procedures and on health care providers across the province,” he said.