Hospitals in Northern Ireland are "facing into an abyss" as the number of coronavirus patients soars - with one forced to put out an urgent appeal on social media for off-duty staff to report for duty.
South West Acute Hospital has been appealing for extra help with diverted patients due to the growing demands, and Craigavon Area Hospital and Daisy Hill Hospital are said to be "under huge pressure".
Dr Anne Kilgallen, chief executive of Western Trust, said hospitals across the country are "facing into an abyss", with patient numbers well up on last spring's peak.
She said: "We can say that this situation is more grave than it has ever been in the course of this pandemic. I would go so far as to say our hospitals are facing into an abyss.
"At the moment one in four of the people in our hospitals have COVID-19. It's about 700 people. At the peak of the first surge there were 400 people in hospital so already we're in a very grave situation.
"The projections show this is likely to double by the third week of January."
She also urged people to think twice before dialling 999, saying A&E departments in Northern Ireland are being reserved for "the sickest people".
"We want you to know the emergency department is open for business but that involves all of us thinking carefully before we use it," she said.
Nearly all surgical procedures have been postponed and patients' families are being relied upon to take them home once they are medically fit, even if they do not have a care package arranged, she added.
"This has been a heartbreaking decision for each of us as chief executives and it's a decision that has not been taken lightly but we're absolutely certain we need to do this now if we're going to be able to provide essential services to those who are the sickest in our society."
The latest figures from the Office for National Statistics (ONS) suggest around one in 200 people in the community have coronavirus in Northern Ireland - compared to one in 50 in England.
Currently, 2.1% of the population has been vaccinated.
In England some crews are being made to wait nine hours in ambulances with patients before they can be admitted to hospital due to spiralling cases.
Tracy Nicholls, chief executive of the College of Paramedics, told Sky News on Sunday that emergency health services are under "unprecedented pressure" nationwide.
In London over the weekend, mayor Sadiq Khan declared a "major incident" as hospitals continued to admit hundreds of new coronavirus patients every day, with the situation posing a "serious threat to the health of the community".
There are currently 7,034 COVID patients in hospitals across the capital, with the number on ventilators up from 640 to 908 in the week to 6 January.
