NI’s six health trusts have warned of “unbearable pressures” across the system, in the event of a likely Covid-19 spike in early January.
In a joint statement, the chief executives of the trusts said “several of Northern Ireland’s acute hospitals are already operating beyond capacity”.
On Monday, the Department of Health recorded five more deaths linked to coronavirus.
Another 419 individuals have tested positive for Covid-19.
In their statement, the trusts said the flow through hospitals had been “seriously impacted by required restrictions as a result of Covid-19”.
“Add pre-existing staffing pressures and staff absence due to Covid-19 infection, or the need to self-isolate, and there is a very real risk that hospitals will be overwhelmed in the event of a further Covid-19 spike in January.
“We are not making this point lightly and as a result, we are appealing to the public to be extremely cautious over the festive period and to take all necessary precautions to stop the virus spreading.”
They added: “2021 can be a year of hope for us all as the vaccine programme rolls out over the course of many months.
“However, we first have to get through what we now face for the remainder of this winter period.”
This follows a similar warning from Dr Tom Black, the NI chairman of the British Medical Association.
He said the Northern Ireland health service is facing a “nightmare” scenario in January and the “logical decision” was to go into at least another four weeks of lockdown.
A limited lockdown that was imposed on 27 November ended on Thursday night.
But Health Minister Robin Swann warned restrictions at the start of the New Year were “inevitable” and the severity would depend on people’s actions.
The total number of coronavirus-related deaths recorded by the Department of Heath is now 1,129, while the total number of confirmed cases is 58,635.
Latest figures show the hospital bed occupancy rate in NI hospitals is now 98%. There are currently 113 coronavirus outbreaks in care homes.
Speaking to the BBC’s Stephen Nolan Show on Monday, Dr Black said the health service was under pressure, but acknowledged that politicians had a difficult time balancing lives and livelihoods.
He said January was always a difficult time in the heath service but that would be compounded by the pandemic.
“We have pragmatism, we have Christmas, we have politicians who want to be able to give Christmas to the public,” he said.
“There will be a balance there to be struck, but have we pushed our luck too far, do we need to step back and just bring in the lockdown that we would bring in at any other time of the year?”
First Minister Arlene Foster has said the executive will “undoubtedly” have to discuss whether more further Covid-19 restrictions across NI are needed before the end of December.
She was asked by SDLP assembly member (MLA) Sinead McLaughlin to respond to Dr Black’s remarks.
Mrs Foster said she would take her advice from the executive’s chief medical officer and chief scientific adviser and also take into account the executive’s testing and vaccination programmes.
She said while she believed nothing was inevitable if more people “cut down their social contacts”, she accepted that “the numbers are not where we’d like them to be”.
“So we (the executive) will undoubtedly be having further discussions about this in the days just before Christmas or just after Christmas,” she added.
Roger Pollen, of the Federation of Small Businesses, said the evidence suggested the virus was spread mainly in people’s homes.
“The only policy response seems to be to jump in and close businesses because we’re failing to deal with it in other areas, in other ways,” he said.
“We seem to keep lurching into closing down the economy, opening it up again, closing it down, whilst at the same time sending out mixed messages.”
Colin Neill, of Hospitality Ulster, said there had to be a move away from “repeated lockdowns”.
“The hospitality industry has done everything in its power and we’re being shut as a controllable risk – we’re not actually spreading this virus,” he said.
Meanwhile, further doses of the Pfizer-BioNTech Covid-19 vaccine arrived in Northern Ireland at the weekend.
Almost 50,000 doses have now been received in total, according to the DOH.
Plans are being developed to allow the vaccination of people aged 80 and over to begin.
The DoH anticipates the vaccination programme will continue until the summer of 2021.
According to the Northern Ireland Statistics and Research Agency (Nisra) the total number of registered Covid-related deaths is 1,480 since the beginning of the pandemic.
Nisra’s figures are based on mentions of the virus on death certificates, so people may or may not have previously tested positive for the virus.
By comparison, the DOH daily figures are based on a positive test result having been recorded.