Hospitals across Northern Ireland may be forced to ration intensive care beds in the event of a surge of coronavirus cases, it has been warned.
Under worst case scenario plans being drawn up by health bosses, doctors would be faced with the potential life and death decision on which patients get an intensive care bed.
It comes after a senior health official said he cannot guarantee there will be enough critical care capacity to deal with a surge in coronavirus patients, which he said could happen by mid-April.
Dr Seamus O'Reilly, medical director at the Northern Trust, was speaking hours before it emerged that two more people have been diagnosed with the Covid-19 virus, bringing to three the total number of cases here.
"We're looking at intensive care capacity across all of the trusts, it's part of the forward planning we are doing," he explained.
We are planning for the possibility that we may lose up to 20% of our staff at any one time and we're looking at how we will copeDr Seamus O'Reilly
"It's not as simple as purchasing 60 extra intensive care beds, you need specifically trained staff to work in intensive care, so if you don't have the staff you can't open the beds."
Dr O'Reilly said health trusts are also preparing for the possibility that high numbers of staff will be unable to come to work - either because they contract coronavirus themselves or they have to self-isolate if they are exposed to the virus.
He said this has the potential to further exacerbate the ability of the health service to treat critically ill patients.
"We are planning for the possibility that we may lose up to 20% of our staff at any one time and we're looking at how we will cope," he said.
Asked whether there will be adequate intensive care beds to cope with a surge in people becoming critically ill, he said: "We can't give that assurance."
He also ruled out the possibility of seriously ill patients being transferred to hospitals in England, Scotland and the Republic for treatment if there are no beds available.
"No, that won't happen because they will want to protect the intensive care beds that they have," he said. "We are preparing for the worst case scenario and hopefully we will never get to that stage, but it may mean doctors having to prioritise which patients get an ICU bed.
Plans are in place for containment and we are already preparing for a surge, which could possibly happen in about six weeksDr Seamus O'Reilly
"That may be a decision we have to make a bit further down the line as part of the pandemic plan. Hopefully that won't happen because the clinicians won't want to have to make that decision, because it will be difficult for them ethically.
"The system is already under significant pressure, so we may also see the likes of outpatient appointments and elective surgeries being affected if there is a surge in coronavirus cases."
Dr O'Reilly also said it is too early to predict how Northern Ireland will be affected by the spread of the Covid-19 virus.
"I think Italy will probably let us know how it's going to develop in the western health system and that will give us a better idea of how we can prepare," he said.
"Plans are in place for containment and we are already preparing for a surge, which could possibly happen in about six weeks.
"That could all change tomorrow, though, because it's all very fast moving and we're getting new information in every day."
Dr O'Reilly was speaking as staff at Antrim Area Hospital demonstrated the Northern Trust's drive-through testing centre for the Covid-19 virus.
Anyone who suspects they may have contracted coronavirus should telephone their GP or the NHS 111 line for advice.
If it is believed the person should be tested for the virus an appointment will be made for them to attend one of the test centres around Northern Ireland.
An appointment must be made in advance or the patient will be turned away.
Antrim Area is one of a number of hospitals that have opened a drive-through testing facility.
This allows patients to undergo a series of diagnostic tests, including having their temperature taken and provide a mouth swab, without entering the hospital.
It is the first time such a measure has been put in place in an attempt to reduce the spread of a virus.
Dr O'Reilly said: "I think we have realised because our health service is already under significant pressure, we can't bring these patients into the hospital.
"Other hospitals will have areas where they can test patients away from the rest of the hospital, but we don't have that facility at Antrim, which is why we have opened up the drive-through.
"We want to try and prevent it getting into our normal population. Our test facility is open between 9am and 10am and we have the ability to see 18 patients in one day, but if usage increases we may look at that again."
The UK saw its biggest increase in coronavirus cases on Wednesday, bringing the total to 87.