Extra ICU beds are being made available in Belfast as hospitals struggle to cope with a surge in Covid-19 admissions.
Six beds for Belfast health trust patients are being put in place at Belfast City Hospital due to capacity issues at the Royal Victoria and Mater hospitals.
On Monday, the Belfast Trust said it had 100 Covid-19 inpatients across its hospitals.
Chief nursing officer Charlotte McArdle warned that the numbers in ICU had increased significantly in Northern Ireland over the weekend, with 27 Covid-19 patients in intensive care as of Sunday.
Two were moved overnight, with 25 Covid ICU patients on Monday morning.
Both the Belfast Trust and the South Eastern Trust issued emergency appeals to off-duty staff on Sunday to come in to work to help colleagues deal with the escalating situation.
On Monday, the Belfast Trust said there was a significant degree of pressure on staff.
“We are predicting admission rates for Covid-19 to continue to increase for some days and have developed a number of contingencies to facilitate this additional demand on our resources,” said a trust statement.
The trust cancelled almost 100 non-urgent elective surgeries last week and is considering further cancellations to free up more staff.
“This is never a decision we take lightly and reflects the magnitude of the situation we are facing,” said the trust.
“In critical care, six beds are in the process of opening at Belfast City Hospital to provide care for critically ill Covid-19 patients.
Ms McArdle said there was currently no plan to reopen the region-wide Nightingale facility at Belfast City Hospital but she warned that would become a “very real possibility” if the surge continues.
Ms McArdle said around 60% of those being admitted to hospital in Belfast had not been vaccinated.
She said an increasing number of young people were also being admitted to hospital with the disease.
In Northern Ireland, only 56% of people aged 18-29 have come forward for vaccination to date, an uptake rate that is causing concern about senior health officials.
Ms McArdle told BBC Radio Ulster’s Nolan Show: “We haven’t yet made a decision to reopen regional Nightingale, but if this pressure continues that’s a very real possibility and, of course, that comes with complications and other decisions that need to be made around the balance in keeping surgery going.”
She said all five health trusts in Northern Ireland were under increasing pressures.
“All our trusts are having extreme difficulties coping, the health and social care system across all our trusts are struggling to cope with the current levels of demand for care,” she said on Monday morning.
“It’s impacting on the emergency departments, on GP services, on the ambulance service, and in all areas really.
“The five trusts today are in extreme escalation and at the moment across the five trusts there are 190 people waiting more than 12 hours for hospital admission.”
Ms McArdle said hospitals were having to deal with an increase in Covid-19 admissions at a time when accident and emergency departments were already under severe pressure with patients reporting with other illnesses and injuries.
She said staff absence rates has also increased significantly in the last week.
The chief nurse said the pressure on ICUs ramped up over the weekend.
The trust staffing appeals came on the day when Northern Ireland passed the one million landmark for people in the region who are fully vaccinated.
Around 70% of the adult population have received both doses of the Covid-19 vaccine.
However, while uptake has been high in older age groups, many younger people in Northern Ireland are still not coming forward to get jabbed.
Ms McArdle added: “There is an increasing number of young people requiring a very high level of acute care in some of our hospitals settings at the moment.”