Eilish O'Regan: 'It's already bad - but worst of the misery may still be to come'
Is January 7 the new January 2? The traditional dramatic spike in patients coming to hospital A&Es - normally seen after New Year's Day - seems to have been pushed out this month.
But there is only so long it's possible to keep some form of control on winter overcrowding pressures.
Hospitals ran out of beds for 541 patients yesterday and there is worse to come.
It's not that the HSE's winter plan has been a failure - the anti-congestion measures, along with hard-working staff deserve credit for helping to stop last winter's records being broken so far.
Supports such as delivering extra homecare packages and step-down options to free up beds in the run-up to Christmas have been crucial.
But now the flu is taking a stronger grip and this means more patients have to be isolated to ensure infection does not spread, leaving staff with more struggles to find a bed.
Flu is still at moderate levels and is not the main culprit.
Instead it is simply very sick patients, who need to be in a ward, who may have held out over the past two weeks but now need to be admitted and treated.
The artificial level of low activity of the past fortnight which has provided some reprieve to hospitals is now over.
Surgeons must call on some of the precious beds, not just for urgent operations, but for patients who are in danger of deteriorating if they are not brought to theatre.
Thousands of other waiting-list patients, whose medical condition is serious, have had their surgery put on hold for weeks. Even this drastic restriction will not provide a panacea to preventing the trolleys from piling up.
One of the most ominous figures released by the HSE yesterday was the increase in the number of patients who are delayed discharges. They no longer need hospital care but cannot be discharged without supports.
They have risen from 471 on Christmas Day to 526.
It shows how quickly beds can fill up again with these patients despite some 300 getting homecare packages before Christmas.
A shortage of beds remains at the core of why several hospitals such as University Hospital Limerick and Cork University Hospital remain so jam-packed.
Extra beds have been promised but they are slow to roll out.
The HSE said yesterday that 145 additional beds have been funded as part of its winter plan.
They include 66 community beds, of which 40 are scheduled for this spring.
There will be another 75 hospital beds, funded for six months only.
By yesterday afternoon extra beds were opened in five hospitals. But although they will provide some ease they will not be enough to accommodate the stream of patients who need to be admitted and will have to endure hours on trolleys. It's also the case that the extra homecare packages will be used up shortly and this will increase the number of patients who are bed blocking. The worst days of the trolley crisis may yet be ahead despite the positive spin from Health Minister Simon Harris.