Covid-19 case numbers continue to rise in most counties but the rate of increase generally is slowing, latest figures show.

Yesterday, the incidence of the virus was up in 15 counties relative to the previous day, and down in 11, according to Health Protection Surveillance Centre data.

Relative to five days earlier, yesterday’s figures were up in 19 counties, down in six and unchanged in one (Longford).

Hospital Report

Over the five-day period, the incidence of the disease has more than doubled in two counties, Monaghan and Cavan. Cases have nearly doubled in counties Donegal and Cork.

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In contrast, the incidence in Dublin is growing only slowly now - 11 per cent over five days. And in Wicklow and Waterford, two counties threatened with further restrictions, relative cases numbers have fallen in both the one- and five-day windows.

The highest 14-day incidence yesterday was in Donegal, at 185.3 per 100,000 people, followed by Dublin on 152.9.

The lowest incidence was in Tipperary, at 20.7, though this figure is increasing slightly.

The national incidence was 84.5, compared to 70.7 five days earlier.

Meanwhile, the number of hospitalised cases is relatively stable, with 108 confirmed cases last night, down from 110 the previous day.

There were 17 patients in ICU, down from 18 the previous day.

There are currently 48 free critical care beds, out of 272 which are currently staffed and open.

This morning, there were 192 admitted patients waiting for a bed in the State’s hospitals, according to the daily count by the Irish Nurses and Midwives Organisation.

Significant impact on hospitals

Meanwhile, the head of the Health Service Executive has warned the impact of Covid-19 on hospitals is as significant now as it was during the peak of the virus.

"Although lower than our worst peak, the impact on our hospitals is as significant as we're now trying to keep all of our other services running too," Paul Reid, CEO of the HSE, wrote on Twitter.

His warning comes as a further 430 cases of Covid-19 were confirmed in the State, the most cases in a day since 701 cases were reported on April 26th, while no additional deaths were reported by the National Public Health Emergency Team (NPHET).

Senior Government sources have described the figures as “very worrying” and have expressed concerns about the growing pressure on capacity in the health service.

Intensive care consultant Dr Catherine Motherway has called for clarity over the exact number of intensive care beds that will be opened up under the Government's Winter Plan.

The former president of the Intensive Care Society said she was uncertain whether the 17 ICU beds mentioned in the plan were additional or part of the extra capacity created during the pandemic.

There was also the issue of how the beds were to be funded and if they could be staffed, she told RTÉ radio's Morning Ireland.

The extra intensive care and high dependency beds created in March had been provided with temporary funding, she said and there was an urgent need to know what funding will remain and how these beds will be staffed given the scarcity of intensive care nurses and the length of time it takes to train staff.

Intensive care beds were very expensive to run because of the staffing levels required, explained Dr Motherway. The staff to patient ratio in ICU is 1:1, in a high dependency bed it is 1:2 and on a ward it could be 1:6.

Dr Motherway also expressed concern about the cancellation of surgeries because of Covid-19 and said this could mean a reduction in “good outcomes” for some patients.

Health professionals could only respond to what was happening in the community, she said, which was why the public response was important, everyone needed to be as responsible as they could, washing their hands, observing social distancing and keeping contacts to a minimum.

“We need clarity on the extra beds, where they are so we can recruit.”

‘The flu times 10’

Separately, infectious diseases consultant Dr Eoghan de Barra has warned that the pressure on the health care system this winter will be "like the flu times 10".

The health service will cope, but it will be difficult, he told Newstalk Breakfast. “We’re in a much better place to deal with it now” because lessons were learned in March, he said.

Dr Mick Molloy, a member of the IMO consultants committee and a consultant in Emergency Medicine in Wexford General Hospital told the same show that cancelling elective surgeries had made the space to cope with Covid-19 earlier in the year, but it was now taking staff much longer to deal with each patient because of the protective measures they had to take.

Some hospitals essentially had a parallel ICU system to deal specifically with Covid-19 patients which meant there was a need for more staff.

Dr Molloy called for more consultants to be appointed to help with the flow of patients through hospitals.

Dr Clive Kilgannon, also of the IMO's consultants committee, told RTÉ radio's Morning Ireland that the winter will put extra pressure on the health care system. "We're now heading into the second phase, the good news is that this time we know better how to treat patients."

But he warned that everyone needed to continue to follow public guidelines to make a difference. “All of us need to redouble our efforts.

“What we all do now will have a disproportionate effect in a month’s time. We need to move quickly now as a society.”

Dr Kilgannon called for the immediate implementation of the Winter Plan, the deficits medical staff and bed numbers needed to be addressed to avert a second wave.