A further 4,570 cases of Covid-19 have been reported in the State, bringing the total number of people infected in the Republic since the pandemic began to over 500,000 - or one in 10 people in the State.

The number of people with Covid-19 in hospital has exceeded 600 for the first time, with 622 people in hospital as of 8am Monday.

The hospital figures have not been that high since February 24th, during the third wave, when there was 652 people in hospital. Of those in hospital now, 283 are receiving non-invasive ventilation.

Hospital Report

There are 117 people with Covid-19 in intensive care units (ICU), up one from 8pm on Sunday. Eighty-one of them are being ventilated, the highest level of medical intervention.

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Health Service Executive (HSE) chief operations officer Anne O'Connor said there has been a 25 per cent increase in hospital admissions and a 41 per cent increase in ICUs in the last week.

As a result 25 hospital sites have less than five vacant beds and just 94 beds are available across the country.

"That is affecting our ability to bring people in for their long-awaited procedures," she told the RTÉ News at One programme.

The spike in numbers is hampering the ability of hospitals to deal with non Covid-related illnesses and there have been many non-elective cancellations.

Those entering hospitals tend to be very sick and are spending longer time in hospital, she warned. In addition there were 3,800 healthcare staff off last week with Covid-19 symptoms.

“People are worried because these numbers are growing at such a pace. We can’t see when this is going to turn. It’s a very, very grim situation,” she said.

The Government is expected to advise people to work from home where possible due to the high level of Covid-19 infection at present, but Ministers are to resist any calls for more widespread restrictions.

A recommendation from the National Public Health Emergency Team (Nphet) to return to a policy of working from home where feasible has won the support of a number of Cabinet members as the number of people sick with the disease in hospital continues to rise.

The Cabinet Covid-19 subcommittee will meet on Monday evening to discuss the latest Nphet advice and also to “take stock” of the current pandemic picture.

Taoiseach Micheál Martin has said he is extremely concerned about rising numbers. A more general use of antigen tests, working from home and a rollout of Covid certs to places such as gyms and hairdressers are all likely to be considered.

Unvaccinated

HSE chief executive Paul Reid on Monday said 40 per cent of people in hospitals are unvaccinated though they constitute just 7 per cent of the adult population.

The unvaccinated constitute 52 per cent of admissions to ICU and the partially vaccinated another 5 per cent, he revealed.

Mr Reid said an “extremely high” number of people in ICU are being fully ventilated with many people presenting to hospital with severe symptoms.

He told Newstalk's Pat Kenny Show that the situation in hospitals is "stark" at present.

Medical staff are having to cope with a surge in Covid-19 cases along with providing other services that were not provided for during the previous wave in January.

Intensive care specialist Dr Colman O’Loughlin confirmed that half of the patients in ICU at present are unvaccinated. The other half is made up of people who are fully vaccinated but have medical vulnerabilities or are immunocompromised.

Dr O'Loughlin, who is a specialist in the Mater hospital and the president of the Intensive Care Society of Ireland, on Monday said the vaccinations were tested on people who had the original strain of the disease not the Delta variant.

“We are seeing a disproportionate number of unvaccinated people coming in,” said Dr O’Loughlin.

“Nearly everybody else is somebody who has gone and got the vaccine, but they are very vulnerable because they are on strong immunosuppressant medication.”

Dr O’Loughlin called for the rolling out of the vaccine booster programme to other cohorts of the population and there is no need to wait for the evidence that boosters work.

“The harm of vaccines is exceptionally low. If it is in the country and it is in fridges, I don’t see what good it is doing there,” he said.

“The evidence suggests it will make a difference. Something has to give here. We can’t see a way out of this just by continuing as we are. Something has to happen.” He said personal responsibility is important, too.

Work from home

Minister for Tourism, Culture, Arts, Gaeltacht, Sport and Media Catherine Martin on Monday welcomed Nphet's recommendation on self-testing using antigen kits as it added an extra layer of protection.

The Minister told RTÉ radio's Today with Claire Byrne show that she expected the Government to bring forward rules on the wider deployment of antigen testing.

Booster vaccines would have a significant role to play, but the Government would have to await the advice of the experts on such a roll out, she said.

“The Government focus is on working together. We’re at a different point now with Covid than we were this time last year,” said Ms Martin.

“We thought vaccines would be the answer.”

HSE chief clinical officer Dr Colm Henry said the vaccine was not the only line of defence – it helped, but people still had to wear masks, practice social distancing and reduce contacts.

Dr Henry told Newstalk Breakfast that what happens next with regard to restrictions and lockdowns is up to the public and their individual actions.

He said he was worried about Covid-19 levels and that the link between case numbers and hospitalisations had been threatened, but not broken. The link was twice as weak as it was in January, he said.

ICUs, especially in the Dublin area, are under severe pressure, elective operations were being cancelled and patients were being exchanged between hospitals, he said.

“We are seeing an overheated health care system at the moment,” said Dr Henry.

Meanwhile, Richard Guiney, the chief executive officer of the business group Dublin Town, called for a strategy for working and living with Covid-19 in the long term.

The decrease in footfall in the retail and hospitality sectors when people were working from home had a major impact, he told RTÉ Radio 1's Morning Ireland. Mr Guiney called for a move away from restrictions and lockdown and said there was a need to understand "how all these pieces fit together".

Infectious diseases expert Prof Sam McConkey on Monday said antigen tests should cost as little as €1 to €2 each in a bid to get people to use them more frequently.

Speaking on Newstalk Breakfast, Prof McConkey said that to be effective antigen tests should be used two to three times a week. He also suggested the booster campaign should be deferred until there is a new vaccine specifically tailored to combat the Delta variant.

People needed to stay out of congregated settings, he said, and work from home where possible.