The Chief Clinical Officer of the HSE said 37% of patients in ICU have not completed their primary course of vaccination.
Speaking at a HSE briefing, Dr Colm Henry said those who are unvaccinated or not fully vaccinated are disproportionately represented in those who are seriously ill.
He said there is "a large degree of uncertainty" regarding the trajectory of Covid-19.
"There is a high degree of immunity from natural infection and vaccination [but] re-infection is possible," Dr Henry said.
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However, he said infections are now "less likely to translate into severe disease."
He said "the conversion into hospitalisations and ICU is at a much lower rate" due to the protection from infection or vaccination.
"There are now multiple opportunities for the virus to transmit in the community," Dr Henry said.
He said the most important preventative measures "by a country mile" are to get vaccinated and to get boosted.
He also said people who are sick or have symptoms should stay at home and people should also consider the use of masks on public transport.
Hospitals and nursing homes under pressure
The HSE said Covid-19 is having a highly disruptive impact on health services and it has appealed to people to consider all care options before attending emergency departments over the coming days.
HSE Chief Executive Paul Reid said there should not be undue stress or concern from the highlighting of the impact of the virus on services.
Dr Henry said there has been a rise in the age of people with Covid-19 in hospital.
Dr Henry said: "73% of Covid-positive cases in hospital are now over 65 years of age."
The Chief Operations Officer of the HSE said there has been six admissions to to intensive care units related to Covid-19 over the last 24 hours, which she described as "a significant number".
Anne O'Connor said the virus is continuing to have an impact across the health system.
She said 248 beds in hospitals are currently closed, while there are just 98 beds available "heading into a four-day bank holiday weekend, which is not a lot".
Ms O'Connor said there are 4,102 healthcare workers out on Covid related leave, which is an increase of 697 on last week.
Ms O'Connor said the average weekly trolley count has been climbing and is higher than this time last year. She said capacity challenges are leading to the high trolley count.
She said the HSE is seeing significant challenges in some smaller sites, such as Bantry, which had 20 Covid-19 patients this morning.
"So small hospitals can be very, very congested," she said. Many mental health units are also full.
Ms O'Connor said the HSE is still very challenged in terms of outbreaks across nursing homes and services for older people.
She said there are 612 open outbreaks across community facilities.
The HSE COO said there were 96 new confirmed outbreaks across community facilities in last seven days, 42 of which were in nursing homes.
She said some nursing homes are reaching out for support in terms of staffing. She said 940 staff are also off work across nursing homes.
BA.2 variant now dominant
Dr Henry said the effect of Covid's presence in hospital is highly disruptive.
He said the HSE is still seeing unvaccinated people disproportionately represented in hospitalised and ICU patients.
Dr Henry said that of the 566 patients with Covid-19 in hospital today, only around 44% are boosted.
He said the BA.2 variant is now the dominant variant and represents about 90% of those tested. He said his core message is that those who are unvaccinated or unboosted should get it done.
Dr Henry said more vulnerable groups are advised to consider wearing a mask in any setting.
He also said that even though masks are not mandatory, they could still be used in areas such as public transport.
He said it may be wiser to wear a mask than not wear one when in any situation where there is a high degree of congestion.
Mr Reid said the reality of Covid-19 is that predictability is something you can not rely on.
He said the HSE is pleased society has moved on and Covid-19 is certainly less severe in terms of illness, but notwithstanding that the message today is a combination of the high level of transmissibility along with pressure on services.
Ms O’Connor said she is not sure the HSE could have foreseen the level of activity it has seen in the last couple of weeks, saying it is extraordinarily high and staying high.
She said it does not have a relationship with private nursing homes other than administering the Fair Deal scheme.
She said the reality is they are businesses in their own right, so the HSE can not set conditions in nursing homes.
Services for Ukrainian refugees
When asked if Ukrainian refugees will add more pressure to the health service, Ms O’Connor said the HSE has services all around the country.
She said the HSE is seeing a significant response all over the country, with teams bringing people into the system.
Ms O'Connor said there are challenges with things such as pregnancy, post-natal and Covid screening, but the HSE is working at a cross-sector level to try to respond.
She said the HSE wants the right supports to be in place and it is tapping into any of its own workforce who are Ukrainian.
She said the goal is to ensure the HSE is providing the same level of service to people.
