The health system is facing its biggest challenge of the pandemic as a tsunami of infections has led to record numbers in our hospitals.
The extra measures announced by Government today for schools, construction, retail and travel mark something of a last throw of the dice, to try and contain and reverse the current surge in cases.
In the last 24 hours, around 6,800 swabs have tested positive for coronavirus, while the dramatic increase in hospitalisations and rising ICU cases are a significant concern.
However, the current situation remains manageable and anyone who needs to attend their Emergency Department for emergency care should do so.
With Level 5 lockdown restrictions already in place since before Christmas Day, there is little left to do in further measures, beyond further small tweaks, which may have minimal impact.
Meanwhile, the impact of the measures taken before Christmas have yet to be felt.
In terms of the transmission of the virus over the festive season, the dye is cast as we see the impact of decisions people made during the holiday period in the latest figures of thousands of cases each day.
The increasing impact of the UK variant representing around 25% of cases is also notable.
The Taoiseach said this evening that 41% of people travelling from the UK to Ireland who tested positive had the UK variant. He also said that the new variant was first detected in early November.
The main concern now is that the health system could be overwhelmed.
Effectively everyone is asked to stay at home, unless they have essential work to perform elsewhere.
So with little or no social activity underway in Ireland, it should mean that cases will begin to fall slowly in the coming weeks.
For health staff, who need to access childcare, if there are widespread difficulties securing this, it will affect the number of HSE workers who can attend hospitals and other areas, adding to pressure on services.
"The arrival of vaccinations and today the approval of a second vaccine, Moderna, is a new element that did not exist in the first wave."
We are now back in the same space as last Spring, with planned surgeries, outpatient clinics and other non-urgent care being cancelled.
But this time is different – there is sufficient personal protective equipment, the management of cases is clinically better informed because of the experience to date and Covid and non-Covid care is separated in hospitals.
While CervicalCheck is continuing, with limitations, the situation will be under constant review and a further pause, as seen last year, can not be ruled out.
BreastCheck has been operating at a reduced capacity at the start of this year and some units are temporarily closed due to Covid-19.
One of the important messages from the Chief Medical Officer this week was that the surge in cases and hospitalisations can be turned around quickly, if people stick to the measures that worked last Spring.
Under the new measures announced this evening, essential construction projects will continue so that means various health building programmes, including the new National Paediatric Hospital, will continue.
The mobility of large numbers of people helps the virus spread. It remains to be seen what the impact will be of allowing 61,000 Leaving Certificate students go to school for three days a week from next week will be. It's certainly a smaller number than the movement of one million people linked to a normal school day.
The Government position remains that schools are safe places and that 75% of schools have had no interaction with public health. The general closure of schools follows advice from the Chief Medical Officer about the considerable risk due to scale of the virus now in the community.
The arrival of vaccinations and today the approval of a second vaccine, Moderna, is a new element that did not exist in the first wave.
Tomorrow, the HSE will begin providing a weekly figure on the number of vaccination doses that have been administered so far. The promise is that 35,000 will have been given by the end of this week.
The delivery schedule of vaccines is a big factor.
Vaccination is a very important tool in our armoury now and the speedy and efficient roll-out of vaccines is essential, in saving lives and also in building public confidence that better days lie ahead.