The number of deaths this month due to Covid-19 is a "stark reminder of the impact of this current wave", Health Service Executive CEO Paul Red has said.
He said it is expected there will have been 500 deaths due to the virus by this evening.
Speaking at a HSE briefing this afternoon, Mr Reid the situation in hospitals "is of the highest level of concern that we have ever had", and the number of patients has increased by 10% in one week.
He said almost 300 people are being treated outside of intensive care units for advanced respiratory support and 342 beds have been opened, which is close to the surge capacity of 350.
There are three people being treated in ICUs in private hospitals.
Mr Reid said patients are receiving the highest level of care, but expressed concern that patient numbers are continuing to rise and said the HSE did not want to see it reach a level where they could lose control.
He urged people to be "relentless" in following the public health guidelines and in taking care of themselves and each other.
Paul Reid says the situation in Irish hospitals "is of the highest level of concern that we have ever had". He says between 6 and 19 January, 2,685 people were hospitalised for Covid-19, with 163 being admitted to ICU | https://t.co/LBmhaVS09R pic.twitter.com/Tdo0Tv6W7p— RTÉ News (@rtenews) January 21, 2021
Mr Reid told the briefing that following investment in mobile intensive care mobile ambulance service, 33 cases have been handled in the past number of weeks, where patients have been moved from smaller to larger hospitals.
Mr Reid said between 6-19 January, 2,685 people have been hospitalised for Covid-19, with 163 being admitted to ICUs.
Also speaking at the briefing, HSE Chief Operations Officer Anne O'Connor said the number of people being seen by GP out-of-hours services has reduced in recent weekends.
She said the establishment of community care networks has been a "massive change" for the HSE.
Ms O'Connor said there are 114 people on trolleys and the "lower trolley number is being maintained."
She said Covid-19 outbreaks were of "hugh concern."
Ms O'Connor said that there were currently 480 open outbreaks across our hospitals and long term residential care and 133 of those recorded during the week ending on 19 January.
Of those, there were 29 new hospital outbreaks and 104 new outbreaks in long-term residential care.
Ms O'Connor said they had a "real concern in terms of some of the nursing homes around the country", but she added that in recent weeks they have also seen disability and mental health residential services have been "very challenged in respect of outbreaks."
Ms O'Connor said that there were 166 nursing home centres dealing with outbreaks and that this represented 29% of the 570 nursing homes around the country.
That figure was at 20% on 11 January she said.
Ms O'Connor said that there were 183 outbreaks in disability and mental health settings.
She said, as of today, 362 outbreaks were reported across all long-term residential settings, and 290 of those were in January and in December there were only 56.
Anne O'Connor, HSE’s Chief Operations Officer, says there are 480 open outbreaks across hospitals and long-term residential care. She says staffing in nursing homes is a challenge, with over 1,800 staff currently on Covid-related leave | https://t.co/tdxJY1wHkA pic.twitter.com/bkVPaEQDNp— RTÉ News (@rtenews) January 21, 2021
She described the situation at all HSE sites as "very challenged" and while "numbers are slightly down, we still have a huge challenge."
There are 345 people in Citywest and Ms O'Connor said the HSE are reaching their "limits in terms of what we can do at Citywest".
She said staff accommodation is also being provided to 2,366 people.
The Clinical Lead for Covid-19 for the HSE, Dr Colm Henry, said the demographic impact of the virus has not changed.
He said while more young people have been admitted to hospital for Covid-19, "this is a function, not of a changing nature of the way the virus behaves in different age groups, but is a function of the scale of disease in the community."
Dr Henry said the five-day moving average is 2,555 "in comparison to 4,500 a week ago."
He said: "While this is an improvement this is still a remarkably high level of disease in the community."
Dr Henry said over half of the people in ICU are being ventilated, "not to mention the additional number of people receiving respiratory support outside of ICU."
The first healthcare professional to be vaccinated against Covid-19 in Ireland, Bernie Waterhouse told the briefing that she was "delighted and honoured" to be the first vaccinated healthcare worker in Ireland after "a really difficult, challenging year".
She was one of around 1,000 people to have received the second dose of the vaccine this week.
The Clinical Nurse Manager at St James' Hospital said that she and her staff were a surgical team but that they had been redeployed and she had spent the last ten months working on a Covid-19 ward.
Ms Waterhouse said: "We've had days which have been hugely stressful for our staff, where we've had maybe a couple of deaths and also a couple of patients that have gone to ICU on the same day."
"Unfortunately, sometimes care has been omitted because you just physically can't provide the care that is needed for these patients," she said adding that many required one-to-one nursing care which they struggled to provide.
Ms Waterhouse spoke of the staffing shortages they have experienced, especially due to colleagues contracting the virus.
She told the briefing, on the week she started on the ward, 12 staff were out, from a total of 21.
Ms Waterhouse spoke of staff in their 20s and 30s who were still experiencing Covid-19 symptoms ten months on from their original infection and who were unable to return to work as a result.
She also spoke of how some staff members who return to work after contracting the virus cannot work normal shift patterns straight away.
Ms Waterhouse said: "They are just so fatigued so I've had instances where we bring staff back for maybe for an hour or two, and we have to build it up over a number of months before we can get the nurses to work a long day of 13 hours, so that's really difficult for them."
Ms Waterhouse said that the third wave of the pandemic is much worse than the first but added that there is hope now due to the vaccine.
Additional Reporting Laura Flecther