Thousands of new beds and hundreds of new staff to fill vacant posts are the "minimum" needed to handle the forthcoming winter in Irish hospitals, healthcare professionals have warned.
It comes as hundreds of patients wait for beds and the number of Covid-19 patients who require hospitalisation increases.
A €600m plan, expected to be launched by the HSE this week, must support a "zero-tolerance" approach to overcrowding in hospital emergency departments, the Irish Nurses and Midwives' Organisation (INMO) has warned.
The typical winter trolley crisis simply cannot be tolerated in the Covid-19 environment, it said.
The INMO's Trolley Watch reported more than 230 patients on trolleys waiting for beds at hospitals on Monday, a figure which has been rising in recent weeks and comes ahead of the typical flu season which last year caused a record surge in trolley numbers.
At the same time, up to 90 patients with Covid-19 are now in hospitals, up from 49 two weeks ago, and a number of hospitals last week had to cancel procedures due to pressures on their departments.
INMO general secretary Phil Ní Sheaghdha said that without a "proper" winter plan, the strain on patients and staff will be "unimaginable".
“Covid and overcrowding simply cannot mix," said Ms Ní Sheaghdha.
"Social distancing isn't possible with trolleys lining the corridors.
The Irish Hospital Consultants Association said an extra 2,000 inpatient beds were needed, at a "minimum", to deal with significant challenges this winter.
The association also called for a doubling of ICU beds, an extra 300 psychiatric beds, 1,300 step-down beds, waiting times to be reduced to a maximum of 18 weeks, and for 500 vacant consultant posts to be filled as a matter of urgency.