The Welsh Ambulance Service has pleaded with the public to use 999 sensibly as it deals with "acute pressure" and moves to the highest level of escalation.
It said it is currently dealing with double the amount of calls predicted and "sharply rising levels" of Covid-19 in the community.
Just last week, the service declared a critical incident and asked for public support as staff worked to meet the demand.
It comes as the health minister Vaughan Gething allowed health boards to redeploy their workforce, ensure people only access 999 or hospital care if it is essential as Wales continues to see its highest ever number of coronavirus patients in hospital.The ambulance service said the pressures mean some patients will wait a long time for help this evening and in the coming days."If it’s not an life threatening emergency, some patients will be asked to make alternative arrangements to access care, including seeing their pharmacist or GP, receiving advice over the phone or making their own way to hospital if that is appropriate" it said in a statement.
Chief Executive Jason Killens said: “Winter is our busiest period, and this year we also have a global pandemic to contend with, and now rising rates of infection in our communities.“Last week’s critical incident was a sign of just how busy we were, and today, we again find ourselves under extreme pressure.“We need to manage people’s expectations about what service they’ll get if they call for an ambulance.“As always, we’re prioritising those immediately life threatening calls, so if your call is less urgent, we may ask you to make an alternative arrangement.“The 111 Wales symptom checkers are the best place to start if you’re ill or injured and unsure what to do.”Jason urged the public to help and thanks NHS staff for "working flat out". “We need people to go back to supporting the NHS the same way they did in the first lockdown, thinking seriously about what it is absolutely necessary to do and remember – hands, face, space.“We – the NHS – are the same people working flat out, with now higher levels of demand, but we are seeing people being less compliant with the guidance but expecting the same level of service they would get in less pressurised times, and that just isn’t feasible.“In an escalating second wave of a global pandemic, we’re working closely with our health board colleagues to step up, and staff are doing their very best.“Please public – help us help you.”