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Senior managers at Plymouth's Derriford Hospital say they have seen a record number of patients over the past week - and are warning that a third Covid wave could cause extreme pressure as the summer holidays approach.
As legal restrictions ease across England, ITV News has been given exclusive access to the hospital's emergency department (ED), where staff are said to be "exhausted and frustrated".
Dr Beth Newstead, a consultant in the emergency department, said: "Life is really quite hard for us at the moment.
"We've come out of Covid, and we were hoping for a little bit of respite, but actually, our numbers have gone up and up over the last few weeks. We're currently seeing in excess of 300 patients a day, which is a new record for us as a department."
In the past seven days in Plymouth, more than 2,300 people have tested positive for coronavirus. That's almost double the number from the previous week and well above the regional and national average.
Numbers being admitted to Derriford are still relatively low but beginning to creep up. But there has not been a single Covid-related death recorded in the city since March.
Dr Newstead said staff are "exhausted and frustrated".
"At the end of the day, we're all here, and we want to deliver really good patient care, and that's become quite difficult at times," she said.
"Everybody's very excited about 'freedom day', but for us, in the hospital, it's very much business as usual and trying to keep people safe in exactly the same way.
"Every wave we have thought the worst was behind us, and then the next wave would come. I think we probably are looking at a third wave. The numbers are on the increase, and with restrictions lifting, that's likely to get worse before it gets better."
One of the biggest problems is ambulances queuing outside the emergency department with all the beds full.
"We try to mitigate as much as possible, we use every single space that we can, but there does come a point when we are full," Dr Newstead said.
Earlier this year, a surprise inspection of the hospital's Emergency Department found issues with overcrowding, patient safety and infection control. Managers say they have made big changes as a result.
Chief operating officer Jo Beer said: "Ambulance patients now go in through an ambulance entrance, and people who are walking in go in through a dedicated walk-in entrance.
"When we are having extremely challenging days, some of our consultants will go into the back of the ambulances to assess and re-prioritise patients as the day progresses to make sure everyone is clinically cared for.
"The ethos of the staff is amazing. It's like a big family; everyone wants to do their best, but at the same time, we are under immense pressure, and the staff are tired."
Waiting times in ED are another major headache. Last week the longest wait to be seen and treated was 15 hours, and the hospital has not escaped the 'pingdemic', with many staff absent and self-isolating.
A second dedicated Covid ward is set to open tomorrow (July 22), and a third will be up and running in the next few weeks.
Chief executive Ann James added: "If the numbers continue to increase, then we will be making some decisions about what we're doing and what we're able to do."