South Australia's emergency departments are in crisis, with staggering wait times on the first day of winter as respiratory illnesses including COVID-19 sweep the state.
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A system-wide 'code yellow' was declared for the state's public hospitals, meaning some elective surgeries will be cancelled for up to a week.
SA Health chief executive Robyn Lawrence said the pressure on the system was the worst she'd ever seen, with COVID, pneumonia, heart failures and other conditions particularly affecting older people crippling emergency departments.
On Friday, there were 200 more people in SA's hospitals than at the same time last year, which Dr Lawrence labelled a "significant uplift".
And things remained just as bleak on Saturday morning, with every public emergency department classed as 'busy' or 'very busy' with wait times as long as 4.5 hours for non-urgent cases.
Dr Lawrence addressed criticism that cancelling some elective surgeries, such as colonoscopies and endoscopies, might have little impact easing the burden on emergency departments.
"There is some flexibility for sites around day cases, however I really want to reinforce we have numbers of staff across our system, which impacts doctors, nurses, allied health, admin staff," she told reporters.
"We need to be ensuring we're able to allocate our staff to the patients who need that care most critically, and therefore there may be impacts in day cases as well."
State opposition leader David Speirs said Premier Peter Malinauskas owed an apology to anyone who had an elective surgery cancelled, while describing the health system as in an "unprecedented state of crisis".
"(They) promised they would fix all this, but instead we have record ramping, consistent code whites which means no free beds across the whole hospital system, and now the cancellation of elective surgery," Mr Speirs said.
Mr Malinauskas has been contacted for a response.
Health Minister Chris Picton said his government was prioritising health spending and would see "hundreds and hundreds" of extra beds rolled out in the coming years.
"It's very clear what we need - additional beds, to be able to meet the needs we are seeing at the moment," he told reporters.
Around 270 health staff were off work sick with COVID or another respiratory illness on Friday, with around 140 patients in hospital with those same conditions.
Dr Lawrence messaged all staff on Friday outlining the system-wide response to try and ease the load, including by working with aged care providers to return as many of those patients as possible and increasing the use of telehealth for regional patients to help them remain in a hospital close to home.
Chief Public Health Officer Nicola Spurrier was disappointed with the state's COVID and flu vaccination rates, suggesting that was adding pressure to the hospital system.
"I actually find it difficult to understand if you have a loved one in an aged care facility, why people are not being a bit more proactive about protecting them," she told reporters.
"So that's a very, very clear message to all South Australians to get vaccinated particularly against the flu, but for those people that are more vulnerable against COVID-19 as well to look at their booster status."
Australian Associated Press
