A record number of patients have turned up to Middlemore Hospital's emergency department, as flu and other winter illnesses hit hard.
On 2 July, 448 people, including 135 children, were treated at the emergency department.
Middlemore's director of operations, Vanessa Thornton, said that was the ED's busiest day ever - but many other days in the past few weeks had come close.
"We've had higher presentations in children, as well as the adults, related to the respiratory type illnesses. Particularly, influenza has been very high, influenza A, a lot of presentations over the last few weeks with that virus amongst others," she said.
Those who were most seriously ill had often developed pneumonia.
The entire hospital had been very full, and it had created 15 extra overflow beds a day to extend its ward capacity for winter, Thornton said.
Vouchers were being given to some less acute ED patients so they could go to after-hours or urgent care clinics instead.
It was not only Middlemore feeling the pressure.
College for Emergency medicine NZ chair Kate Allan said EDs from "the bottom of the south to the top of the north" were 10 to 15 percent busier than the same time last year.
It was hard to say what was behind the increase - including whether the flu was more virulent this year, she said.
"But there is no doubt that people seem to be more unwell with respiratory illness so they're tipping over and needing more hospital level care than we've seen previously."
Pressures across the health system as a whole could be adding to the big numbers, she said.
"We've got patients who are unable to get into primary care so are potentially are deteriorating before they can get on top of their problems so coming to us more unwell."
Thornton said population growth was also adding to the pressure, but in a positive development, ED nursing numbers were better than ever.
She urged people to do what they could to stay well including trying to get into their GP, calling Healthline, getting vaccinated and making sure their inhalers and other medications did not run out.
Both doctors said those turning up to emergency departments could face long waits if their illness was less acute, but those who needed urgent help should still come.
All of Auckland's hospitals carry out surveillance on the rate of secure acute respiratory infections.
The Institute of Environmental Science and Research website said the hospitalisation rate for the region for the week ending 7 July was significantly higher than the same time last year, at 11.37 people per 100,000 (127 patients).
That put it on the cusp of the Very High Activity category for the first time in the 10 years of records displayed.
The latest available Te Whatu Ora data showed 173 people were hospitalised with Covid nationally as of 7 July.