Aotearoa's hospitals are preparing for the biggest surge in winter illness on record.
This year will be Aotearoa's first winter with COVID-19 widespread in the community, but it's not COVID causing the current surge.
Hospitals are used to winter surges, but not like the one that's on the way. Auckland's busy Middlemore Hospital is already seeing record numbers.
"I think we had 425 presentations in one day last week, that's the highest we've ever had," Middlemore emergency department clinical director Dr Vanessa Thornton said.
Middlemore Hospital is already up 17 percent on last year, and the numbers are set to get worse.
"We're expecting that to go slightly higher but that is a real peak for us."
And it's not COVID-19 causing this surge so far - influenza A is rife.
"Three-quarters flu at the moment so flu is really dominating presentations in the emergency department across children and across adults."
Back from Switzerland and recovered from his own COVID experience, Director-General of Health Dr Ashley Bloomfield has a stark warning.
"There's no doubt the next few months are going to be tough and the health system can't do it alone."
To get through winter in good shape, Dr Bloomfield said Kiwis should keep up to date with COVID and flu vaccines. Wear a mask if unwell, and stay home and away from elderly and vulnerable people. And test.
COVID-19 cases nationally are declining with 6133 new infections on Tuesday, with a further 23 deaths reported and 377 hospitalisations.
Data shows those who are not vaccinated or boosted are six times more likely to be hospitalised.
"It also shows that those who're unvaccinated when they are in hospital have a more severe course of their illness and are about three times more likely to end up in intensive care," Ministry of Health Chief Science Advisor Dr Ian Town said.
To cope, hospitals are putting plans in place.
"Looking towards recruiting additional staff, we've also been doing a campaign around maintaining wellness across the community."
And if you do get COVID, don't assume you're safe after a week in isolation.
"There's nothing special about seven days, you'll recall it previously was 10 days and prior to that it was 14 days, so here's my advice, even after your seven days, be careful," Dr Bloomfield warned.