King Edward VII Memorial Hospital has been placed on alert because of overcrowding.

The Bermuda Hospitals Board raised the alert level to 3 — level 4 being the highest — in light of increasing pressure on the emergency department and the acute care inpatient units at the hospital.

On Monday, 115 people presented at the emergency department, which was the highest number in a single day this year. Average attendance is 85 to 87 patients a day.

An increase in Covid-19 cases is also contributing to the problem, the BHB said.

A high number of patients who are medically fit for discharge remain in hospital and the situation is compounded by rising numbers of people seeking emergency care and increasing admissions.

Judy Richardson, the chief of nursing, said that 36 patients who could be discharged remained in acute care beds, while 21 admitted patients waited in emergency for those same beds.

She added: “In some cases, there are no appropriate community placements for these patients. For others, the delay stems from a situation at home.”

Anna Neilson-Williams, the chief of staff, said that people who really needed the acute care beds were not receiving them.

She added: “Patients boarding in emergency are cared for by the emergency department team in tandem with additional nurses and a hospitalist from the inpatient units, but we recognise this is not an ideal situation for the patient, the family or the staff.”

The BHB said that increasing numbers of patients had been seeking care in the emergency department.

Ranjini Patton, the acting chief of emergency, said: “Generally, almost half of patients who come to emergency are low acuity, meaning they could be helped by their family doctor or go to one of the urgent care centres.

“We see patients in order of acuity, so those who are low acuity will wait much longer than patients who require emergency care.”

She added: “If you think you may have Covid, take an antigen test from a pharmacy.

“Please do not come to the hospital seeking Covid testing.

“If you have Covid and are very sick, contact your primary care physician for advice. If you need emergency care, call us first at 239-2009 so we can take precautions to ensure you are cared for away from other patients and visitors.”

Ms Richardson noted: “Please remember our patients are more vulnerable to infections like Covid, flu and colds.

“All visitors are expected to wear a mask while at the hospital to help protect patients, staff and yourself.

“If you are sick, even if you think you might be sick, protect our patients and staff by not visiting until you are well again.”

There were problems with overcrowding in March when the hospital was placed on alert level 3.

The challenge related to medically fit individuals remaining in hospital was part of the issue then.

Pressure eased the following month when the alert level was reduced to 2.

In December 2024, the BHB said that almost half the hospital beds reserved for acute care were being used by people who were medically fit for discharge.

R. Scott Pearman, the board’s chief executive and president, said then that between September 2023 and October 2024 there were 563 cancelled surgeries, 40 of which had to be called off owing to a lack of beds.