Ambulance bosses have discussed the fine balance they face over the winter period with a rising number of staff sickness due to coronavirus.
The East of England Ambulance Service has seen a steady increase in Covid patients since January 2 and said that its focus was on patient and staff safety.
Marcus Bailey, chief operating officer, told the trust's board meeting on Wednesday that calls "started to rocket" on December 27 and 28 and entering January it was important to mitigate the loss of patient-facing staff following a rise in sickness.
He said: "We know that our staff are unwell and our staff are being affected by Covid, they are no different to others. Importantly it is how we match and mitigate that loss of patient facing staff hours going forward."
Sickness in the workforce stood at 6.87pc at the end of November. The highest rate of sickness was recorded at the peak of the pandemic in April at 8.95pc.
John Syson, head of HR, said: "There has been a sizeable increase in community transmissions around Covid. Our sickness absence percentages have sadly increased since this was produced. Up until November, we were continuing to see sickness absence outside of Covid within our normal trends."
But the trust has begun its Covid vaccination programme with 1,277 members of staff, receiving their first jab since Monday.
The rise in coronavirus cases also brought additional difficulties including the delayed handover of patients at the hospital.
Figures to the board showed handovers to hospitals in November saw 61.95pc were over 15 minutes, 13.91pc over 30 minutes and 3.73pc over 60 minutes, with indication figures decreased further in December.
Tom Davis, acting chief executive, praised the organisations pre-planning for winter and for drawing on lessons learnt from the first wave, adding that despite the pandemic the trust was not far from maintaining national standards.
The trust has also been providing mutual aid to support London Ambulance Service since Christmas Eve. This includes providing call handling capacity; staff; vehicles; planned and safe transfer of patients to alternative hospitals and triage by paramedics in A&E departments - a decision that is made on a risk basis.
Mr Davis said: "This is undoubtedly the most challenging thing any of us will have experienced as healthcare professionals.
What we are seeing is a great testament to that pre-planning but the ability of the organisation to respond to the on the day challenges.
"Winter is challenging enough in an ambulance service without adding a Covid pandemic.
"I think it is really key that we acknowledge that working across systems both locally, regionally and nationally we have had to very carefully balance our response times to patients and safety to patients with our ability to provide mutual aid to our colleagues and patients in areas where services are more a challenge."
Comments: Our rules
We want our comments to be a lively and valuable part of our community - a place where readers can debate and engage with the most important local issues. The ability to comment on our stories is a privilege, not a right, however, and that privilege may be withdrawn if it is abused or misused.
Please report any comments that break our rules.
Read the rules here