North West Ambulance Service has warned it is 'very busy with emergencies' tonight and told people to expect delays.
The service put out the message via its official Twitter account at around 5pm on Monday.
It said: "We’re very busy with emergencies right now. We're prioritising those in the most serious condition so you may be waiting longer than expected.
"Only call 999 in a life threatening emergency and consider other options if you can.
"Unsure? http://111.nhs.uk can help."
NWAS was forced to declare a 'major incident' in November with reports of patients stuck in corridors for hours, ambulances queuing outside hospitals and a surge in callouts.
It also related to a Monday evening and at the time NWAS Unison branch secretary Jeff Gorman described the situation as 'the worst he's seen in 30 years'.
He added: "I'm hoping it's a one-off but I do think we're going to have problems with hospitals keeping ambulances outside and the number of staff self-isolating. "
An investigation was launched to establish what happened and how a potential reoccurrence could be avoided.
Health sources told the M.E.N at the time that a combination of factors were at play, not just coronavirus, including a 36 per cent increase in 999 calls.
However, there have been claims of hospitals forcing paramedics to wait for hours to hand over patients at A&E due to Covid-19.
A senior health source also told the M.E.N around one in ten primary care staff have been absent due to the virus.
The M.E.N has contacted NWAS tonight for further comment on its latest warning.
