text: The Royal Cornwall Hospital Trust said it was overwhelmed over Easter and is struggling to discharge patients.
  A ward closed at Truro's hospital on Monday because of an outbreak of Norovirus. People are being urged to avoid A&E unless absolutely necessary.
  In February, the trust declared a "black alert" for about a week.
  A black alert is the highest level of alert and means hospital services are unable to cope with demand.
  Dr Andy Virr from the trust said there were some issues with the NHS 111 phone system during the weekend which prevented calls getting through to the Cornwall GP service, which caused delays.
  That "led to people voting with their feet and coming to A&E" which meant some patients remained on trolleys for 10 or 11 hours and operations were cancelled, he said.
  Debbie Pritchard, from patient group Healthwatch Cornwall, was not surprised the alert was declared.
  "There is still a lot of confusion around what services people should access out of hours," she said.
  The county's Clinical Commissioning Group (CCG), NHS Kernow, is now asking people to consider the most appropriate place to go for treatment when unwell.
  Peter Stokes, deputy director of operations at the CCG, requested "relatives and friends be available to pick up people who have been inpatients and are ready to be discharged to free up beds".
target: A hospital trust in Cornwall has declared a "black alert" for the second time this year due to "extreme" pressure on its services.