Fears of a second wave causing repeat scenes of chaos in Spanish hospitals have grown with the health ministry adding 156 deaths to the national toll in 24 hours, the largest daily rise since mid-May.
Of 303 deaths recorded in the past week, 115 were from Madrid, Spain's hardest-hit region where infection is rising faster than anywhere else in the country.
Jens Spahn, the German health minister, on Tuesday expressed confusion about why the numbers were rising.
“There aren’t many other countries in the European Union to have adopted such tough measures to contain the first wave,” he said.
Hospitals in Europe’s Covid-19 hotpots are close to saturation point, with admissions to intensive care units increasing exponentially in cities such as Marseille and Madrid.
Hospital officials in Marseille say they may soon have to send intensive care patients to hospitals elsewhere in France. All but four of the Mediterranean city’s 35 intensive care beds are occupied.
Jean-Olivier Arnaud, director of Marseille’s main hospital, said: “We’re not far from saturation.” Some surgeries are being postponed to cope with the spike in coronavirus infections.
“But there’s no question of massively postponing operations as we had to in March and April,” Mr Arnaud said.
“Further delays would be too damaging in terms of public health. We’ll now have to deal head-on with two waves of patients: Covid cases and all the others, who are very numerous.”
He said the main worry was staffing. “We have recently recruited about 100 health workers but we won’t have as many staff available for the Covid cases as we did in the spring.”
Foreign health workers are to be fast-tracked for naturalisation to show gratitude to frontline staff in the battle against the coronavirus, the government said. The residency requirement could be reduced from five to two years.
Bordeaux’s main hospital has 24 Covid-19 patients in intensive care. “The number has more than doubled in the past 10 days,” said Yann Bubien, the hospital’s director. “All the warning signals are flashing red.”
Nevertheless, he said Bordeaux’s hospitals are well prepared. “We now have 180 critical care beds and we’re capable of going up to 300 intensive care beds and that’s only at the Bordeaux teaching hospital, not counting nearby hospitals and private clinics.”
Paris also has ample spare capacity despite having more than 200 Covid-19 patients in intensive care, more than a quarter of the national total of 712, nearly 450 of whom were admitted over the past week.
In Madrid, however, health workers are warning of an imminent collapse of hospitals and health centres. The Madrid area currently accounts for a third of all new cases in Spain.
Some 84 per cent of its intensive care beds are now occupied by more than 300 Covid patients. However, the region quadrupled its intensive care capacity to 1,500 beds at the height of the pandemic in April and May.
Surgeries and other treatments are already being cancelled as extra intensive care capacity is prepared for the second wave, the CCOO health workers’ union said.
However, hospitals are short of staff, especially specialist nurses. Health workers say they will be unable to cope with a repeat of the collapse that took place in the spring, which left them exhausted and grappling with painful decisions about which patients to prioritise.
High levels of Covid-19 infection among health workers further increased the work load.
“Yesterday we finished at 3am after almost 24 hours awake, exhausted and on the verge of giving up. No sense of vocation is great enough to put up with this,” said César Carballo, a doctor in the emergency department of Madrid’s Ramón y Cajal hospital on Tuesday.
Madrid has 359 Covid patients in intensive care, more than a quarter of the national total of 1,273. Spanish hospitals are treating 9,752 Covid-19 patients. In France, nearly 5,500 coronavirus patients are in hospital.
Marseille and Bordeaux have limited public gatherings to a maximum of 10 people and have banned standing at bars. They have lowered the number of people allowed to watch sports matches or public events to 1,000 from 5,000.
Greek authorities also tightened restrictions in the Athens area. Nikos Hardalias, the deputy civil protection minister, said: “The prefecture of Attica is now between a moderate to high epidemiological risk. There is an increase in the occupancy of intensive care beds.”
The spread of Covid-19 infections may be linked with influenza outbreaks, according to a European study. A higher incidence of flu may be associated with increased coronavirus transmission, it suggests.
French doctors are urging people to get influenza vaccinations this autumn to prevent them from catching flu and Covid-19 at the same time, a potentially deadly combination. The flu jab, however, will not protect against Covid. Pharmaceutical companies are increasing production of flu vaccines in anticipation of higher than usual demand.