With close to 900,000 registered infections and more than 33,000 deaths, Spain has become the coronavirus hotspot in Western Europe.
At Madrid's Infanta Sofia hospital, emotional fatigue has already set in among intensive care staff, on a level even worse than in the first wave in the spring.
And that's despite the fact they're better prepared now.
Miguel Angel Gonzalez is the head of the intensive care unit here.
"When it is over and it has been overcome, you believe that whatever comes next will be bearable. Then all of a sudden you find yourself with an outbreak that is far from small. That produces a feeling of emotional exhaustion that we just didn't have during the first wave."
Treatment for severe cases has improved here over the last seven months.
But they're not expecting the pressure to ease anytime soon.
Thirty-eight percent of intensive care unit beds are already occupied in Madrid.
That compares to a national average of around 19 per cent.
Since Spain exited a tough lockdown in June, the infection rate has soared -- with more than 10,000 cases diagnosed daily since August.