Not two months after battling back the coronavirus, Spain's hospitals have again started admitting patients who are struggling to breathe.
The deployment of a military emergency brigade to set up a field hospital in the northeastern city of Zaragoza this week is a grim reminder that Spain is far from claiming victory over the virus that overwhelmed it in March and April.
The Spanish government's top virus expert, Fernando Simon, said on Thursday that the 3,500 hospital beds occupied nationally by coronavirus patients represented just 3 per cent of total capacity.
"I would not say that what we are seeing now is similar to what we experienced in March and April. It is not in any way comparable," Simon said. "But it is true that transmission is increasing in every region, and we can't drop our guard. We are still facing an important risk."
Experts are working to determine why Spain is struggling more than other countries after western Europe had achieved a degree of control over the virus.
Spain, with a population of 47 million, leads Europe with 44,400 new confirmed cases in the past 14 days, compared with just 4,700 new cases reported by Italy, which has 60 million inhabitants and was the first European country to be rocked by the coronavirus.
The Spanish Health Ministry embarked on one of the world's largest epidemiological surveys. Randomly testing over 60,000 people, it found the virus prevalence to be 5 per cent, showing that the population was far from a "herd immunity."
Hospitalisations with COVID-19 have quintupled in Spain since early July, when cases were down to a trickle after a nationwide lockdown.
"There is no one single factor in such a pandemic," said Manuel Franco, a professor of epidemiology at Johns Hopkins University and Spain's University of Alcala.
Franco cited economic inequalities in Spain that have exposed poorer communities, especially fruit pickers, to greater harm, understaffed epidemiological surveillance services, and a large tourism industry as among the country's vulnerabilities.
Others have argued that social customs prevalent in Mediterranean cultures, which emphasise physical contact and smaller personal space, have worked against Spain.
Italy, the first European country ravaged by the virus, has extended its state of emergency through to October 15, and the government has used that authority to pass a series of decrees, ordinances and measures to protect public health.
The Spanish government, in contrast, ceded to pressure from some regions to end its three-month state of emergency in June.
Elsewhere in Europe, France reported more than 2,500 new COVID-19 infections for the second day in a row on Thursday, levels last seen in mid-April when the country was in the middle of one of Europe's strictest lockdowns.
Despite the rise in cases, which could prompt Britain to remove France from its list of safe travel destinations, the number of people hospitalised due to the disease continued to fall.y
Experts say this is because more young people are being infected, who are less likely to suffer serious effects
Australian Associated Press