Italy reported a record number of new coronavirus cases, underscoring Europe’s struggles to maintain control of the pandemic.

The region’s leaders are intensifying efforts to contain the disease, with German Chancellor Angela Merkel discussing next steps with state leaders and French President Emmanuel Macron due to appear on national television later Wednesday, when he may announce additional restrictions.

Authorities face growing difficulties in devising curbs that slow the spread of the disease without resorting to national lockdowns, which decimated economic activity in the second quarter. With stringent limits on movement still taboo, leaders are focusing on targeted measures and imploring the pandemic-weary public to abide by hygiene and distancing measures.

“We must stop this curve and to do so there is no better way than to respect the rules,” Prime Minister Giuseppe Conte said. “If the number of infected people, and the number of people in hospitals, and especially in intensive care grows, we will be in trouble again.”

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The resurgence in Italy, Europe’s original epicentre for the virus, has so far been less severe than in neighbouring France or in Spain, but the outbreak has been accelerating in recent days. The intensity and duration of the spring lockdown in Italy and the country’s relatively late fall school reopening help explain the discrepancy.

New cases jumped to 7,332 on Wednesday, higher than the 6,557 infections at the peak of the pandemic on March 21. The spike at least partly reflects more thorough screening. Daily tests totalled 152,196, almost 10 times the March daily average of 15,752.

But with hospitalisations on the rise again — notably in southern regions that were largely spared from the initial outbreak — the Italian government last week reimposed the mandatory use of masks outdoors and this week added new curbs on nightlife, social events and amateur sports.

The number of patients in intensive care units rose by 25 Wednesday to 539. That compares with 337 a week ago, but still a fraction of the early April peak of more than 4,000. Daily deaths rose to 43 from 41 on Tuesday.

European infections began a resurgence in late summer, fuelled by returning travellers and young party-goers. Local family, work and social gatherings have since spurred further contagion.

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Europe as a whole recorded almost 700,000 new cases last week, the most since the pandemic began, and taking the total to just below 7 million, the World Health Organisation said on Tuesday in its latest situation report. Britain, France, Russia and Spain accounted for over half of all new cases, the report said.

Conte has repeatedly ruled out fully shutting the country down again, after a three-month lockdown in the spring brought Italy’s already fragile economy to its knees. Some experts have cast doubts on whether a new lockdown can be avoided if the pace of new infections does not slow down.

“A lockdown during Christmas would be a natural turn of events,” University of Padua virologist Andrea Crisanti said on Rai state television. “We need to focus on tracking and stopping the virus rather than people’s behaviour.”

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