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MADRID (AP) — By the time Patricia Nez's cough started, she was already familiar with the dreaded dry hacking sound tormenting patients who had for weeks been filling the Madrid emergency ward where she works.
"We were fed up of hearing it at the hospital, so it was just a matter of time before I would contract it," said Nez, a 32-year-old nurse who tested positive for the new coronavirus about a week ago.
Speaking via video call from her home, Nez said she is eager to recover, so she can relieve overworked colleagues dealing with a rising wave of patients and dwindling numbers of healthy nurses and doctors.
"The worst thing is that you need to stay at home, worried about infecting relatives, while knowing that you are dearly needed at work," she told the Associated Press.
The coronavirus is waging a war of attrition against health care workers throughout the world, but nowhere is it winning more battles at the moment than in Italy and in Spain, where protective equipment and tests have been in severely short supply for weeks.
Spain's universal health care system is a source of national pride and often hailed as a reason for its citizens' legendary longevity, but the outbreak is exposing its shortcomings, some of which are the result of years of budget cuts.
The country's hospitals are groaning under the weight of the pandemic: Video and photos from two hospitals in the Spanish capital showed patients, many hooked up to oxygen tanks, crowding corridors and emergency rooms. At the 12 de Octubre University Hospital, patients could be seen on the floor as they waited for a bed in recent days. The hospital said the patients have since been accommodated elsewhere.
On Wednesday, the number of medical personnel infected was nearly 6,500 nationally, health authorities said, representing 13.6 percent of the country's 47,600 total cases and about 1 percent of the health system's workforce. At least three health care workers have died.
"We are collapsing. We need more workers," said Lidia Perera, a nurse who works with Nez at Madrid's Hospital de la Paz, which has 1,000 beds.
This week, 11 of the hospital's 14 floors are devoted to caring for those suffering from COVID-19, and there is still not enough room: The patients with less serious cases of the disease are put in the hospital's gym or in a large tent outside.
"If you had told me three months ago that I would be working in these conditions in Spain, I wouldn't have believed you," Perera said, adding staff at La Paz are only being tested for the virus if they have symptoms. "If they did (regular testing), they might end up without any workers."
Widespread infections among health workers reflect the universal difficulty of stemming the spread of the pandemic. However, sick health workers do double damage: They add to the toll while also hampering the ability to respond to the crisis. On top of that, they raise the specter of hospitals becoming breeding grounds of infection.
Spain's experience has been reflected elsewhere.
In Italy, where nearly one-tenth of more than 74,000 infections are among medical workers, doctors and nurses have been begging the government daily to provide more masks, gloves and goggles.
"Please don't leave us alone: Help us help you," Dr. Francesca De Gennaro wrote in an open letter, asking for gear. De Gennaro heads a small private medical clinic in hard-hit Bergamo — where some 90 of 460 workers have tested positive.
In addition, 33 doctors have died, according to the Italian federation of doctors, although it was not clear if all were in service at the time.
There was no immediately available data on infections among health care workers in the United States. Neither Iran nor France is disclosing those figures.
However, in China, where the outbreak started and more than 80,000 people became infected in three months, more than 3,000 medical workers were believed to have fallen ill by the end of February, said Dr. Liang Wannian, the leader of a team of Chinese experts working with WHO to study the outbreak.
Spanish authorities have repeatedly said protecting medical staff is central to their efforts to do what's known as "flattening the curve": spreading out the time period over which infections occur, in order to reduce the burden on intensive care units. However, health workers said even simple things such as gowns and masks are still in short supply, as are tests.
In response to the criticism, authorities have promised to distribute hundreds of thousands of masks and COVID-19 fast tests this week. On Wednesday, Health Minister Salvador Illa announced a 432-million-euro purchase of Chinese medical material, including 500 million masks, 5.5 million test kits and 950 ventilators.
Authorities have also called up more than 50,000 additional workers, including recent graduates and retired doctors and nurses.