BARAKALDO, Spain (Reuters) – At the Cruces hospital just outside the Spanish city of Bilbao, the sound of power drills and hammers rings out as a construction crew gets to work on a new intensive care ward in preparation for a potential winter surge in COVID-19 cases.

“Winter is going to be a high-risk time for us as more people will be staying at home in enclosed spaces, raising the risk of infection,” said Dr Alberto Martinez Ruiz, the hospital’s head of anaesthesiology and recovery.

During the epidemic’s first peak in March, when the virus spread unchecked through Spain’s population, the hospital struggled to accommodate an unprecedented surge in critically ill patients.

“Our experience of the COVID epidemic was of a terrible avalanche of patients in a short time,” Dr Ruiz recalled. “In March we were admitting up to seven or eight patients a day.”

Irregular spaces like gyms were