Madrid is going back under city-wide lockdown measures after a surge in coronavirus cases in the Spanish capital, in a dramatic move that illustrates the growing intensity of Europe's battle against a snowballing surge of infection.

People will not be able to leave or enter their area except for work, education or health reasons, gatherings will be limited to six people and stores, bars and restaurants will have to reduce capacity by 50% and close by 10 p.m.

“Madrid is special because the health of Madrid is the health of Spain,” Spanish Health Minister Salvador Illa told a news conference Wednesday as he announced the measures, calling the situation “complex” and “worrying.”

The restrictions will apply to municipalities with more than 500 cases per 100,000 people in the past 14 days, where the number of positive cases surpasses 10% of all diagnostic tests or where Covid-19 patients make up more than 35% of occupied ICU beds.

Madrid reported 1,586 new infections Wednesday, or 40% of the national increase. Its regional government opposed the measures, arguing that the outbreak was under control.

The sweeping confinement echoes strict new measures that are being introduced in many countries across the continent as a second wave grips Europe.

Professor Gail Carson, Vice-Chair of the Global Outbreak Alert and Response Network, told CNN “we must take the recent surges of Covid-19 in Europe seriously and continue to do all we can as part of a community to limit the spread.”

“The virus creates a collective need, which merits a collective response. We know from earlier this year how quickly the virus spread can get out of control,” she said.

New restrictions in northern England

UK Health Secretary Matt Hancock on Thursday announced a ban on households mixing indoors for Liverpool and several other cities in northern England following a rapid rise in cases. The new measures also recommend against non-essential travel, amateur sports watching and care home visits except in exceptional circumstances.

Prime Minister Boris Johnson said Wednesday that this was a “critical moment,” adding that if the evidence requires it, he will not hesitate to take “more costly” measures.

There were 7,108 new cases in the UK on Wednesday after a record rise on Tuesday. Hancock warned that the R (reproduction) number remains above 1, meaning the virus “continues to spread,” but he told Parliament that there were “early signs” increased measures were having a positive impact.

An interim report from the UK’s largest community Covid-19 testing program released Thursday estimated that more than 1 in 200 people in England have coronavirus, or 0.55% of the population, compared to 0.13% active case in the previous round of testing. Over 65s saw a seven-fold increase, the biggest rise in cases, while young people continued to have the highest rates of infection, with 1 in 100 estimated to have coronavirus.

“While our latest findings show some early evidence that the growth of new cases may have slowed, suggesting efforts to control the infection are working, the prevalence of infection is the highest that we have recorded to date,” said Professor Paul Elliott, director of the REACT (REal-time Assessment of Community Transmission) program at Imperial College London.

Prevalence increased in all parts of the country, with the northwest remaining the highest at 0.86%, and cases increased five-fold in London, from 0.10% to 0.49%. Black and Asian people were again found to be twice as likely to be infected compared to White people.

Chief scientific adviser Patrick Vallance warned Wednesday there was “fast growth” in cases in parts of the country, adding: “Things are definitely headed in the wrong direction.” Chief medical officer Chris Whitty said there was “a significant uptick in the number of people who are entering intensive care.”

Merkel: ‘We have to be reasonable’

Germany’s coronavirus cases rose by 2,503 to 291,722 Thursday, its second-highest increase since April. German Chancellor Angela Merkel on Wednesday appealed to citizens to “obey the rules” going into winter. “I am sure: life as we know it will return, but now we have to be reasonable.”

Merkel on Tuesday announced an array of new measures aimed at stopping a recent spike in infections in the country. She said that gatherings in public venues would be limited to no more than 50 people in areas with a large number of cases.

“We know that a more difficult time is coming, fall and winter,” Merkel told a news conference as she explained the restrictions, which also include fines of at least 50 euros for patrons in bars and restaurants who provide false contact data to authorities for tracing.

Merkel also issued warned that if action wasn’t taken, Germany could see up to 19,200 new cases per day in the winter months. “This underscores the urgency to act,” Merkel said.

Cases are also spiking in the Netherlands, where 3,025 infections were reported Tuesday. On Wednesday, the government was into a U-turn on masks — they must now be worn in all public indoor areas such as shops, museums and petrol stations. The government had previously said masks were not necessary if other measures were followed.

The Dutch government announced Tuesday that it was introducing stricter measures after the daily rate of reported infections doubled the levels seen during its first wave in the spring. These include working from home where possible, pubs and restaurants closing at 10 p.m., and gatherings being limited to four people.

And in France, the head of the Paris regional health authority said Wednesday that the data from hospitals was not looking positive.

Aurelien Rousseau told France Inter radio that 34% of intensive care beds were occupied by Covid-19 patients in the region. He added the incidence rate is very high for people between 20 and 30, with 450 cases per 100,000 people.
Rousseau said the incidence rate for people over 65 was more than 100 per 100,000 inhabitants.

With worsening numbers the government may decide that Paris, like Marseille and the overseas department of Guadeloupe, classifies as a zone of “maximum alert,” meaning bars and restaurants would be forced to close.

The European Center for Disease Prevention and Control said that high case levels (at least 60 per 100,000) or a sustained increase in the 14-day Covid-19 case notification rates had been observed in 20 countries in the EU and UK, calling the situation in many countries “concerning.”

CNN’s Vasco Cotovio, Pierre Bairin, Frederik Pleitgen, Sarah Dean and James Frater contributed reporting.