ROME (Reuters) – Italy ramped up coronavirus restrictions in Tuscany and four other regions, effective on Wednesday, to rein in the second wave of the pandemic, a health ministry source said on Monday.

Last week, the government imposed nationwide curbs including a nightly curfew, and divided the country into three zones based on the intensity of their COVID-19 outbreaks, calibrating additional limitations accordingly.

Tuscany, which includes the cities of Florence and Siena; Liguria; Abruzzo; Umbria and the southern Basilicata region are designated as ‘orange zones’ where bars and restaurants are closed but shops remain open. People are free to move within their towns and cities but not leave them.

The zoning depends on factors such as local infection rates and hospital occupancy. Milan and most of the industrial north are part of the ‘red zone’ under a partial lockdown.

The northern province of Bolzano will be added into the red zone, the source added.

The southern regions of Puglia and Sicily were already part of the orange zone.

Italy, the first European country hard-hit by COVID-19, tamed its outbreak after a rigid lockdown in March and April, but has toughened up its curbs once again following a resurgence in infections and deaths.

On Monday, Italy registered 25,271 new infections after 32,616 the day before, mainly due to a customary fall in daily tests on Sundays. COVID-related deaths were 356, the health ministry said.

The steady surge in hospitalizations is straining the country’s health system, and doctors warn that Italy could suffer some 10,000 fatalities in the next month on current trends.

“The situation could become tragic. … We need drastic measures, such as a total lockdown,” said Filippo Anelli, the president of Italy’s doctors federation.