Experts say large elderly population, social behaviour and weak healthcare system have contributed to high fatalities.
A UNESCO World Heritage Site and one of the biggest public hospitals in Barcelona, Hospital de Sant Pau is now on the forefront of the battle against COVID-19.
Al Jazeera has been given an exclusive look inside the hospital as it faces the global pandemic in Spain, the second worst-hit country in Europe with more than 80,000 cases.
The country is struggling to slow the spread of the disease with at least 6,800 reported deaths and rising fears over a lack of basic protective equipment for medical personnel.
“There are two important fears that at the moment are difficult to combat and are difficult to rationalise,” Joaquin Lopez-Contreras, chair of the Infection Control Unit at Sant Pau Hospital, told Al Jazeera.
“On the one hand, we started the epidemic with a much lower amount of protective material than we would like to have. We are threatened every day that we may run out of protective material.”
Government figures have revealed that Spanish healthcare workers account for nearly 14 percent of the country’s cases. Three-quarters of nurses on Dr Lopez-Contreras’s team have contracted COVID-19 and are in self-isolation.
“When a professional decides to become a doctor, decides to become a nurse or decides to be an administrative officer working in a hospital,” says Dr Lopez-Contreras, “everyone quickly realises that there may be a time when we can fall ill as a result of our profession.”
But thinning ranks of doctors and nurses in Spain and in other affected countries are hampering the ability to fight the pandemic, straining hospitals and raising fears that health workers are also spreading the virus.
In Italy, France and Spain, dozens of health care professionals have died of the coronavirus, and thousands of others have had to self-isolate.
“There is no longer only the danger of falling ill but there is the danger that we become vectors of the virus and transmit it to our loved ones,” Dr Lopez-Contreras said.
It is impossible to know how many patients have infected doctors and vice versa, but the fast spread within hospitals has now left the government struggling with a shortage of both professionals and equipment.
Last week, the Spanish government launched an emergency recruitment plan to add 50,000 health care workers, ranging from medical students to retired doctors.
“If things are as they seem to be in mathematical calculations, we will surely suffer,” Dr Lopez-Contreras predicts.
“We are going to have difficulties serving the entire population safely. I think that will save many lives, but I don’t know if it will save all the lives we would like to save.”
This exclusive report was filmed by Guillem Trius in Barcelona, Spain and edited by Al Jazeera NewsFeed’s Katya Bohdan in Doha, Qatar.