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The death rate in Bulgaria soars as hospitals struggle to cope and doctors fall ill.

A patient is intubated in the intensive care unit of Haskovo Hospital in Haskovo, Bulgaria, this month.Credit...Hristo Rusev/Getty Images

Bulgaria, after enforcing a strict lockdown in the spring and largely containing the spread of the coronavirus, is now confronting a surge in infections that is straining an already underfunded health care system.

The surge has led the Balkan country to have one of the highest coronavirus death rates in Europe, with more than 15 people of every one million dying from the virus, according to the European Center for Disease Prevention and Control, which gathers data from national agencies. In the past week, the percentage of positive tests was between 37 and 44 percent.

Dr. Peter Markov, an epidemiologist and lecturer at the London School of Hygiene and Tropical Medicine, said the rate would continue to climb if Bulgaria did not take more restrictive measures to curb its spread.

“Given the very high mortality in Bulgaria, some form of a lockdown or closing down of schools becomes increasingly important at least for a month or two until the rates of infection go down,” Dr. Markov said.

During a meeting with senior health officials on Monday, Prime Minister Boiko Borisov, who recently recovered from Covid-19, said, “No single measure should be taken to an extreme” and stressed that the country needed “a working economy.”

Kostadin Angelov, Bulgaria’s health minister, seemed to push back on the prime minister’s comments by proposing a package of measures to tackle the outbreak, amid calls from medical professionals for further restrictions.

During a news briefing on Monday, Mr. Angelov suggested that Bulgaria close most nonessential businesses — including shopping malls, restaurants and bars — shut down in-person learning in schools and universities, as well as ban sporting events, conferences and private parties. His proposal will be discussed by the cabinet later this week. If approved, the measures will start on Friday.

Bulgaria’s strained health care system, overwhelmed by an influx of patients, has faced acute shortages of hospital beds and medical workers, many of whom have fallen ill themselves.

Last week, two men died after being left to wait at the steps of a hospital in Plovdiv, Bulgaria’s second largest city. They were expected to be admitted after being transferred from another medical facility. At the end of October, a 33-year-old man died after waiting for hours for an ambulance in Bulgaria’s capital, Sofia.

As many hospitals across the country ran out of beds, the government ordered them to open additional wards for coronavirus patients, despite the strain on resources and staff.

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