MADRID (AP) — A proposal to set national standards for fighting coronavirus outbreaks in Spain’s large cities was accepted Wednesday by most of the country’s regions but rejected by Madrid, where Europe’s second coronavirus wave is expanding at the fastest rate on the continent.

The rejection of the standards by five of Spain’s 17 regions represented a new setback for Prime Minister Pedro Sánchez’s left-wing coalition, which is trying to push for a stricter response in the opposition-ruled Spanish capital.

The deadlock also exposed some of the pitfalls of the country’s highly decentralized political system, irritating many Spaniards and undermining their trust in politicians’ handling of a worrying surge in virus cases more than six months after the pandemic first overwhelmed Spain.

Madrid is leading the resurgence of the virus in Spain and Europe. The region has a two-week infection rate of 784 cases per 100,000 residents, which is 2 1/2 times higher than the national average of 294 cases and seven times higher the average rate in Europe, which stood at 94 per 100,000 residents last week, according to EU statistics.

Sánchez’s government wants to see tougher action in Madrid that does not only target working-class neighborhoods, as do existing restrictions in the parts of the city with the highest contagion rates. But Madrid’s center-right regional government is resisting a citywide partial lockdown, arguing that it doesn’t want to further damage the economy.

The Spanish Health Ministry proposed a set of health metrics that would dictate when cities with populations of 100,000 of more need to adopt heavier restrictions to curb the virus. Under those criteria, measures ranging from curbs on people’s movements to limits on social gatherings currently would apply only to the city of Madrid and nine of its suburban towns.

In addition to Madrid, officials from three other regions led by conservative and center-right parties andas well as from the separatist-ruled northeastern Catalonia rejected the government’s document at a meeting Wednesday.

Regional health chief Alba Vergés said that Catalonia had decided to follow its own plan, which she described as more ambitious than the national guidelines designed with Madrid in mind.

“This has turned into a circus. We have said that at this stage there needs to be action with responsibility and that they need to find agreements that don’t endanger public health,” Vergés said. “We have been discussing a document that collides with the measures that we are already carrying out.”

Given that 13 regions ended up backing the guidelines, Health Minister Salvador Illa announced at a press conference that the plan would be implemented nationally regardless of the opposition.

“When one goes to the doctor, one expects to be told the truth: the situation in Madrid is tough,” Illa said, stressing that four of every ten infections reported in Spain on Wednesday was in the Spanish capital. “We are facing very tough weeks,” he added.

Confirmed COVID-19 cases have risen steadily nationwide since a state of emergency declared over the pandemic ended in late June. Sánchez, facing some criticism for hoarding too much power, handed over control of the pandemic to regional governments.

In theory, the move gave regional officials the ability to fine-tune their responses to new outbreaks according to local conditions, but results from the change have varied.

While the Aragon and Galicia regions in the north managed to ease their infection curves and the Asturias region has so far avoided major case clusters, Madrid has accounted for one-third of the new cases reported daily in the past few weeks. As the number of confirmed cases multiplied there, regional officials handed the blame back to the central government, demanding help and national guidelines.

Much of the conflict has to do with a decades-long political fight for control of the Madrid region, a conservative stronghold that for more than two decades has provided a showcase for the policies of the conservative Popular Party.

Under the new metrics, all large cities are subject to new curbs if they record a two-week infection rate above 500 cases per 100,000 residents, have ICU occupancy above 35% of maximum capacity, and if more than 10% of virus tests performed come back positive.

The restrictions include having to justify trips in and out of the cities, capping gatherings at six people, closing playgrounds and limiting customers and opening times at shops and restaurants.

Over 1 million people already live under such measures, and many expressed doubt Wednesday about how effective they are.

“The government should fine those who don’t abide by the medical recommendations, like young people,” Carlos Medrano, a taxi driver in central Madrid, said. “Only when you target people’s pockets is when they start complying.”

Fellow taxi driver Gregorio Muñoz, agreed that the current measures were insufficient. “It would be better if we stayed at home and didn’t go out, like we did in March,” Muñoz said.

As of Wednesday, Spain reported a total of nearly 770,000 confirmed coronavirus cases during the pandemic and a virus death toll of over 31,700, although experts say all numbers understate the true toll of the pandemic due to limited testing and other factors.

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Bernat Armangue in Madrid contributed to this report.

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