A viral video of a dead man sprawled out on the bathroom floor of an emergency room in the southern Italian city of Naples is indicative of the nightmare Italy’s impoverished south is facing as the second wave of the COVID-19 pandemic hits the area hard. The man, in his 80s, was waiting for a COVID-19 test in the overcrowded Cardarelli Hospital, which has run out of COVID-19 beds. Down the road in Naples’ Cotugno Hospital, another video showed suspected COVID-19 patients receiving oxygen in their cars as they waited outside the emergency room. It prompted Italy’s interior minister to declare Italy’s third largest city “out of control.”

Southern Italy largely escaped the brunt of the first wave of the pandemic last spring when the wealthier north took the hardest hit. The government had promised to beef up emergency room facilities across the country, but almost no new beds were added in Naples’ already run-down facilities. This week, Italy topped one million COVID-19 cases, with more than half of them logged in the last 19 days.

WARNING: GRAPHIC FOOTAGE BELOW