The Philippines passed the 10,000 mark for new daily COVID-19 cases for the first time on Monday and put its capital region back on one of its stricter levels of lockdown, to try to tackle a spike in infections that is testing its healthcare capacity.

Manila and surrounding provinces were put back under enhanced community quarantine (ECQ), the highest tier in its containment protocols, for the first time since May 2020 to try to curb the surge in cases, despite inroads late last year towards controlling its epidemic.

The country registered 10,016 new cases on Monday, bringing the overall tally to 731,894, with deaths at 13,186, one of the highest caseloads in Asia.

Health authorities blame the surge on poor public compliance with prevention measures and the presence of new and more transmissible COVID-19 variants in the capital region, which accounts for nearly a third of economic activity.

Benjamin Co, an infectious disease expert with 3 Manila hospitals, said “this spike is really challenging while ECQ is painful particularly for the economic sector.”

The Philippines was the first country in Asia to go under a nationwide lockdown and broad restrictions and movement curbs saw its economy dwindle 9.5% last year, its worst economic contraction on record.

Government data showed that hospitals’ intensive care and isolation bed capacity in the capital region have reached critical levels or above 70% usage.

“I can give you beds, I can give you rooms. The problem is I cannot give you additional manpower capacity, like nurses and doctors to take care of you,” Co added.

Health experts say the spike in cases highlights the need to speed up a national vaccination drive, with only 656,331 healthcare workers so far given their first of two doses. The government aims to inoculate 70 million people this year.

It has also struggled to secure vaccine supplies, with an inventory of 2.525 million shots, mostly of Sinovac Biotech’s vaccine, one million of which arrived on Monday.