(Bloomberg) -- Chile’s government is struggling to control a coronavirus outbreak that’s pushed hospitals toward collapse and could threaten to revive mass social unrest.

With a population of just 18 million, Chile is reporting new Covid-19 cases at a pace comparable to that of Spain at the peak of the virus’s spread in March, on a per-capita basis, and resources are close to maxed out in Latin America’s wealthiest economy. In Santiago, the nation's capital, 95% of intensive care beds are occupied, and hospital patients are being airlifted to other parts of the country. Adding to the public health dilemma, the current crisis has highlighted the inequality and poor public services that drove millions of protesters to the streets last October.

“Coronavirus is testing Chile’s health system, which is already deficient,” said Dr. Jose Miguel Bernucci, the national secretary of Chile’s medical professionals association, in a WhatsApp message. “It is another symptom of the shortcomings of Chilean society.”

The country was still recovering from last year’s wave of anti-government riots when the pandemic hit, and now President Sebastian Pinera finds himself in a delicate situation. With social upheaval fresh on their minds, government officials walk a tightrope locking down Santiago to slow the virus spread, at the risk of stirring more discontent.

“A quarantine is a tool that has many adverse effects, such as hunger, misery, social unrest and increases in domestic violence,” Health Minister Jaime Manalich said during a May 21 press conference, when he opposed a nationwide lockdown. “You have to use it carefully and weigh the damage it produces against the benefits.”

Dynamic Quarantines

As recently as a month ago, Chile’s strategy of dynamic quarantines -- which restricted movement in specific neighborhoods instead of entire districts -- seemed to be working. Establishments such as malls set plans to reopen, and in late April Pinera revealed intentions to restart schools and offices, signaling the worst was over.

But since then, the number of new virus cases rose from 500 per day to over 4,000 per day. Police checkpoints have been set up around Santiago, the outbreak’s epicenter; people caught without a permit must pay a fine. Hospitals are overburdened, and even many of the city’s private establishments have no more room for patients.

Hospital staff are feeling the pressure. Gabriel de la Fuente, a doctor at the intensive care unit of the state-run Felix Bulnes Hospital in Santiago, works 24-hour shifts once every two days, grabbing sleep where he can. He said he hasn’t seen his children in two weeks due to the workload.

“It is getting a lot, lot worse,” he said. “Many elderly people are now scared to go to the hospital and are leaving it to the last minute before coming. When they do get here, they are in a really serious condition and need ventilators within hours.”

Social Crisis

Against that backdrop, Pinera is spending the equivalent of 7% of GDP on stimulus efforts while rushing to deliver emergency aid packages to households that are suffering an economic toll under lockdown.

But in some places, unrest has already begun. Last week tensions boiled over as violent protests against food shortages broke out in poor districts of Santiago, including El Bosque and La Pintana.

Read more: Protests Over Food Shortages Erupt in Chile Amid Virus Lockdown

While many people aren’t forecasting a repeat of 2019’s massive marches right now, officials were caught off guard by the incidents last week. Some mayors warn that more unrest is on tap. Complicating matters, Chile will face an “unprecedented“ economic drop in the second quarter, according to Goldman Sachs.

“The health crisis is giving shape to the social crisis,” Sadi Melo, who is the mayor of Santiago’s El Bosque district, said on Twitter. “The national government needs to have a stronger presence.”

Disapproval Up

The good news is that the situation is not as severe outside Santiago. Some parts of northern and southern Chile have only used 50% of their hospital capacity. Hundreds of ventilators are still available nationwide, according to health ministry data, and plans are underway to add 500 new hospital beds.

But polls suggest those positive points still fall short in the eyes of most citizens. Nearly two-thirds of the population disapproves of the way Pinera’s government is handling the coronavirus crisis, according to a nationwide Cadem poll carried out May 13-14.

In Santiago, hospitals across the city are hiring new staff, retraining nurses, pulling doctors in from other units and refurbishing rooms. It still may not be enough.

Read more: How Chile Went From an Economic Star to an Angry Mess: QuickTake

“We are trying to do what is humanly possible, but we’re getting overwhelmed,” said De la Fuente, from the Felix Bulnes hospital. “If it goes on like this, we won’t be able to attend to everyone properly. More people will start to die outside the hospital.”

©2020 Bloomberg L.P.