Watching Dr Silvana Di Florio ready herself to enter an intensive care ward where every bed currently set aside for COVID-19 patients is already full reminds you of the seriousness of the virus.

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With the help of another staff member she layers herself in protective clothing; a mask, overalls, and then a vast hood with a clear visor, looking other-worldly to the untrained eye.

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She is the head of ICU nursing at the Tor Vergata Hospital in Rome and is feeling the intense pressure of a second wave of COVID.

We get a chance to speak to her before she enters the area where day by day the demands on staff increase dramatically. And these are medical professionals still trying to recover from the physical and mental stresses of the spring outbreak.

She seems calm as she starts to speak: 'At the beginning we were those who were facing a global health emergency.'

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She then pauses and starts to sob, telling us: 'Now we are facing a war. We are tired. We are few. Some are sick, and with few resources.

'But we are always present, always prepared, always really careful.'

Gallery: Coronavirus 2020: Visual diary of a global pandemic (Photo Services)

As she composes herself, she says: 'I believe that sometimes we are able to go on even just for the 'thank you' that the patient tells us.'

It is clear that Dr Di Florio and others dealing with the second wave of COVID are struggling physically and emotionally.

She tells us that her staff get tested regularly in order not to miss a shift. Demand is growing and scared as they might be, they feel like 'missionaries' doing a job.

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Tor Vergata Hospital is one of the largest in the Italian capital and doctors and nurses are blunt about the reality facing them - that it will not be able to cope if COVID numbers continue to rise.

From the safety of a corridor in the infectious diseases department we are shown rooms all now occupied by COVID patients.

Just days ago, ambulances queued for up to nine hours to admit patients.

Looking through the glass into the rooms one can only imagine what it is like for the sick here; cut off from family, unable to have visitors, wondering if they will even be aware when and if the day comes when they will deteriorate far enough that they will need to be moved to ICU.

Professor Massimo Andreoni, who heads the department, warns things are going to get worse and there is, he says, only one solution - a national lockdown.

Mac os theme for windows 10. 'So I think that it is very important to start quickly in lockdown and to stop the pandemic,' he says.

'This is the only possibility because there is not the capacity to have sufficient beds in the hospital for these patients.'

It is a stark warning from a man who fears impossible pressures on the health service.

For now though, it is a move the Italian government resists. What happens in the nation's hospitals in the coming days may force a change in political strategy.

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Stay alert to stop coronavirus spreading - here is the latest government guidance. If you think you have the virus, don't go to the GP or hospital, stay indoors and get advice online. Only call NHS 111 if you cannot cope with your symptoms at home; your condition gets worse; or your symptoms do not get better after seven days. In parts of Wales where 111 isn't available, call NHS Direct on 0845 46 47. In Scotland anyone with symptoms is advised to self-isolate for seven days. In Northern Ireland, call your GP.