ROME, Italy (AFP) – Italy today  became the European country with the highest pandemic toll, its new total of 64,036 deaths overtaking Britain, according to an AFP tally.

The Italian health ministry said that 649 people had succumbed to the virus in the previous 24 hours and that 19,903 new cases had been diagnosed.

Worldwide, the United States has reported the highest number of Covid-19 deaths, with 295,539 as of Saturday at 1100 GMT, followed by Brazil, India and Mexico.

According to the AFP tally for Europe, Italy overtook Britain, which has reported 64,026 deaths and is followed by France with 57,567 and Spain with 47,624.

Italy was the first European country to suffer a wave of infections earlier this year, and imposed a nationwide lockdown against what then was a new and terrifying deadly virus.

The UK’s toll overtook that of Italy on May 6, with close to 30,000 fatalities, and for a while over the summer the southern European nation appeared to have weathered the storm.

But despite the introduction of mass testing, cases began rising again in early autumn, as they did in many other nations — and deaths inevitably followed.

Italy’s national medical association said Friday that a total of 251 doctors have now died from the virus.

Among the most recent was Francesco Gasparini, a 67-year-old anaesthetist who came out of retirement to help with the crisis.

“In this second wave, it is mainly general practitioners who are paying the highest toll,” warned Filippo Anelli, head of the FNOMCeO association.

He blamed “greater circulation” of asymptomatic patients, but added that all doctors did not have the necessary protective equipment.

“We must put an end to this massacre,” he said.

If the toll keeps rising as it has in recent weeks, the so-called second wave could become as deadly as the first, which saw close on 35,000 fatalities towards the end of July.

While UK and France imposed partial national shutdowns this autumn to try to bring cases under control, Italy chose to impose the toughest restrictions on the worst-affected regions to protect a struggling economy.