Dealing with the first wave was like a sprint, the second will be more like a marathon. That’s how Dr. Olivier Joannes-Boyau, head of the intensive care unit at University Hospital in the southwestern city of Bordeaux, describes the resurgence of Covid-19 in France. After young French people took advantage of the lifting of lockdown and summer months to socialize freely, Covid-19 hospitalizations have risen in large cities like Paris, Bordeaux and Marseille on the Mediterranean coast. French hospitals are now preparing for the long slog. The last time University Hospital dealt with a rise in Covid-19 cases, it put aside all other emergency procedures to deal the crisis. This time, it is trying to keep the rest of its services going too. Just like the wider country, it is adapting to a virus that looks like it is here to stay. Hospital staff are more experienced than they were when the coronavirus first swept through France, and Bordeaux University Hospital is now armed with steroids to reduce Covid-19 symptoms and improved ventilators, both of which can reduce intubation rates. But juggling the swelling number of Covid-19 patients alongside those with other conditions will be difficult, says Dr. Catherine Fleureau, the hospital’s director. “It’s also going to be harder than last time, because this wave, I think, will grow progressively and then last over time.” Earlier this year, the first coronavirus wave spiked fast, but was cut short by a strict nationwide lockdown. In total more than 31,000 people died from the disease in France, out of over 433,000 cases, according to Johns Hopkins University. Now, the number of new cases is rising fast. A record was set over the weekend with more than 10,000 new cases in a single day. The number of clusters has been rising steadily and, most worryingly, nationwide, the number of people in intensive care has risen 25% in the past week. That number is still 10 times lower than they it was in the spring but it is a worrying trend; like in the spring it will be about how fast the numbers move upwards. The French government is determined to avoid a second general lockdown that could cripple its economy, so is tasking local authorities with responsibility for reducing the virus’s spread. In response, Bordeaux and Marseille have tightened their Covid-19 regulations, extending the places where masks must be worn, limiting the size of public gatherings and hardening enforcement. More checks are to be carried out to ensure that Covid-19 regulations are being respected. In Bordeaux, the plan announced by regional officials includes a ban on gatherings of more than 10 people in public parks, along the river banks and on beaches. In cafes and restaurants clients will no longer be able to eat and drink while standing up. In both cities regional officials lowered the number of people allowed to gather for large events to 1,000 from 5,000 previously, resulting in the cancellation of sporting fixtures. And just since the start of the school year, 81 schools and 2,100 classes have had to close due to Covid cases. Minister for Education Jean-Michel Blanquer also said Wednesday 1,200 new infections among students had been recorded, compared to last week. The success of these measures will dictate the number of patients that ultimately reach doctors like Dr. Joannes-Boyau. “The major problem will be to keep the wave, really low,” he says. “Because if this wave grows a lot, we will face a large number of patients with Covid-19 that will come and we will not able to treat them.” It’s too early to judge whether local restrictions can keep the coming wave manageable, but his intensive care unit is already nearing capacity, with 33 of the 35 available ICU beds occupied on Wednesday. As Joannes-Boyau says, it takes about three weeks for any change in the state of a population’s health to be measurable. Now the city is braced to see if it has the endurance to last the marathon. An earlier version of this story incorrectly understated the number of ICU beds that were occupied in Bordeaux on Wednesday. It was 33.