Italy on Saturday 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.
- Battle still not won -
Giovanni Rezza, head of infectious diseases at the Istituto Superiore di Sanita (ISS), Italy's top health agency, said this week the situation was improving "but very, very slowly".
Health Minister Roberto Speranza told a symposium Saturday that "I am worried about the two weeks of Christmas holidays. We are up against a dramatic pandemic which is ongoing -- the battle still has not been won."
Regional affairs minister, Francesco Boccia, told Italian television the country remained "in the most critical phase" with "intolerable" ongoing daily death tolls.
He warned that unless people did not adopt a very careful approach "the risk of a third wave is almost certain."
The death rate per 100,000 inhabitants in Italy -- at 104 as of December 10 -- is one of the highest in the world, but the reasons why remain contested.
Italy's 60-million-strong population is older than most in Europe, and official figures show the median age of patients is over 80.
"The reasons for the high death toll remain a mystery," Lorenzo Richiardi, a professor of epidemiology and medical statistics at the University of Turin, told La Stampa daily last week (DEC 4).
"One theory is that it is because we have an elderly population, but that is not enough."