The regions, which are responsible for health care, are pushing hard for more powers to tackle the contagion, but ministers are resisting.
More than half the country's 17 regional governments have called on Madrid to alter a state of emergency imposed in October.
The emergency grants them powers to impose curfews between 10:00 pm and 7:00 am, order restaurants and other businesses to close and impose limits on the size of public gatherings.
Regions argue that they should be allowed to go further and impose wider curfews and restrictions but Prime Minister Pedro Sanchez's government says the existing powers are enough.
“It is not a question of adding many more measures suddenly but of applying the ones which have been adopted well and waiting the required days to evaluate their results,” Health Minister Salvador Illa told a news conference late on Wednesday after meeting regional officials.
Hospitals filling up
Spain has been among the hardest-hit countries in Europe, registering more than 2.4 million cases and more than 54,000 deaths since the epidemic hit.
The country imposed one of the world's strictest lockdowns early last year, which crippled its economy and left the public traumatised.
The drastic measure helped curb infections during the summer but there was a spike in autumn and another has emerged in recent weeks, with nearly 42,000 new infections and 464 deaths on Wednesday alone.
In six Spanish regions, more than 40 percent of intensive care beds are occupied with Covid-19 patients.
At Barcelona's Hospital del Mar, every intensive care bed is taken because of the virus surge.
“For weeks, it's been difficult to find empty beds,” Dr Mati Gracia told AFP.
The wine-producing La Rioja region, Valencia on the east coast and Andalusia in the south have all ramped up their measures.
“We can't do more with the authority that we have been assigned,” said Andalusia's regional health minister, Jesus Aguirre, of the conservative Popular Party.
His region is among those to have asked the Socialist-led central government for more power.
Some officials have openly expressed their frustration, with Francisco Igea of the Castilla y Leon region labelling the refusal to expand their power “unfair” and “authoritarian”.
“Thousands of people are getting sick every day, thousands of people will die,” he told public radio.
By AFP's Daniel Silva