Senior doctor Thomas Marx puts on his personal protective gear (PPE) before he enters the room of a patient infected with the novel coronavirus (Covid-19) in an intensive care unit (ICU) at the hospital in Freising, southern Germany.LENNART PREISS | AFP | Getty ImagesGermany is set to decide on tougher Covid-19 restrictions and could even opt for a full lockdown amid record daily infections and mounting pressure on hospitals.The country’s health minister, Jens Spahn, has already issued a dire warning to Germans this week, saying that by the end of winter “pretty much everyone in Germany will be vaccinated, recovered or dead.” Outgoing Chancellor Angela Merkel has called on the heads of Germany’s 16 federal states (which have largely been free to determine their own Covid measures) to decide upon stricter rules by Wednesday.On Tuesday, Spahn reiterated that request, adding that more public spaces should be restricted to the vaccinated, the recently recovered, or those that have had a negative test — otherwise known as the “3G rule.” From Wednesday, 3G rules apply to any Germans going into the workplace or accessing public transport.Many states in Germany have already restricted access to public spaces like bars, restaurants, movie theaters and museums under “2G rules,” restricting access to only those who are vaccinated — “geimpft” in German — or recovered, “genesen.” A number of major German Christmas markets which have not been canceled this year have adopted 2G rules.2G sign is seen during the opening of Christmas market in Cologne, Germany on Nov 22, 2021 as Coronavirus cases are at a high peak in Germany.NurPhoto | NurPhoto | Getty ImagesLast week, the government and federal states agreed to further nationwide restrictions that would come into force based on the hospitalization rate in the respective federal state.Hospitals and vaccinesSpahn also warned about rising pressure on hospitals in Germany, noting that “we are having to move patients around as intensive care units are full and that doesn’t just affect Covid-19 patients,” he told Germany’s Deutschlandfunk radio, according to a Reuters translation.The warning comes as the number of daily Covid infections hit a new record on Wednesday, with 66,884 new cases (a massive number for Germany and a big jump from the 45,326 new cases reported Tuesday) with the seven-day incidence rate passing 400 for the first time since the pandemic began, according to the Robert Koch Institute. Almost 100,000 people in Germany have died from the virus to date.German officials are also said to be considering compulsory vaccinations, having already implored those not yet vaccinated to take up a shot. The country has one of the stubbornly lower vaccination rates in western Europe, with 68% of its population fully vaccinated.Like other European countries, Germany has been desperately trying to boost Covid vaccinations and the deployment of booster shots as winter approaches. But vaccine hesitancy and the spread of the highly infectious delta Covid variant, which is far more virulent than previous strains, make the task far harder.The idea of compulsory vaccinations has been a controversial idea in Europe but the dramatic Covid landscape has made the debate an increasingly prevalent one, and some officials believe mandating vaccines is the only way to stop the virus.Covid vaccines greatly reduce the risk of severe infection, hospitalization and death from the virus, but we also know vaccine immunity wanes after around six months and that they are not 100% effective at reducing transmission. Experts say there are a number of ethical questions to consider regarding vaccine mandates, but some countries have sidelined concerns in favor of the overall benefit that vaccination confers.Read more: Are Covid vaccine mandates ethical? Here’s what medical experts thinkAustria has already announced it will make Covid vaccines compulsory from Feb.1 next year (it has also just introduced a full lockdown) and a number of countries (such as Italy and France) have made Covid vaccines mandatory for frontline health workers. The U.K. will follow suit in spring 2022.German states have called for mandatory vaccinations for medical workers and health care staff, and the idea is being considered by the federal government, which had previously ruled out compulsory vaccination.That some lawmakers are now calling for compulsory vaccination shows the current level of concern in Germany at the Covid crisis.”We’ve reached a point at which we must clearly say that we need de facto compulsory vaccination and a lockdown for the unvaccinated,” Tilman Kuban, head of the youth wing of Merkel’s Christian Democratic Union, wrote in Die Welt newspaper on Sunday, noting that 90% of coronavirus patients in German intensive care beds are unvaccinated.The unvaccinated, Kuban said, were bringing Germany “to the brink of desperation” adding that “it cannot be that the entire population is locked away every winter.”Ongoing political negotiations to form a new coalition government have been going on against the backdrop of Germany’s Covid crisis. However, negotiations between the Social Democratic Party, the Greens and the Free Democratic Party are expected to conclude any time now and a coalition deal is expected to be announced Wednesday.