Germany registered a record number of COVID-19 cases on Thursday, breaking a record set in December 2020. The Robert Koch Institute (RKI), the country's disease control agency, reported 33,949 new infections in a single day.

The news came a day after Health Minister Jens Spahn declared that Germany was living in a "pandemic of the unvaccinated" and that the fourth wave of the virus was "in full force" across the country.

What is the situation for hospitals and vaccines?

With Germany's vaccination program lagging behind other European countries, Spahn also warned that those unwilling to get vaccinated could face new restrictions, such as being barred from shops and restaurants.

Recent figures from the RKI show that only 66.5% of Germans are fully vaccinated, compared to 88% in Portugal and 81% in Spain.

Hospitals are also beginning to buckle under the pressure as the number of intensive care beds filled up, largely populated by the unvaccinated.

On Wednesday night, the rate of hospitalizations per 100,000 residents over seven days, the German government's new key statistic to measure the severity of the pandemic, rose to 3.62 up from 3.29 just the day before.

What are health ministers debating?

Spahn met with the health ministers of Germany's 16 federal states on Thursday in the southern city of Lindau to discuss the possibility of imposing new restrictions.

Over the past few months, although mask mandates for indoor public spaces remain in effect, life has largely returned to normal in Germany.

During talks spanning two days, ministers were also set to discuss the country's booster campaign, which has been criticized for a lack of clarity about who can get one, and where.

Bavarian Health Minister Klaus Holetschek, who is chairing the conference, has called for a booster for everyone, not just the elderly and those with preexisting conditions.

"We need to make it very, very, clear what the next steps will be," said Holetschek ahead of the meeting.

He added that it was clear "that the medical field is at its limit."

Also up for discussion was whether or not to end Germany's state of emergency, which will lapse on November 25. It has given the federal government more direct power to control the pandemic. 

State of emergency nearing end

The three parties working to form Germany's next coalition government have signaled they will let it run out, despite a plea from state leaders not to do so.

Ministers will also be looking at issuing new safety advice to businesses and public institutions.

In many places, those who are vaccinated, have recovered, or can present a negative test are allowed to enter public spaces. 

Possible new suggestions include nixing negative tests alone and only allowing the recovered and vaccinated into buildings, a rule known as "2G" in Germany. 

However, not all health experts are in agreement with how to adjust the rules. 

"We don't test anymore, that's why I think rules like 2G are relatively dangerous. Last fall and winter, testing served us very well," Hendrik Streeck, director of the Institute of Virology at Germany's Bonn University, told DW.

"Even now, testing is needed for both the vaccinated and unvaccinated," he added. 

An even stronger rule would see the recovered and vaccinated also needing to present a negative test result.

Experts have said the latter should especially be considered for entering elder care homes, though that proposal has not made it into a government draft of new regulations.

"Vaccinated people are almost not tested at all in Germany, so we do not know how many vaccinated people are infected and can pass on the virus," Streeck said. 

Ulrich Weigeldt, the head of Germany's general practitioners' association, told the Bild newspaper that unvaccinated people "should not be allowed to have contact with vulnerable groups...that goes for care homes as well as for intensive care units."

wmr,es/rt (dpa, Reuters)