Germany’s health minister has issued a stark warning to the country’s public, telling citizens that vaccination was the key to their survival.

“Some would say this is cynical but probably by the end of this winter, pretty much everyone in Germany will be vaccinated, recovered or dead … That’s the reality,” Jens Spahn told a press conference in Berlin on Monday.

Blaming “the very contagious delta variant” for the country’s rapid surge in infections, which is seen as its fourth wave of the pandemic, Spahn said “that is why we so urgently recommend vaccination.”

Germany is considering whether to implement stricter Covid-19 measures and even a partial lockdown like its neighbor, the Netherlands, as cases soar. On Monday, more than 30,000 new cases were recorded, according to the Robert Koch Institute for infectious diseases.

In the meantime, Germany has one of the lower vaccination rates in western Europe with 68% of its adult population fully vaccinated, but only 7% having received a booster shot. Boosters are needed as we know that the immunity offered by vaccines wanes after around six months.

Spahn told Germans not to be picky about which vaccine they wanted to receive, saying “some vaccinating physicians say BioNTech is the Mercedes of the vaccines and Moderna is the Rolls-Royce,” Deutsche Welle reported.

“There is enough vaccine for all upcoming vaccinations,” Spahn said. “And both vaccines work.”

Germany deploys both the Pfizer-BioNTech shot (BioNTech is a German company and Germans have tended to prefer this shot) as well as the Moderna vaccine, AstraZeneca-University of Oxford vaccine and the Janssen (Johnson & Johnson) shot.

Covid vaccines greatly reduce the risk of severe infection, hospitalization and death but some countries in Europe have experienced greater vaccine hesitancy than others. And there is increasing segregation now when it comes to access to public spaces for vaccinated and unvaccinated people.

Outgoing Chancellor Angela Merkel also issued her own warning to the country on Monday, stating that current Covid rules were “not enough” to stop the fourth wave and that stronger action needed to be taken.

“We have a highly dramatic situation — the current rules are not enough,” Merkel told a meeting of leaders of her conservative Christian Democratic Union party, Reuters reported.

Having met with the leaders of Germany’s 16 federal states, which have largely determined their own Covid response measures during the pandemic, Merkel called on state premiers to decide on tougher restrictions by Wednesday.

Germany has already implemented stricter Covid rules in recent days. Last Thursday, Merkel and the country’s 16 state premiers agreed a new package of measures to tackle the virus, with restrictions introduced for unvaccinated people in areas of the country where hospital admissions exceed a certain threshold.

Merkel noted at the time that “many of the measures we are announcing would not be necessary if more people were vaccinated.” She said the country was also considering making it mandatory for hospital staff to be vaccinated, and that free Covid testing would resume.

Several states and cities have already imposed stricter rules requiring the public to show Covid passes, which have an individual’s vaccination status or if they’ve just recovered from the virus (also widely known as “2G rules” as they refer to whether people are vaccinated — “geimpft” in German — or recovered, “genesen”) in order to access bars, restaurants and other public venues like movie theaters or museums.

Germany is not alone in witnessing a rapid increase in Covid cases as winter sets in, with Europe as a whole seeing soaring infections, prompting many countries to tighten rules.

Austria has re-imposed a full lockdown with citizens asked to work from home and non-essential shops closed, while the Netherlands’ partial lockdown sees bars and restaurants closed at 8 p.m. (among other rules) and is meant to last until early December, although it could be extended.

Many countries are increasingly relying on Covid passes to keep leisure activities and businesses open, although critics say they are segregating societies down vaccination lines.

Read more: Protests against Covid rules and lockdowns erupt across Europe

Europe has been rocked by protests in the last few weeks against fresh restrictions, with demonstrations breaking out in Brussels, Vienna, Rome and Amsterdam last weekend.

The region’s Covid crisis has not been lost on the U.S. which only recently lifted an international travel ban that had prohibited visitors from 33 countries, including the U.K. and much of Europe. On Monday, the U.S. State Department warned Americans not to travel to Germany due to the “very high level of Covid-19 in the country.”

The advisory came after the U.S. Centers for Disease Control and Prevention issued a statement to “avoid travel to Germany. If you must travel to Germany, make sure you are fully vaccinated before travel.”

“Because of the current situation in Germany, even fully vaccinated travelers may be at risk for getting and spreading Covid-19 variants,” the CDC warned. The same level of travel warning applies to the U.K., Austria, the Netherlands, Slovakia, Denmark and Norway among other European countries.