President Emmanuel Macron will address France on Wednesday to unveil tough measures aimed at curbing a dramatic surge in Covid-19 cases that threaten to overwhelm hospitals in several parts of the country.

Macron has rejected scientific advice to impose a strict lockdown, ordering an evening and night-time curfew but keeping schools and shops open in a “third way” intended to limit repercussions on the economy and mental health.

The government this month shut non-essential shops and limited movement in Paris and 20 other hard-hit areas, measures criticised by many health professionals as insufficient to counter the more contagious UK variant driving France’s third wave.

But with daily infections doubling to 40,000 since February and more than 5,000 Covid patients in intensive care the highest since October tougher restrictions seem to have become inevitable, with many experts saying only a full lockdown will be enough.

On Tuesday, health authorities reported 569 new ICU patients in 24 hours, the highest number since April last year during the first wave of the pandemic. The death toll has also started to rise, averaging nearly 350 a day over the past seven days, compared with just under 250 last week.

The greater Paris region has been particularly hard hit, with a seven-day incidence rate of 644 cases per 100,000 people. “We needed a strict lockdown earlier, but it’s still not too late,” said Gilbert Deray, a senior doctor at Pitié-Salpêtrière hospital in Paris.

Citing government sources, French media suggested that three options were possible: mass school closures; a third full lockdown in the worst-affected areas; or a major logistical operation to transfer ICU patients to regions with free beds.

Gabriel Attal, a government spokesman, said after a cabinet meeting on Wednesday that the country had “some difficult weeks ahead of us”. There had “probably been mistakes”, he said. “What’s important is to recognise this.”

Macron, who faces presidential elections next year, has said he had “no regrets” about his choices, describing every day out of lockdown as a bonus. His decision not to follow scientific advice to lock down in January was popular with voters.

After a dismally slow start, mainly as a result of a shortage of doses, France’s vaccination campaign has accelerated, with 350,000-400,000 shots a day now being administered and the country on course to meet its targets of vaccinating 20 million people by 15 May and 30 million roughly half the population by mid-June.

As the third coronavirus wave continued to build in Europe, neighbouring Germany reported more than 17,050 new infections over the past 24 hours.

The country’s leading virologist, Christian Drosten, said another hard lockdown was inevitable in order to “delay the dynamic that has undoubtedly developed”, adding that Germany’s situation was “serious and complicated”.

Markus Söder and Winfried Kretschmann, the leaders of hard-hit Bavaria and Baden-Wuerttemberg, called on other state premiers to reinstate tougher measures, saying the situation was “more serious than many believe” and encouraging leaders to “live up to our responsibilities”.

In Sweden, meanwhile, where a light-touch approach to the pandemic has been an international outlier, prime minister Stefan Löfven said the government would postpone a planned easing of some restrictions until at least 3 May. “The situation is serious,” Löfven said. “The spread of infection is at a high level.”

Cases had risen sharply in recent weeks to levels last seen in December, the national health agency said, putting the healthcare system under severe strain in some areas.

This content first appear on the guardian

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