Europe is experiencing a surge in coronavirus infections to levels not seen in months, alarming health officials and sparking fears that the continent could be engulfed by a new wave of the pandemic this winter.

Hans Kluge, regional head of the World Health Organization, said the pace of transmission across Europe, as well as Central Asia, was a “grave concern”, adding that the region was moving back to the “epicentre” of the health crisis.

“Today, every single country in Europe and Central Asia is facing a real threat of Covid-19 resurgence, or is already fighting it,” he said.

Germany on Friday reported 37,120 new infections, its largest daily increase since the start of the pandemic. The incidence of infection now stands at 169-9 per 100,000 people over seven days — a level not seen since the peak of the third coronavirus wave in the spring — while the number of Covid patients being treated in German intensive care wards is the highest since May.

The fear is that the surge in cases will place Europe’s health systems under fresh strain after months when the virus, if not fully defeated, appeared to be in abeyance.

Explaining the sharp rise, experts said the onset of colder weather had prompted people to spend increasing amounts of time indoors, where the virus can spread more easily. They also cited stubbornly high vaccine hesitancy and waning immunity among those who had been inoculated.

Studies show the risk of breakthrough infection roughly doubles five months after a second jab. The new Delta coronavirus sub-variant, which appears to be about 10 percent more transmissible, may also be playing a role, along with fatigue with mask-wearing in public places. Studies have shown mask-wearing reduces viral transmission.

Antoine Flahault of the University of Geneva’s global health institute noted the “devastating” surge in new cases in central and eastern Europe over recent weeks and the “alarming” death rates there. From the east, “this pandemic wave is now spreading towards western Europe”, he said.

He also pointed out that although new infections were rising in countries such as the Netherlands, Austria and Belgium, all had relatively low mortality and hospital admission rates, for now.

Fergus Sweeney, head of the clinical studies division at the European Medicines Agency, said it was “very concerning” that the continent’s key metrics — cases, hospital admissions and deaths — were all rising as winter approached.

He urged all Europeans to get vaccinated or complete their vaccination course.

“We’re not all protected until everyone is protected in that respect,” he said.