In Frankfurt, Germany, you can’t simply grab a burger inside a restaurant, go to an indoor pool or have a drink in an indoor bar. Before doing so, you have to present either certification of full vaccination, or a negative test result from the last 24 hours. To make this work, testing centres are literally at every corner (often in converted barber shops), with results available within 10-15 minutes (you can either wait for the result, or have it emailed to you). Testing is free for children under 12 (who cannot be vaccinated yet) and for those who cannot get vaccinated for medical reasons. And these aren’t the only precautions. When in shops and on public transport, masks are required – and not cloth masks. Only surgical or FFP2 medical grade masks are permitted. And Oktoberfest, the largest beer festival in the world, was cancelled this year owing to limits on mass gatherings and international travel. It’s not surprising, then, that Germany is managing to control its Covid epidemic and bring down the numbers of cases and deaths. England (and the UK) by contrast is seeing a sharp rise in cases. Deaths are now on the increase too: this week’s daily reported toll was the highest since March. While the UK government continues to ask people to be vigilant and keep calm and carry on, the clock is ticking. Time is running out to put in some basic measures to prevent a further spike in cases, the NHS becoming overwhelmed, and very possibly another lockdown. Germany, meanwhile, is keeping its economy and society running, and looks in a strong position heading into the bumpy winter months. While we debate whether “plan B” is necessary – the health secretary, Sajid Javid, said on Wednesday he had no plans to implement further restrictions – we risk being pushed further and further towards a “plan C” (even harsher restrictions, such as bans on household mixing) to avert a winter crisis. Waiting and watching just doesn’t work with Covid, as we have learned repeatedly over the past 22 months. No one is talking about a “stay at home” lockdown, or a shutdown of certain sectors, as happened in 2020 and early 2021. Instead, the measures that doctors and health chiefs are now urging are minimally restrictive and aimed at keeping maximum economic and social activity while limiting the spread of the virus. The simplest step is to make masks compulsory again in shops and on public transport in England (masks are still mandatory in these settings in Scotland, Wales and Northern Ireland). When this is left to individual discretion, many assume masks aren’t necessary (otherwise the government would be enforcing them) and stop wearing them. This puts other citizens, even mask-wearers, at risk. It’s analogous to the ban on indoor smoking, or on drink-driving. We regulate these actions in order to protect the health of others. Likewise, I wear a mask to protect you, and you wear a mask to protect me. We now know that outdoor Covid transmission is minimal, while indoor settings such as pubs, gyms, restaurants and nightclubs are the riskiest. This is because they are places where masks can’t be used, and where there is minimal social distancing and a lot of loud talking, and little ventilation. Now that Britain has ample testing and vaccination, we can keep these settings open. But they should require vaccine certification, or a negative recent test result before the public are allowed to enter (France and New York City have already done this). This would mean that those going to these settings to enjoy themselves, and those working there, were far better protected and could feel safer. And while Britain had an early vaccination campaign, other countries are now surpassing us in terms of fully vaccinated people over the age of 12. This is because of a late rollout of jabs to teenagers (months behind the US, Spain and Germany) as well as lower take-up in young people. Compare this with Portugal, where over 98% of over-12s have been jabbed, or even Australia, which is slowly increasing its coverage. The tale of the tortoise and the hare comes to mind. Ultimately, we are social beings who want to work and enjoy life and not be locked in our homes. We routinely take risks every day. But the aim of public policy for decades has been to minimise these risks so that we can protect life and community wellbeing, and have a functional society. Think of speed limits on roads, seatbelts in cars or alcohol licences. While vaccines and testing can now do much to control Covid, they can’t do it all, which is why further restrictions are so necessary. We need the UK government to step up now – and for England to align with the measures other countries are taking to make Covid a manageable problem. On top of this, a major climate conference in Glasgow starts next week, which will bring thousands of people to the country and is likely to result in a spike. The writing is on the wall: if the government doesn’t move immediately towards plan B (ie masks and vaccine certification), infections and hospitalisations could escalate, and we will be pushed into a plan C this winter that will look a lot like lockdown. We have learned now that the best way to have our freedoms and keep a strong economy is by minimising Covid infections. It’s time to start acting on that now. Prof Devi Sridhar is chair of global public health at the University of Edinburgh