Northern Ireland is at a "crossroads" in dealing with the rise in Covid-19 cases and more action to curb it must be taken, Robin Swann has warned.
The health minister was speaking as Northern Ireland recorded another high of new positive cases on Wednesday.
A further 424 cases were announced - 139 of which were in the Derry and Strabane council area.
One new Covid-19 related death was reported, bringing the Department of Health's total to 579.
In the Republic of Ireland, 429 new cases of Covid-19 have been confirmed and one more person has died, bringing the overall death toll there to 1,804.
Speaking at Stormont's executive press briefing on Wednesday, Mr Swann said he was "more concerned about what lies ahead" than at any stage since he became minister in January.
He said it was "inevitable" additional restrictions will need to be introduced in the Derry and Strabane area, which has had an infection rate of 323 per 100,000 in the last seven days.
Mr Swann said he did not want to pre-empt anything ahead of Thursday's executive meeting, but that it was "inconceivable" for ministers not to take action.
'Examine your conscience'
"Those conversations will happen tomorrow and we will have to decide what new restrictions apply and whether they are NI-wide, or whether they are more localised."
Mr Swann also did not rule out introducing a circuit breaker in NI during the Halloween holidays, when children are off school.
"No decision has been made in regard to school holidays but there would be a timeliness around it," he added.
"I'm not saying that's when I'm going to suggest it but it's clear the one thing we want to maintain is our schools - whatever support is necessary.
"If a circuit breaker could be brought in around the Halloween break it would get us around having to close schools - but what we're seeing in regards the advance of cases is whether we can wait until then."
Four of the highest daily numbers of new cases since the current tests model was introduced have been confirmed in the past six days.
Three hundred and twenty new cases were announced on Tuesday and 1,950 in the last seven days.
Mr Swann said people were "not powerless".
"To the selfish minority not taking it seriously - please, please examine your conscience."
Chief Scientific Adviser Prof Ian Young said the increase in cases was "not due to an increase in testing".
He told the briefing it was due to increased community transmission of the virus and that there would be significant rise in hospital admissions soon, if efforts to curb the spread did not increase.
Prof Young previously warned that if the present trend continues, Northern Ireland could have 1,000 new cases a day in a month's time.
'Circuit breaker not appropriate yet'
Prof Young said a "circuit breaker" was "one of the more powerful interventions in terms of reducing the transmission of the virus".
He added that the executive would need to consider any more restrictions in terms of their economic, societal and mental health implications.
The chief scientific adviser also said he did not believe it was yet the time for "Northern Ireland-wide measures of that magnitude".
Earlier, First Minister Arlene Foster said the rise in cases in NI was not "irreversible".
She told a press conference at Hillsborough Castle, after meeting Prince Charles, that Northern Ireland "can deal with this".
"We will meet with the chief medical advisers this evening and we'll see what they have to say in relation to the location of new cases about whether more action needs to be taken," she added.
"You do have to have a period of time to allow the restrictions to work, we only put in the Northern Ireland-wide restrictions in place last week, we won't know until next week whether there's been an impact."
Deputy First Minister Michelle O'Neill said the executive was prepared to respond with further restrictions if necessary.
"We are clearly at a juncture now in our fight back against Covid-19 that's very worrying, we have to chart a way forward," she said.
Northern Ireland is currently recording an average of 250 new cases a day and the number of Covid-19 patients in hospital was doubling every 13 days, according to Prof Young.
In a month, that would equate to 200 patients in hospital with the disease.
Sixty-seven Covid patients are currently in hospital, up from 59 on Tuesday; 10 patients are currently in intensive care.
In total 11,269 cases of Covid-19 have been diagnosed in Northern Ireland since the pandemic began - just under 17% of those have been recorded in the past week.
'Things are changing'
A stark warning today from the health minister, but you wouldn't be wrong for thinking you had heard it all before.
To drive the message home again, Robin Swann used some old script lines including: "Northern Ireland is at a cross roads" and that "this isn't a dress rehearsal", but the difference tonight is the figures.
They tell a different story, and according to Mr Swann, are proof that things are changing - changing fast with the potential of becoming a lot worse in three weeks.
In fact, according to Chief Scientific Advisor Professor Ian Young, we are now leaving the "lag" period, which describes the incubation when people are experiencing Covid symptoms but not in hospital.
Hospital outbreak concerns
Meanwhile, one patient and five members of staff at a cardiology ward in Belfast's Royal Victoria Hospital have tested positive for Covid-19, BBC News NI has learned.
It is understood staff received the positive test results over the past fortnight and testing is ongoing.
The Belfast Health and Social Care Trust confirmed the outbreak.
The trust also said one patient was self-isolating but that no one was currently off work as a result of the cluster.
Meanwhile, the police have told Good Morning Ulster that they have not fined anyone for breaching the rules over wearing face coverings.
To date 15 people have been issued with a £1,000 fine for breach of the international travel regulations.