Japan marked the ninth anniversary Wednesday of the massive earthquake and tsunami that rocked the Tohoku region and killed more than 15,000 people in 2011, as health fears over the spread of COVID-19 prompted the cancellation or scaling down of a number of events.

A state-sponsored memorial ceremony that had been held every year in Tokyo since 2012 was canceled for the first time ever, with Prime Minister Shinzo Abe saying he would instead observe a moment of silence and deliver an address from his official residence.

Many municipalities in the hardest-hit prefectures of Fukushima, Iwate and Miyagi canceled or postponed their ceremonies, but still set up altars where people could offer flowers. Other areas have drastically downsized events.