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The novel coronavirus continues to spread in the capital and its health care system needs further strengthening, the Tokyo Metropolitan Government’s expert panel said Wednesday as it announced its decision to raise the city’s risk status to red — the fourth and highest level of its largely symbolic alert system.

It was the first time for Tokyo’s status to be classified at level four since the city revised its COVID-19 monitoring system guidelines on June 30.

That change was widely seen as an attempt to draw attention away from new and untraceable cases — as was the case with the original criteria — and focus more on the health care system and whether hospitals are capable of accepting more patients in the event of an explosive outbreak.

The designated risk level for the city’s health care system is orange — the second highest level — meaning experts believe it needs to be further bolstered in preparation for a large outbreak.

“Residents need to understand the urgency of the situation for virus countermeasures to have an effect,” Tokyo Gov. Yuriko Koike said during a meeting of the city’s coronavirus taskforce Wednesday.

The governor urged local businesses to comply with coronavirus countermeasures and residents to avoid restaurants, stores and shops that do not observe the measures.

She said Tokyo aimed to increase its testing capacity to 10,000 a day, and that as it stood the city was conducting around 3,000 tests each day. In addition, the city was said to be working with hospitals to secure 2,700 hospital beds for COVID-19 patients experiencing mild symptoms.

The metropolitan government has secured two facilities for asymptomatic patients, both hotels, one of which will start accepting patients Thursday while the other will begin next week.

The capital is in the midst of a surge in infections that began last month, when 55 cases were reported on June 24. Less than two weeks later it reported 131, and then, more recently, the city saw four consecutive days in which new infections exceeded 200.

Tuesday and Wednesday saw Tokyo record 143 and 165 infections, respectively. But the rolling average of daily new cases calculated over the span of a week was 173.7 as of Tuesday, its highest since the capital was placed under a state of emergency in April by Prime Minister Shinzo Abe.

“Compared to the first wave, this ongoing outbreak in the capital is different in almost every way,” said Norio Ohmagari, deputy director-general of the National Center for Global Health and Medicine, during the taskforce meeting.

Young people in their 20s and 30s account for the majority of new infections in Tokyo. Not only that, while the city might be conducting more tests the infection rate has remained roughly the same, Ohmagari explained.

Tokyo’s monitoring guidelines carry no binding call to action aside from whatever suggestions, opinions or recommendations Koike, or other arms of the metropolitan government, announce publicly.

The city offered up the first iteration of its monitoring guidelines in late May, along with its plan to reboot society by incrementally lifting social distancing measures and voluntary business closure requests.

Tokyo entered the third and final stage of its plan in early June. But now that it is recording more cases of COVID-19 than during its peak in April, the capital is being forced to reconsider voluntary measures that experts say will gradually become less effective.

On June 2, after the city reported 34 new cases of the novel coronavirus, Koike initiated “Tokyo Alert” — a warning system in accordance with the now-revised original guidelines that would convey a general advisory to residents through a live television broadcast by the governor and the illumination of two major landmarks, the Metropolitan Government Building in Shinjuku Ward and Rainbow Bridge in Tokyo Bay.

Critics have said the alert system was superficial and failed to give residents tangible instructions beyond the vague call for them to “practice increased caution.”

Policymakers and municipal leaders in the nation are prevented under the Constitution from imposing mandatory social distancing measures or demanding local businesses temporarily close. They can only suggest certain behavior or strongly request residents to practice caution.

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