The recent nationwide surge in novel coronavirus infections is raising questions over whether Japan will reimpose a state of emergency, with the central government’s seemingly wait-and-see attitude prompting some medical experts to warn about a growing burden on the nation’s health care system while pushing for a longer-term approach.

With 239 new infections in Tokyo on Sunday, the capital surpassed the 200 mark for the sixth straight day. A day earlier, there were 803 new cases reported nationwide, pushing the country’s cumulative total over 30,000. And last week, Tokyo’s daily number of cases topped 300 for the first time, with other prefectures like Osaka setting new daily highs.

While cities worldwide have been reimposing lockdowns in response to a more potent return of the virus, the Japanese government has said there is no need to reimpose a state of emergency, despite the country’s own apparent second wave.

“We’re doing careful monitoring … but we’re not in a situation that immediately warrants the issuance of a fresh state of emergency declaration,” Abe told reporters Friday.

But some medical experts are becoming concerned that the government’s somewhat hands-off approach is making the nation more complacent of the risks presented by the virus.

Yoshihiro Yamaguchi, a specialist in critical care who has been serving on the front lines in the fight against the deadly virus, said during a recent meeting of experts appointed to judge the situation in Tokyo that the central government’s assessment was “mistaken.”

He called on authorities to take a longer-term view in dealing with the outbreak, stressing that it takes about two weeks to bolster hospitals’ intensive care units and regular bed capacity.

On July 15, the Tokyo Metropolitan Government raised its coronavirus alert to its highest level in a bid to warn residents that infections were spreading — a level it has maintained since. But it has retained an alert level of 2 on a scale of 4 for hospital capacity, meaning that, despite the rising cases, the health care system in Tokyo is not yet strained, even if steps are needed to increase capacity.

According to Yamaguchi, however, arrangements to increase bed capacity require changes in the transportation of hospitalized patients, adjustments to hospital staffing structure and changes to the layout of hospitals in order to prevent infections from spreading.

He said that such decisions should be made at least two weeks ahead of time.

“We cannot say the health care system is not stretched,” said Yamaguchi, who is the head of the Trauma and Critical Care Center of Kyorin University Hospital in Tokyo.

Yamaguchi has previously expressed his concerns that the pace of new infections could surpass the number of beds available for COVID-19 patients.

Tokyo aims to boost the number of beds for such patients from 1,000 to 2,800, and has secured 2,400 so far. As of Saturday, 1,105 COVID-19 patients were hospitalized in Tokyo, with 16 in serious condition. But another 1,015 patients were waiting to be hospitalized and undergo treatment, according to metropolitan government data.

While the metropolitan government has linked recent infections to nightlife entertainment districts, the nation in recent weeks has seen a rise in infections in areas unrelated to such districts, as well as among people in their 40s and 50s who are at a higher risk of COVID-19 complications, and, therefore, hospitalization.

Tokyo Gov. Yuriko Koike and other local government leaders, meanwhile, have urged residents to refrain from nonessential outings, especially during the four-day holiday weekend that wraps up Sunday. Her pleas came as the central government kicked off its controversial GoTo Travel campaign promoting domestic travel. Tokyo, initially part of the campaign, was excluded after public outcry amid its record-setting surge in coronavirus cases.

But despite the recent uptick, and in contrast with the central government’s earlier declarations that the state of emergency could be reimposed “in a worst-case scenario” if Japan saw a surge in infections, the relative lack of long-term, strict measures aimed at controlling the spread of the virus has sparked calls for a more proactive approach amid the current spike.

On Sunday, health minister Katsunobu Kato said the situation is still not as severe as it was in April, when the central government first declared a state of emergency that later grew to cover the entire country.

“With a higher ratio of younger patients, fewer patients in critical condition and a lower ratio of untraceable cases, I think the current situation is different from what we saw when Japan was under the state of emergency,” he said on an NHK program on Sunday morning.

Shigeru Omi, who heads a new government subcommittee on COVID-19 measures, noted that “it is essential to monitor and assess the situation as the pandemic continues to change its character.”

“If the situation changes, the government may change its approach and it’s vital to explain to the public the rationale behind any twists in its response to the pandemic,” he said during the same NHK program.

Yukio Edano, lead of the main opposition Constitutional Democratic Party of Japan, has also called for Abe to explain his rationale in the Diet or at a news conference to reassure the nation that the pandemic does not pose as serious a threat without imposing strict measures such as a state of emergency.

“(Abe) has failed to give any detailed information,” Edano said. “He only talks in the abstract that his decisions are based on ‘experts’ advice’ but that’s not enough to reassure (that the situation is under control).”

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