Tokyo Gov. Yuriko Koike raised the capital’s health care alert system to its highest level on Thursday, sounding the alarm just hours before the city reported a record-breaking 822 new cases of the novel coronavirus.

The nationwide tally of new cases also hit a record, with media reports putting the figure at 3,211 as of late Thursday evening.

This is the first time Tokyo has reached the fourth level of its alert system, indicating that officials and experts on the metropolitan government’s task force believe hospitals are being overwhelmed and could soon struggle to provide treatment to patients other than those infected with COVID-19.