The fate of Tokyo’s postponed Olympics is once again mired in doubt after Japan declared a second state of emergency for metropolitan areas as COVID-19 cases soar to new levels.

Japan is one of several countries where the virus has made a comeback in winter months with Tokyo logging a record 2,447 cases on Jan. 7. The discovery of new and possibly more infectious strains in the U.K. and South Africa has also alarmed governments around the world. With less than 200 days left until the opening ceremony, the situation has revived questions about the feasibility of safely holding even a limited version of the quadrennial games.

While Japan’s infection count has been well below other rich industrialized nations, the pandemic has been a persistent cloud over the Olympics since they were delayed almost a year ago. The restart of sports events around the world and development of vaccines have provided some optimism, but organizers have said the 2020 Olympics will be canceled — not delayed — if they can’t go on as scheduled. That said, Prime Minister Yoshihide Suga reiterated he was determined to hold the games even as he announced the new restrictions.