The rapid spread of new and more contagious coronavirus variants across Japan, including in the Tokyo metropolitan area, is renewing fears that a further rise could push the medical system in the capital to the brink of collapse.

As the nation enjoys the Golden Week holiday season, which will generally finish Wednesday, growing complacency and mutated variants are prompting concerns that the 17-day state of emergency covering four prefectures — Tokyo, Osaka, Hyogo and Kyoto — may not be enough to curb the virus’s spread.

On Monday, the health ministry said the number of severely ill patients with COVID-19 in Japan had reached an all-time high of 1,084.

The government declared its third state of emergency on April 25, as the nation’s medical system already faced growing pressure from the rise in infections tied to coronavirus variants.

The highly infectious N501Y mutation is especially feared, since experts have pointed out that those infected — including younger people — are more likely to develop serious symptoms. In Osaka, where the N501Y variant has been spreading quickly, the occupancy rate of beds for severely ill COVID-19 patients had surged to 99.7% as of Monday.

According to the health ministry, the number of people confirmed to have been infected with a new variant and in a critical condition — being treated on ventilators or in intensive care units, for example — rose to 1,050 on Sunday, then the highest figure to date.

The N501Y mutation has been found in British, South African and Brazilian variants. Overseas, that mutation has been reported to make death 1.55 times more likely compared with previous strains.

A vehicle with a sign warning people about the spread of the N501Y coronavirus variant drives through Tokyo's Shibuya Ward last week. | KYODO
A vehicle with a sign warning people about the spread of the N501Y coronavirus variant drives through Tokyo’s Shibuya Ward last week. | KYODO

A recent analysis by the Tokyo government and private medical institutions has indicated that N501Y variant cases are increasing in Tokyo.

The Tokyo Metropolitan Government said Monday they had examined 1,087 people who were infected with the coronavirus over three days through April 29, and found that 649, or 60%, were confirmed to have contracted a variant. Local media reported it was the N501Y variant, and among those infected with the mutated strains, 193 patients were in their 20s and 106 were in their 30s.

As of Tuesday, Tokyo was treating 65 seriously ill patients and had allocated a total of 373 beds for such cases, so the strain on the health care system is not as grave as in Osaka Prefecture. Because of the dire medical situation there, Osaka Gov. Hirofumi Yoshimura said in late April that people may not be able to receive appropriate medical care if they become infected with the virus.

If the N501Y variant continues to spread in the capital, Tokyo’s hospitals may face a surge in severely ill patients similar to that seen in Osaka.

Experts monitoring the pandemic situation in Tokyo have said the N501Y mutation accounted for more than half of the infections seen in April, and they have estimated that the variant now accounts for more than 80% of new cases in Osaka and the neighboring prefectures of Hyogo and Kyoto.

Tokyo Gov. Yuriko Koike has warned that the most recent surge involves a growing number of young people in their 20s and 30s, and has repeatedly asked Tokyoites to stay at home during the Golden Week holidays amid the state of emergency.

But the government’s efforts to mitigate crowds over the holidays apparently did not resonate in the nation as expected.

A report published Monday by NHK on the situation at major locations in Tokyo, Osaka, Hyogo and Kyoto that day showed that even though the number of people not at home was lower compared with the weekends during the second state of emergency earlier this year, foot-traffic was higher than on the weekends under the first state of emergency in April and May last year. The report was based on cell phone location data collected by tech company Agoop Corp. in a form that does not identify individuals.

According to the report, daytime and nighttime foot-traffic near Tokyo Station was about 2.7 times and 2.5 times higher, respectively, while movement near Umeda Station in Osaka was 2.8 times higher during the day and rose threefold at night compared with the same period last year.

Under the state of emergency measures, establishments that serve alcohol or offer karaoke have been asked to close, along with large shopping facilities.

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