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With various coronavirus countermeasures active in nearly half the country, the looming possibility that the state of emergency will be expanded nationwide — and doubts over the efficacy of such a move — weigh heavily on Japan.

After case numbers began to rebound in March, the central government declared a state of emergency and pre-emergency measures in places where infections were spreading rapidly. But new cases continued to rise as the nation’s fourth wave took shape.

Still, the central government remains hesitant to further expand the order.

“Rather than expanding the order nationwide, we intend to enforce effective measures regionally,” Prime Minister Yoshihide Suga said during a news conference Friday.

But prefectural governors say stronger steps should be taken now, before it’s too late.

During a remote meeting last Wednesday with Yasutoshi Nishimura, the minister leading the country’s coronavirus response, Kamon Iizumi, governor of Tokushima Prefecture and president of the National Governors’ Association, said a nationwide state of emergency “may be necessary considering the situation in a growing number of prefectures.”

As of Wednesday last week, more than half of all hospital beds for virus patients were occupied in 20 prefectures, according to health ministry figures released Friday, and those figures continue to climb, as do new cases and deaths linked to COVID-19.

Hospitals are under the most pressure in Osaka Prefecture, where health ministry data showed 82.5% of beds for coronavirus patients were occupied.

The central government says an area has reached Stage 4 — signifying an “explosive increase in new cases” — if more than 50% of beds reserved for COVID-19 patients are full.

According to the health ministry, the 20 prefectures that have reached Stage 4 include Osaka, Okayama, Hiroshima, Fukushima, Gifu, Aichi, Shiga, Kyoto, Hyogo, Nara, Yamaguchi, Tokushima, Kagawa, Fukuoka, Nagasaki, Oita, Kagoshima, Okinawa, Ishikawa and Gunma.

That list, which grew by six prefectures compared with the previous week, includes eight of the nine prefectures where a state of emergency is in effect, and three of the 10 where pre-emergency measures have been employed.

Prime Minister Yoshihide Suga says the government intends to declare states of emergency in prefectures where infections are spreading, rather than expanding it nationwide. | POOL / VIA AFP-JIJI
Prime Minister Yoshihide Suga says the government intends to declare states of emergency in prefectures where infections are spreading, rather than expanding it nationwide. | POOL / VIA AFP-JIJI

Virus experts advising the central government and regional leaders are calling for stronger measures.

When the central government consulted with experts on Friday before expanding virus countermeasures, its initial plan was to issue pre-emergency measures in a handful of prefectures. But experts on the government’s coronavirus subcommittee insisted that wasn’t enough, and officials conceded and announced later that evening that the state of emergency would be expanded to three more prefectures, and contingency measures to three more as well.

The country’s third and ongoing state of emergency was first declared in late April in four prefectures — Tokyo, Osaka, Kyoto and Hyogo — until May 11. When the order was extended to the end of May, two more — Aichi and Fukuoka — were added to the list. Hokkaido, Okayama and Hiroshima were added last week.

Meanwhile, pre-emergency measures meant to prevent the need for a state of emergency that were first enforced in four prefectures in mid-April have been expanded to 10 prefectures until June 13.

To contain the spread of the pandemic, vaccinating the population is key. But only roughly 3% of Japan’s 126 million people have received their first shot of a COVID-19 vaccine, the lowest of all major economies.

To speed up the rollout, the central government plans to inoculate elderly people at two large-scale vaccination sites in Tokyo and Osaka slated to become operational on May 24. The country is looking to initially inoculate elderly residents of Tokyo, Saitama, Chiba, Kanagawa, Osaka, Kyoto and Hyogo at a rate of 5,000 shots a day at the Tokyo site and 2,500 in Osaka, though it will aim to double those numbers.

“Without the vaccine,” Tokyo Gov. Yuriko Koike said in April. “We’re fighting the virus empty-handed.”

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