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Osaka Prefecture said Tuesday it will ask the central government to extend its COVID-19 state of emergency until around June 20, a move likely to create a ripple effect on eight other prefectures currently under a state of emergency that is set to be lifted Monday.

Prime Minister Yoshihide Suga is expected to formally decide by the end of the week whether to grant any requests from prefectural governors and for how long. Health minister Norihisa Tamura said Tuesday that the government would consider discussing extensions for Tokyo, Osaka and seven other prefectures.

On April 25, rising numbers of COVID-19 cases and a shortage of hospital beds led the central government to place Tokyo, Osaka, Kyoto and Hyogo prefectures under a state of emergency until Monday. Aichi and Fukuoka were added to the list on May 12, followed by Hokkaido, Okayama and Hiroshima prefectures on May 16.

A 10th prefecture, Okinawa, was put under a state of emergency Sunday that is scheduled to be lifted on June 20.

“As we’ve seen, powerful mutated virus strains have infected 1,000 prefectural residents over three weeks,” Osaka Gov. Hirofumi Yoshimura told the prefectural coronavirus task force Tuesday, before it decided to request the extension. “The local medical system continues to be under heavy stress. Currently, more than 300 seriously ill people are still receiving treatment and the bed usage rate is 90%,” he added. On Tuesday, the prefecture reported 327 new cases.

Other local governments due to see their state of emergencies lifted on Monday are also indicating that they may ask the central government for an extension. While Hyogo Prefecture recorded only 86 new infections on Monday — the figure falling below 100 for the first time in a month and a half — its seven-day rolling average of new infections remained at 183.4 and 77.4% of prefectural hospital beds were occupied.

“Unless the seven-day rolling average falls well below 100, it would be a stretch to say that the state of emergency declaration has borne fruit,” Hyogo’s Gov. Toshizo Ido told reporters, suggesting it would be difficult to lift the measure next week.

In Kyoto Prefecture, Gov. Takatoshi Nishiwaki indicated Tuesday that he, too, was considering a formal request for a state of emergency extension, saying that while the number of new cases had recently decreased, medical facilities remained under strain.

On Monday, Kyoto recorded only 38 new cases. While the seven-day average of daily cases dropped from 140 as of May 15 to 96 on Monday, 50% of prefectural hospital beds set aside for seriously ill patients, including COVID-19 patients, were occupied as of Sunday night.

Gov. Hidehiko Yuzaki in Hiroshima Prefecture also said Tuesday that ending the state of emergency there next week would be difficult. On Monday, the prefecture reported 103 cases and that 52.6% of available beds were occupied.

Elsewhere, Okayama’s Gov. Ryuta Ibaragi said Tuesday that as the current situation in his prefecture didn’t meet the standards for lifting the state of emergency, there would be no option but to extend it. Fukuoka Gov. Seitaro Hattori also indicated Tuesday that he would seek an extension.

Osaka’s decision Tuesday to seek an extension came the day after mass inoculation centers, operated by the Self-Defense Forces, opened there and in Tokyo. A total of 7,348 people were vaccinated at both centers Monday — 4,876 people in Tokyo and 2,472 people in Osaka.

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