As the coronavirus outbreak soars to new heights in and around Tokyo, a desperate race between the delta variant and the country’s vaccine rollout is forcing the central government and local municipalities to adjust course.

Tokyo reported an unprecedented 3,177 cases of COVID-19 on Wednesday, the capital’s highest ever daily count. The capital’s long-standing record — which was broken on Tuesday with 2,848 cases — was set on Jan. 7, when the city logged 2,520 during the peak of the country’s third wave.

On Wednesday, all three prefectures bordering Tokyo hit record daily highs, NHK reported, with Kanagawa logging 1,051 cases, Saitama posting 870 and Chiba confirming 577 infections. Ibaraki Prefecture, which borders Chiba, also hit a record-high, with 194 cases. The country also reported over 9,500 new cases, its highest-ever daily count, according to Kyodo News.

Compared with the third wave, the country is now facing a larger number of daily infections, more cases among younger people and the threat from highly contagious, deadlier variants of the coronavirus — but far fewer deaths and patients with severe symptoms who require intensive care.

In Tokyo, officials insist the city is better prepared now than at any point in the pandemic, but that confidence might not hold if new cases continue to emerge so quickly.

“The current situation (in Tokyo) isn’t as dire as it was in January, but it could worsen very quickly,” Norihiko Yoshimura, director of the Tokyo Metropolitan Government’s Bureau of Social Welfare and Public Health, told reporters Tuesday evening.

“Foot traffic isn’t declining as quickly as it did in May” when a state of emergency was in place, he explained, “and the delta variant is proving to be more dangerous than we previously thought.”

Currently, blood tests and genomic screening are used to retroactively determine the presence of the delta variant in polymerase chain reaction (PCR) tests. As of Wednesday, Tokyo has detected the delta variant in 4,817 out of 16,680 PCR tests screened since late April.

The delta variant was detected in more than 30% of PCR tests screened between July 5 and July 11.

Of the 2,520 cases of COVID-19 reported on Jan. 7, people older than 60 made up 14% of infections, while people in their 40s and 50s accounted for 29% and people younger than 30 accounted for 57%.

By contrast, people 60 and older represented 5% of the 3,177 cases reported Wednesday, while those in their 40s and 50s accounted for 27%, and everyone younger than 30 made up more than 67% of the total.

A similar trend is occurring in Kanagawa, Chiba, Saitama, Okinawa and Osaka prefectures. With new cases emerging rapidly, the governors of Kanagawa, Chiba and Saitama — which all neighbor Tokyo — are reportedly planning to ask the central government to declare a state of emergency in their respective prefectures.

During the third wave in January, more than 3,400 of Tokyo’s 4,000 coronavirus hospital beds — roughly 85% — were occupied, whereas as of Tuesday less than 2,800 of its nearly 6,000 beds were filled. Furthermore, patients with severe symptoms topped 160 cases six months ago, but on Tuesday the number only just rose above half that figure, with officials reporting 82 active cases in need of intensive care.

While severe cases may be lower now, the increase in infections among young and middle-aged people is leading to a rise in asymptomatic or mildly ill patients, who are currently being sent to hotels repurposed to take in virus patients or hospital wards newly allocated for them.

On Monday, the Tokyo Metropolitan Government issued a request to medical facilities in the capital to reduce or suspend regular intensive care and postpone scheduled surgeries, among other things, by Aug. 6 so more hospital beds can be set aside for COVID-19 patients.

The capital aims to increase COVID-19 hospital beds from 5,967 to 6,406 by the end of next week.

But while some of the countermeasures put in place and changes made in the past six months may look good on paper — such as the gradual increase of hospital beds for COVID-19 patients — they also have unintended consequences, including the interruption of routine medical treatment.

In addition, the habitual declaration of states of emergency is damaging the effectiveness of voluntary countermeasures, and subsequent restrictions — shorter business hours and banning restaurants, bars and dining establishments from serving alcohol — are also choking the economy.

The vaccine rollout, which remains the best weapon against the deadly pathogen, is slowly but surely making progress in Japan, where 26.3% of the population had been completely inoculated as of Tuesday.

In Tokyo, around 26% of the city’s 13.9 million residents had received their first dose as of Tuesday, according to the Tokyo Metropolitan Government, although that figure doesn’t include shots administered by private companies.

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