With just over a quarter of Japan fully vaccinated against COVID-19, some in the Suga administration have been hoping to turn the page in the fight against the virus by shifting attention away from daily case totals and recalibrating the public’s focus on fatalities and serious cases in a bid to restore some semblance of stability.

Prime Minister Yoshihide Suga’s apparent hopes, however, were crushed last week when the number of daily new cases rose to more than 4,000 in Tokyo and surged past 12,000 nationwide for the first time Saturday. Another coronavirus state of emergency, set to take effect Monday, has been announced for Chiba, Saitama, Kanagawa and Osaka prefectures to alleviate fears among a public shocked by the unprecedented jump in new cases.

Japan has appeared to narrow the gap with countries in the West in obtaining and administering vaccines, and has gained the upper hand in the race to beat back the virus. But a combination of the more contagious delta variant and foot traffic, which declined but not as much as previous occasions under the state of emergency, are outpacing the speed of vaccinations.

The public is already showing fatigue from the repeated emergency declarations alongside the ever-rising daily tallies of alarmingly high daily figures and reports of the medical system coming under increasing strain. Considering this harsh reality, the administration’s envisioned exit strategy from the pandemic through vaccines is facing yet another obstacle.

Unless vaccines are administered to a significant percentage of the public, it’s unlikely that the administration will succeed in persuading people to look past the daily caseloads and treat COVID-19 as more of a seasonal infectious disease.

In June, Suga appeared confident that vaccines alone would be enough to stabilize the outbreak when opposition Constitutional Democratic Party of Japan leader Yukio Edano argued that restrictions needed to be in place until Tokyo saw its daily tally drop to at least 50 new cases per day.

“What people are worried about the most is the level of available hospital beds,” Suga said in response. “Even in countries that imposed strict actions like banning going outside, they could not bring the pandemic under control. The fact is we’re making great progress with vaccines.”

He echoed that message during a news conference Friday night when asked by a reporter whether he intends to make a transition from a policy focusing on new cases. To devise an exit strategy, he said he will consider vaccine progress and stress levels on medical resources, including the rate of hospital beds in use set aside for COVID-19 patients who are seriously ill.

Evening commuters wearing protective face masks walk in Tokyo's Shinjuku Ward on Thursday. | BLOOMBERG
Evening commuters wearing protective face masks walk in Tokyo’s Shinjuku Ward on Thursday. | BLOOMBERG

With a general election coming in the fall, the prime minister made an all-or-nothing bet on vaccines delivering success for his administration by vowing that all residents wishing to be vaccinated would be able to receive their shots by November. As of Friday, 73% of seniors and 28% of the entire population had finished their two-dose vaccination course, according to the Prime Minister’s Office.

Beginning from as early as the middle of last year, the central government had examined shifting medical resources to patients in serious condition, many of whom tend to be older and needed oxygen apparatuses to survive.

When the first COVID-19 vaccines were approved earlier this year in Japan, people age 65 and older, who face a higher risk of developing serious symptoms that require intensive care, were among the first group to receive their shots.

As a result, the number of serious cases nationwide fluctuated between 376 and 691 in July, compared with between 1,050 and 1,413 in May, when the country was going through the fourth wave of the pandemic and more older people were critically ill. According to the health ministry, the highest daily figure for virus-linked deaths nationwide in July was 24, while May saw a high of 260.

Behind the scenes, administration officials have been hoping that as more vaccinations are given, the number of serious cases and deaths will drop to a sufficient level to dial back restrictions and treat COVID-19 similar to the seasonal flu.

“A trend worldwide has begun shifting toward (focusing on) the number of serious cases and deaths,” a senior administration official said Monday.

“We need to start to change how we look at things,” the official added, implying the public has had a tendency to become fixated on daily caseloads.

Indeed, public attention has not shifted away from daily case numbers despite the government’s expectations, sapping administration of any momentum toward changing its focus.

Just a day after the official’s comments, COVID-19 cases surged both in the capital and across the country — registering 2,848 in Tokyo and over 9,000 nationwide — as pessimism among the public overtook the government’s optimism. The following two days were even worse, with the capital breaking single-day records on both Wednesday, with 3,177, and Thursday, with 3,825.

Although the number of older people who died or developed severe symptoms has declined, serious cases among people in their 40s and 50s, who have not been vaccinated, continue to rise.

Prime Minister Yoshihide Suga declares a fresh state of emergency at a meeting on the coronavirus in Tokyo on Friday. | KYODO
Prime Minister Yoshihide Suga declares a fresh state of emergency at a meeting on the coronavirus in Tokyo on Friday. | KYODO

After meeting with Suga on Friday, Shigeru Omi, the top coronavirus adviser to the government, sounded the alarm over the trend. The numbers of people in that age group experiencing moderate to severe symptoms and those who are waiting at their homes to be admitted to hospitals are swelling, he said.

“I told the prime minister that hospitals are facing a different type of challenge in terms of their resources facing a heavy burden,” Omi said Friday afternoon. “They can no longer deal with (the situation) using the approach the have taken until now, focusing only on seriously ill patients.”

Previous waves have shown that serious cases begin to climb a week or two after a surge in new infections.

On Friday, Suga was forced to announce a virus state of emergency for the fourth time not just to assuage the public’s trepidation but also to buy more time to emphasize serious cases over daily infection tallies in a bid to improve his standing with voters.

“I made a decision to expand locations and extend the duration of the state of emergency … to ensure medical resources will not be overwhelmed as countermeasures are implemented and more vaccines are administered,” Suga said.

However, the effectiveness of yet another emergency remains questionable, since people have become desensitized to the impact of such warnings. Administration officials concede they are running out of options and are reluctant to introduce more stringent measures such as closing down department stores to curb foot traffic.

Still, those officials believe that the current situation is much better than the one in April and May, when a number of COVID-19 patients in serious condition died at their homes after hospital beds filled up.

“As people who need to be immunized receive their vaccines by September, October and November, we hope we can have a conversation by then about how we look at COVID-19,” one senior administration official said. “We can’t continue to live under restrictions like this any more.”

Meanwhile, some have criticized Suga for downplaying the threat from the latest wave of the virus.

Health experts such as Omi have warned that “the biggest crisis” Japan is facing is the lack of a sense of crisis over the current situation. At the current rate, the experts say, patients in need of medical attention may be turned away as hospitals become increasingly overwhelmed.

“Remarks that make little account of daily cases should not be made at a time when roughly a quarter of the population is vaccinated, the delta variant is spreading and things are still uncertain,” said Takakazu Yamagishi, a political scientist studying health policy at Nagoya’s Nanzan University. “Any effort to treat the number of new cases as insignificant at this point is politically motivated.”

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