As outbreak escalates nationwide, Japan's government considers post-emergency plans

As Japan becomes further inundated by a COVID-19 wave of unprecedented scale and severity, the central government — long criticized for its haphazard response to the pandemic — is looking to revise the country's guidelines for lifting a state of emergency and devise an exit strategy for when the current one expires.

Previously, five criteria — hospital occupancy, the number of coronavirus patients, positive test rates, daily infections and the number of untraceable cases — had been flexibly taken into account when declaring, expanding, extending or lifting a state of emergency. Moving forward, however, two new factors — the vaccination rate and the number of severely ill patients — will be added to the list as the country shifts its primary focus away from daily cases and onto new data points, Chief Cabinet Secretary Katsunobu Kato said during a news conference Wednesday.

The country is pivoting to recovery efforts even as the outbreak continues to worsen. Currently, 13 of the 47 prefectures are under a state of emergency that is scheduled to expire on Sept. 12. Kato said the central government aims to announce the revised guidelines before then.

Until now, public officials had calibrated their pandemic response based on new cases — whether it be a rolling weekly average or daily infections in relation to the population size — or the degree to which the health care system is inundated with COVID-19 patients.

This wave, however — which began in the capital in July but has escalated into a record-breaking nationwide outbreak — has led to far more daily infections, particularly among young or middle-aged patients, but fewer fatalities, severely-ill patients and infections among older people.

Under the current criteria, regions reporting more than 25 cases for every 100,000 people in a week have reached Stage 4, according to the health ministry's four-point alert system. Kato said that figure may be revised.

“We will examine the situation comprehensively and make a decision in close consultation with experts,” Kato said.

Deaths and severe cases are quickly rising and the sheer volume of new cases in some parts of the country has inundated hospitals, public health centers and temporary quarantine facilities, forcing public officials to ask an increasing number of patients with mild or moderate symptoms to isolate at home where they risk infecting the people they live with.

“The vaccine is clearly effective in reducing the number of severely ill patients,” Prime Minister Yoshihide Suga said during a news conference Tuesday evening. “New cases are an important factor, but perhaps the number of severely ill patients or hospitalized patients are better indicators of the state of the health care system, and should therefore be weighed more heavily.”

When Suga administration officials mentioned the creation of an exit strategy earlier this month, critics quickly pointed out not only that the outbreak is getting worse but that the central government is also failing to contain it. Talk of a recovery plan seemed to strike many as hasty.

Japan has endured four waves of the pandemic and is now in the midst of its fifth. After the country lifted a state of emergency in May 2020, the capital attempted to gradually reopen by incrementally lifting restrictions over a span of several weeks. The plan appeared effective at first but gradually cases rebounded.

Between the country’s third and fourth wave, the central government used quasi-emergency measures — more lenient in comparison to the measures in place under a state of emergency — to prevent a viral rebound after the full-blown state of emergency was incrementally lifted. But the effort failed in Tokyo and Osaka, where new cases spiked two to three weeks later.