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Prime Minister Yoshihide Suga announced Wednesday that the country’s state of emergency will be expanded from 13 prefectures to 21, broadening the nation’s strictest measure for a third time as the current coronavirus wave worsens.

Effective Friday, the state of emergency will be active until Sept. 12 in Hokkaido, Miyagi, Gifu, Aichi, Mie, Shiga, Okayama and Hiroshima prefectures, in addition to Tokyo, Ibaraki, Tochigi, Gunma, Chiba, Saitama, Kanagawa, Shizuoka, Kyoto, Osaka, Hyogo, Fukuoka and Okinawa.

Suga also announced that quasi-emergency measures effective in 16 prefectures will be expanded to encompass four more — Kochi, Saga, Nagasaki and Miyazaki — until mid-September.

“Nationwide cases are topping 25,000 a day and remain at an extremely high level due to the spread of the highly contagious delta variant,” Yasutoshi Nishimura, the minister leading the country’s coronavirus response, said Wednesday morning. “Severely ill patients are increasing rapidly and the health care system is under significant strain.”

With emergency or quasi-emergency measures becoming active in 33 of the country’s 47 prefectures, there are growing calls — including from the National Governors’ Association last week — for one or the other to be expanded nationwide as a fifth wave fueled by the delta variant continues to spread across Japan.

Hospitals continue to struggle under a surge in COVID-19 patients that began earlier this month. While young people accounted for the majority of cases when the fifth wave began in Tokyo in July, new cases have recently emerged more broadly across different age groups.

Young and middle-aged people now make up the largest share of new cases in Tokyo, accounting for about 50%, and a growing number of severely ill patients have been reported among middle-aged and older people.

The nationwide tally of severely ill patients reached 1,964 on Wednesday, a record high for the 13th consecutive day.

Streets in Tokyo's Shibuya Ward on Aug. 18 | RYUSEI TAKAHASHI
Streets in Tokyo’s Shibuya Ward on Aug. 18 | RYUSEI TAKAHASHI

A shortage of hospital beds for those with COVID-19 has led to an increase in patients being asked to isolate at home or being given no choice but to do so.

In a major policy shift, the government announced earlier this month that some mild and moderately ill patients will be asked to isolate at home to alleviate pressure on the health care system. However, critics have pointed out that the condition of such COVID-19 patients can suddenly and unexpectedly deteriorate, and that the policy shift could make it difficult for people to receive treatment if that happens.

On Friday, a Tokyo Metropolitan Government COVID-19 monitoring committee revealed that five patients had died at home in the capital over the past week.

As patients in major cities are finding it increasingly difficult to find a hospital willing or able to take them in, public officials have begun to pour resources into the distribution of an “antibody cocktail” treatment that has been shown in clinical trials overseas to be highly effective in preventing patients from developing severe COVID-19 symptoms.

The Tokyo Metropolitan Government also established an oxygen station earlier this week — with plans to add more — where mildly ill patients who have trouble breathing can receive oxygen while they await hospitalization.

Amid efforts by officials to reduce foot traffic, Suga met with business leaders last week, urging them to have 70% of their employees work remotely. But a poll conducted by Persol Research and Consulting Co. showed that only 27.5% of about 20,000 permanent workers surveyed between July 30 and Aug. 1 nationwide said they were teleworking.

As students near the end of summer break, the central government has urged schools to teach classes remotely if and when possible. On Wednesday, Shigeru Omi, chair of the government’s coronavirus subcommittee, urged the government to prioritize the vaccination of teachers, as the country did with health care workers earlier this year.

“With so many cases emerging every day, one could become infected anywhere,” Nishimura told reporters Wednesday. “Tomorrow it could be you.”

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