Japan’s worst COVID-19 outbreak yet has thrown a spotlight on the inability of the country’s otherwise highly regarded medical system to adapt quickly to emergencies, and its lack of reform to meet such needs.

As new cases surged to more than 25,000 a day this month, driven by the delta variant, the number of medical emergencies nationwide that required an ambulance dispatch but had difficulty finding a hospital to accept the patient rose for six straight weeks to a historic high, according to data from the Fire and Disaster Management Agency.

Defined as cases where emergency medics were turned down by more than 3 hospitals and at the scene for more than 30 minutes, the figure jumped to 3,361 in the week of August 9-15, said the agency, which oversees the ambulance system nationally.