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The government plans to extend its COVID-19 state of emergency in Tokyo and 18 other prefectures until the end of this month, beyond the currently scheduled expiration on Sunday, sources familiar with the matter said Wednesday.

The state of emergency is currently in place in 21 of Japan's 47 prefectures. It will be lifted in Miyagi and Okayama, where less strict quasi-emergency measures will be implemented.

The government found that medical systems are still overwhelmed in the 19 prefectures. It will make a final decision on Thursday after hearing opinions from experts.

A health ministry advisory board said that while the number of new COVID-19 cases continues to decline in almost all regions, the number of severely ill patients remains elevated. The COVID-19 situation is still at a disaster level, the board said.

"It's uncertain whether the number of new cases will continue to decline, and it's too early to say that infections have peaked across the country," Takaji Wakita, head of the National Institute of Infectious Diseases who chairs the advisory board, said at a press conference.

The government introduced new guidelines that place a greater emphasis on the availability of medical care when considering whether to lift the state of emergency.

A panel of experts who advise the government on pandemic responses said whether the numbers of severely and moderately ill COVID-19 patients are on a continued downtrend should be taken into account.

Under the previous guidelines, a region with 25 or more new COVID-19 cases per 100,000 population in the past seven days corresponds to Stage 4, the highest of the country's pandemic alert levels, which requires a state of emergency.

But the country's medical system has become able to tolerate 25 cases or more, and the level does not immediately mean strains on the system, said Shigeru Omi, chairman of the panel.

The government will also lift the quasi-emergency designation for six prefectures as it expires on Sunday and extend the designation for six others.

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