Japan's failure to sufficiently stem the spread of the coronavirus under a state of emergency has led to an unexpectedly sharp rise in the number of new cases in Osaka, forcing Prime Minister Yoshihide Suga to designate the western prefecture and two other areas for stricter measures against COVID-19.

Suga was initially reluctant to designate the coronavirus semi-emergency status to the prefectures of Osaka, neighboring Hyogo and Miyagi in the northeastern region, according to people familiar with his thinking.

He apparently feared such a decision would fan criticism that he was too quick to lift the partial state of emergency, which ended finally in the Tokyo region on March 21 after more than two months.

But he was given no choice other than to change his mind Thursday after health experts said Osaka, which saw the state of emergency lifted on March 1 along with five other prefectures, was facing a "fourth wave" of infections.

The new stronger COVID-19 measures will take effect for a month from April 5.

Since a revised law took effect in February, Osaka, Hyogo and Miyagi became the first three prefectures to be designated as being on the brink of a state of emergency. As such they were given the authority to implement the measures, including fines for eateries that ignore mandates to shorten operating hours in targeted cities and towns.

People wearing face masks walk in Osaka's Umeda area on April 1, 2021, amid a resurgence in coronavirus infections. (Kyodo) ==Kyodo

"The rebound is rapid," said Suga, who was seemingly shocked after hearing that the number of new infections in Osaka Prefecture jumped to 432 on Tuesday, more than double the 213 logged the previous day, according to a person who was there at the time.

Osaka Gov. Hirofumi Yoshimura on Sunday phoned Yasutoshi Nishimura, the minister in charge of Japan's virus response, and sounded out on the designation by the central government, saying the infection situation would worsen further.

The prefectural government had been concerned over the number of new cases rising "at a record pace," a senior Osaka official said.

The prefecture logged 56 new cases when the state of emergency was lifted, but the number began to rise sharply in late March, reaching 323 on Sunday to eclipse the daily total confirmed by Tokyo on the same day.

On Monday, Nishimura, who was in favor of the designation, told Suga that Yoshimura was expected to formally request it, but the prime minister did not respond positively at the time, with bureaucrats present believing he was unwilling to go forward with the proposal.

It was only after seeing the Osaka figures jump the next day that Suga decided there was no choice but to introduce the measures, and make it a condition that Yoshimura would agree to thoroughly implement shorter business hours for restaurants and bars, and require them to close by 8 p.m.

Suga was unhappy with Yoshimura's approach as he had publicly advocated the need for the designation. But Osaka Mayor Ichiro Matsui, who has close ties with the prime minister, later served as a middleman between them, according to a person with knowledge of the matter.

Matsui held talks with Suga over the phone and facilitated an agreement between the two sides on the designation despite differences of opinion over where the targeted areas should be.

The move taken by Osaka affected the decisions of the other prefectures, including neighboring Hyogo, where the number of new infections has also been growing fast.

Miyagi Prefecture turned to seek the designation after seeing a similar sudden spike following its temporary resumption of a dining promotion campaign from late February.

People wearing face masks walk on a shopping street in Sendai in Miyagi Prefecture, northeastern Japan, on April 1, 2021. The Japanese government is set to allow Osaka, Hyogo and Miyagi prefectures to take stricter anti-coronavirus measures under a revised law that took effect in February as they have been hit by a resurgence in new infections. (Kyodo) ==Kyodo

The central government forwent with the designation of Okinawa, deeming it needs more time to see the effect of the southernmost island prefecture's original anti-virus measures.

It also decided the same for the northeastern prefecture of Yamagata, with government officials saying if Miyagi successfully contains the virus, they believe the situation there will improve as well.

Still, medical experts are dissatisfied with the central government's virus response.

"We were hit by the first, second and third waves, but I think there was no case in which we thoroughly succeeded in pushing back," Toshio Nakagawa, head of the Japan Medical Association, said at a press conference on Wednesday.

The association had been calling for the designation and implementation of stronger measures should the government decide to lift the state of emergency before the spread of the virus was fully contained.

Medical experts have been apprehensive that people in Japan have become too accustomed to the emergency situation after it was first declared across the country about a year ago, with increased indications that many of them are tired of not being able to go out and meet friends.

"It is necessary for people to think 'This is a serious situation,'" said the association's Satoshi Kamayachi, who is also a member of a government panel. "It would be meaningless if people start thinking, 'Here it goes again.'"


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Japan designates Osaka, Hyogo, Miyagi for tougher COVID-19 steps