With their addition, Japan's third state of emergency since the start of the pandemic will cover an area accounting for one-third of its population and more than 40 percent of the world's third-largest economy.
"We need to maintain a strong sense of vigilance and take further steps" to curb infections, Prime Minister Yoshihide Suga told a press conference after finalizing the decision at a task force meeting.
The state of emergency has been in effect in Tokyo, slated to host the Olympics in less than three months, as well as Osaka, Kyoto and Hyogo prefectures since April 25, with targeted steps aimed at curbing the spread of the coronavirus during the Golden Week holidays.
Restaurants and bars have been prohibited from serving alcohol or offering karaoke services and must close by 8 p.m. with a fine of up to 300,000 yen ($2,750) for noncompliance. Businesses are being encouraged to have employees work from home.
The government will ease some restrictions to mitigate the hit to businesses. Starting Wednesday, large commercial facilities such as department stores and movie theaters will be allowed to reopen, though they will also be asked to close by 8 p.m.
A ban on spectators at sports games and concerts will be replaced with a cap of 5,000 people or 50 percent of the venue's capacity, with events being required to end by 9 p.m.
But Tokyo Gov. Yuriko Koike and Osaka Gov. Hirofumi Yoshimura both said they will continue to ask large commercial facilities, defined as having more than 1,000 square meters of floor space, to remain closed, saying the situation had not improved enough to let down their guard.
In addition, the government will strengthen restrictions on Japanese nationals and foreign residents in the country arriving from India, which has been devastated by a highly contagious coronavirus variant. It will also urge people to refrain from drinking alcohol on streets or in parks in groups.
Suga stressed the state of emergency has been successful in reducing the number of people out and about and that it was possible to stage a "safe and secure" Olympics while "protecting the lives and health of the Japanese people."
The number of daily coronavirus deaths hit a record 148 on Friday, with the nationwide tally of new cases topping 6,000, the most since mid-January.
According to the Ministry of Health, Labor and Welfare, at least 1,131 COVID-19 patients were in serious condition, also a record high and stoking fears of further strains on the health care system.
Osaka and Hyogo, in particular, have struggled to free up hospital beds for COVID-19 patients, with several reports of people dying at home while waiting to be admitted.
Shigeru Omi, an infectious disease expert who heads a government subcommittee on the coronavirus response, warned against lifting the state of emergency prematurely.
"We need to wait two or three weeks after the number of infections bottoms out. That will buy us time until the next rebound," he said.
Meanwhile, Japan's vaccine rollout has lagged behind other countries such as Israel, Britain and the United States, and public dissatisfaction could add pressure on Suga ahead of a general election later this year.
Suga said the government hopes to ramp up to 1 million shots administered per day, roughly triple the current pace, and begin inoculating people with underlying conditions next month.
The government on Friday also extended a quasi-state of emergency covering Saitama, Chiba, Kanagawa, Ehime and Okinawa prefectures to the end of May and added Hokkaido, Gifu and Mie. Miyagi, which has seen a fall in coronavirus cases, will be removed after Tuesday.
Restrictions under the designation, introduced in a legal revision in February, are not as strict as a full-fledged emergency, with requests for restaurants and bars to close early limited to specific areas and carrying smaller fines for noncompliance.