Japan on Monday expanded its COVID-19 state of emergency, raising the alert over a recent spike in coronavirus cases that comes amid the Tokyo Olympics and threatens to trigger a collapse of the medical system.

The government of Prime Minister Yoshihide Suga decided the same day that only patients with severe cases of COVID-19 can be admitted to hospital, an effective policy U-turn. It had said that all patients except for those with mild symptoms should be hospitalized in principle.

The state of emergency, which had covered Tokyo and Okinawa, has now expanded to include the western prefecture of Osaka as well as three prefectures -- Chiba, Kanagawa and Saitama -- near the capital. It is effective through Aug. 31.

People wearing face masks walk in front of JR Osaka Station on Aug. 2, 2021. (Kyodo)

The emergency period in Tokyo and Okinawa was also extended to the end of the month from the initially planned Aug. 22.

Establishments serving alcohol or offering karaoke in the six prefectures under the emergency are asked to close during the period, with the government providing money for compliance. Those not serving alcohol are requested to close at 8 p.m.

The government is expected to outline how it will ease restrictions as inoculation of the population progresses, but the end of the epidemic is not in sight yet in the country.

The surge in infections comes amid the spread of the virus's highly contagious Delta variant, first detected in India.

On Monday, the nationwide tally of new infections totaled nearly 8,400, after the country logged more than 10,000 additional cases for four consecutive days through Sunday.

"Patients other than critically ill people and those with a high risk of symptoms deteriorating should recuperate at home basically," Suga told a meeting of relevant ministers amid growing concern about hospital bed shortages.


Outside the six prefectures, a quasi-state of emergency, which carries fewer restrictions on business activity than the state of emergency, was imposed Monday on parts of five prefectures -- Hokkaido, Ishikawa, Kyoto, Hyogo and Fukuoka -- through the end of August.

Serving alcohol is banned and restaurants not serving liquor are requested to close at 8 p.m. in the five prefectures under the quasi-state of emergency as well. Governors are authorized to relax restrictions based on improvements in the situation.

However, many people in Japan have grown skeptical about the effectiveness of states of emergency partly because they are tired of restrictions, with some ignoring authorities' stay-at-home requests as the country hosts the Olympic Games.

"Since the Olympics are being held, many people might be thinking that it is fine to go out," said Narumi Sakai, a 54-year-old woman who was on her way to work, at JR Tokyo Station.

"The train was as packed as ever," said Tetsu Shiozawa, 46, at JR Kannai Station near the Kanagawa prefectural government office, doubting the effectiveness of the emergency declaration.

Yoshitaka Yamazaki, a 73-year-old lawyer, said at JR Osaka Station that he felt the train hub was as crowded as before the spread of the coronavirus, adding that he believes most of those out on the streets are young people "with little sense of caution."

A 38-year-old public servant in the city of Chiba forecast "a continuous repetition" of virus emergencies in Japan.

The surge in the number of COVID-19 infections in the country became particularly notable after a four-day weekend late last month, fueling worries about the strain on the health care system.

According to data released by the Health, Labor and Welfare Ministry, the number of COVID-19 patients quarantining or being taken care of at home stood at 18,927 last Wednesday, 1.8 times the number a week earlier.

Hospital bed occupancy rates for COVID patients in Tokyo, Saitama, Ishikawa, and Okinawa prefectures were 50 percent or higher, the level that the government's COVID-19 subcommittee designates as stage 4, the highest level of alert.

Related coverage:

Tokyo's daily new COVID-19 cases top 3,000 for 5th day in row

Tokyo Olympics CEO says COVID cases at Olympics "within expectations"

Japan starts giving COVID vaccine shots to citizens temporarily returning