Japan's national vaccination drive has lagged and most people in the capital still have not been inoculated as infections have surged.
The raised status announced by Prime Minister Yoshihide Suga will allow Tokyo's governor to mandate shorter opening hours for bars and restaurants, along with punishments for violators and compensation for those who comply. The measures are to begin Monday and continue through May 11.
Many of Tokyo’s cases have been linked to nightlife and dining, though they have recently spread to offices, elderly care facilities and schools, experts say.
“We will do everything to contain infections within the affected areas and prevent them from spreading across the country,” Suga told reporters.
Tokyo Gov. Yuriko Koike asked residents to avoid nonessential trips and practice social distancing. She asked bars and restaurants in many areas of the prefecture to close at 8 p.m.
“In order to protect the medical systems in Tokyo, we have to work much harder to further reduce the movement of people,” Koike said. “We must curb the infections so we don't have another resurgence at the time of the Olympics."
The alert status was also raised on Monday for parts of three other prefectures — Osaka, neighboring Hyogo and Miyagi in the north. They have had sharp increases in daily cases since early March, soon after Japan scaled down a partial and non-binding state of emergency that began in January.
With Friday's additions, 15 cities in the six prefectures, including downtown Tokyo, are designated for elevated virus measures.
The steps come less than three weeks after the emergency was lifted for Tokyo, underscoring the difficulty of balancing anti-virus measures and the economy. Suga’s government has been criticized for being too slow in enacting anti-virus measures out of a reluctance to further damage the pandemic-hit economy.
The new alert status come with binding orders but only for businesses to close early while measures for the residents are only requests, and some experts are skeptical about their effect.
Dr. Shigeru Omi, head of a government experts' panel, said many people are tired of restrictions and have become less cooperative in response to requests despite the spread of the new variant.
“I think requests for cooperation can no longer effectively reduce infections," Omi said, adding that medical systems will collapse unless Japan manages to prevent a big resurgence through June, when elderly people are due to complete their vaccinations. “We are at a very difficult time.”
Osaka has declared a medical emergency after its hospitals became overwhelmed with new cases and has moved next week’s Olympic torch relay there off public roads.
Just over 1 million people in Japan, or less than 1% of the population, have received the first of two vaccine doses, and the surge in cases may cause further cancellations of Olympic-related events.
Inoculations started in mid-February for medical workers. Elderly people are scheduled to get their shots starting next week through late June. The rest of the population is likely to have to wait until about July, making it almost impossible for Japan to reach so-called herd immunity before the Tokyo Olympics begin on July 23.