Japan expanded quasi-emergency measures to four more prefectures yesterday, bringing the total to 10 and raising questions over whether the Olympics can really proceed on schedule in under 100 days.
The fate of the Games lies on whether Covid-19 can be brought under control soon enough in the country, which will affect issues like delegation sizes, athlete visas and the necessary countermeasures against the coronavirus.
"We are not thinking of cancelling the Olympics," Tokyo 2020 president Seiko Hashimoto said yesterday. "We will continue to do what we can to implement a thorough safety regimen that will make people feel complete safety."
This comes a day after the ruling Liberal Democratic Party's second-in-command Toshihiro Nikai - in a rare breakaway from the government line - said that cancellation is always an option. He said: "What would be the point of an Olympics that spread the infection?"
Experts are warning of the risk of the Games going down in history as a "super-spreader" event, instead of the much-hoped-for symbol of triumph over Covid-19.
The British Medical Journal this week published an article by four doctors, three of whom are Japanese, who said: "Holding Tokyo 2020 for domestic political and economic purposes - ignoring scientific and moral imperatives - is contradictory to Japan's commitment to global health and human security." The doctors added: "Despite its poor performance, Japan still invokes exceptionalism."
Patience is fast running out. The pro-government Yomiuri newspaper, in an unusually blunt editorial yesterday, said the fourth wave "cannot be said to have been unexpected", and pinpointed a "failure to find effective solutions".
Indeed, the path to the Games is riddled with potholes. Only 0.93 per cent of Japan's population have received at least their first inoculation dose as at Thursday, as supplies are affected by factors such as the government's slow approval of the vaccine.
Prime Minister Yoshihide Suga reportedly will make a personal appeal for more vaccine doses to Pfizer's chief executive officer Albert Bourla today. Mr Suga is in Washington for a summit with United States President Joe Biden.
Fears, in the meantime, are mounting over the spread of mutant strains that the authorities warn are more infectious and more likely to cause severe symptoms.
The British N501Y variant is now dominant in the western areas of Japan such as Osaka, which yesterday logged 1,209 cases - the fourth straight day it has had to reset its one-day high. There are now more severely ill patients in Osaka than hospital beds available for them.
Elsewhere, in areas such as Tokyo and Okinawa, the strain wreaking havoc is the E484K mutation that was first identified in South Africa and Brazil and is said to be more resistant to vaccines.
Tokyo Governor Yuriko Koike yesterday explicitly called for outsiders "not to enter the city".
The quasi-emergency measures - now in effect in Tokyo, Osaka, Kyoto, Hyogo, Miyagi and Okinawa - were expanded to Tokyo's neighbouring prefectures of Saitama, Kanagawa and Chiba, as well as Aichi in central Japan. They will take effect on April 20 and last until May 11.
Meanwhile, Ehime in western Japan yesterday said it wanted to be covered by the quasi-emergency measures, which medical experts have recommended should be expanded to Osaka's neighbour Nara and Fukuoka in the south-west.
Japan logged just 600 cases nationwide on March 8 but reported 4,532 cases yesterday, the third straight day that the figure has breached the 4,000 mark.