Customers enter a store that is open until late at night in Naha, Okinawa Prefecture, on Aug. 6, 2021. Okinawa Prefecture is under a continued coronavirus state of emergency. (Mainichi/ Shinnosuke Kyan)

       NAHA -- The explosive coronavirus spread in Okinawa Prefecture is putting its medical system under increasing strain, with weekly new infections per unit of population the worst in Japan and surpassing Tokyo's since the end of July. Two and a half months since the central government declared a state of emergency for the southern island prefecture, why hasn't the outbreak been brought under control?

       In Okinawa Prefecture, 638 new cases of infection were reported on Aug. 11, its second most to date. That is equivalent to Tokyo, with a population 9.3 times that of Okinawa's, reporting some 6,000 new cases. The capital's single-day high is 5,042, recorded on Aug. 5.

       A state of emergency was declared for Okinawa Prefecture on May 23. Daily new infections had decreased to 28 on July 5, but have been increasing again since late July. The weekly count was 780 from July 18 to 24, but it spiked to 2,239 from July 25 to 31 and 3,406 from Aug. 1 to 7.

       The biggest factor was the spread of the highly infectious delta strain. According to prefectural government screening, the delta strain made up 3% of positive tests in early July, but reached 79% in early August.

       "Okinawa is vulnerable to the delta strain," said Dr. Yoshihiro Takayama, a member of the prefectural epidemiological statistics and analysis committee. One contributing factor is the large number of children. As of October 2019, 16.9% of the prefecture's population was under 15, compared to 12% for Japan overall and 11.1% in Tokyo. According to national data, the proportion of those aged 19 or younger among new infections between July 28 and Aug. 3 was 15.4% nationwide and 12% in Tokyo, but 22.5% in Okinawa.

       Takayama said, "Previously, children were mostly uninfected, but with the delta strain, there are many cases where adults are infected and bring the virus home, and children are all infected as well."

       With the prolonged state of emergency, the number of infections at eating and drinking places has gone back up. According to the prefectural government, the number of weekly cases traced to these establishments increased from 14 in late June to 159 in late July.

       The prefectural government has asked establishments serving alcohol to close their doors and for those that don't to shorten their business hours to 8 p.m., but more and more businesses have reopened since July 12, when the emergency originally to last until July 11 was extended until August.

       One prefectural official said, "Some people are saying, 'I've reached the limit of my patience,' and 'Why is only Okinawa still under a prolonged state of emergency?'"

       In response, the prefectural government has been trying to curb the flow of people by asking large commercial facilities to close on holidays after Aug. 7. In recent days, nearly half of the newly infected have been in their 20s and 30s. Jiro Fujita, chair of the prefectural government's expert committee on measures to combat the coronavirus, said, "We have to think about how to deliver our message to young people."

       Meanwhile, the strain on the medical system has grown, and the number of seriously ill patients has gone from four at the end of July, to 17 on Aug. 11. The number of moderate cases increased to 489, the highest number ever. The hospital bed occupancy rate for moderate cases reached 93.8% on the main island of Okinawa. The number of patients recuperating at home also increased to 1,940.

       The prefecture has a policy of hospitalizing patients with moderate or worse COVID-19 symptoms, and mild cases who are at high risk of becoming seriously ill, but a hospital bed shortage is imminent. Some prefectural hospitals, which are priority medical institutions for COVID-19, are suspending hospitalization and outpatient treatment for non-coronavirus patients.

       Doctors and other staff members at the prefectural task force working to coordinate hospitalization expressed grave concern, saying that the medical system could collapse overnight or the next day, as there is nowhere that patients can go.

       It is now peak tourism season in Okinawa, and the influx of visitors from outside the prefecture continues. In addition, the three days from Aug. 20 is the lunar calendar's Obon period in Okinawa, when relatives gather to make offerings to their ancestors.

       Dr. Takayama expressed concern, saying, "There is no prospect of the number of infected people dropping anytime soon, because there is no shared sense of crisis across society and there have been no strong interventions. If the number of moderate cases who cannot be hospitalized grows, some people may die at home."

       (Japanese original by Takayasu Endo and Nozomu Takeuchi, Naha Bureau)

       Font Size S M L Print Timeline 0