India reports 42,640 new COVID-19 cases, 1,167 deaths

FILE PHOTO: Workers carry goods at a market area after authorities eased lockdown restrictions that were imposed to slow down the spread of the coronavirus disease (COVID-19), in New Delhi, India, June 7, 2021. REUTERS/Adnan Abidi

BENGALURU (Reuters) – India reported on Tuesday 42,640 new COVID-19 infections over the past 24 hours, data from the health ministry showed.

The South Asian country’s total COVID-19 case load now stands at 29.98 million, while total fatalities are at 389,302, the data showed. India’s coronavirus-related deaths rose by 1,167 overnight.

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Patients in bind as brain cancer drug price rises to $1,000 per pill

Patients in bind as brain cancer drug price rises to $1,000 per pill

The maker of the expensive brain cancer drug Gleostine has removed it from the Medicare drug rebate program, a move that could have dire consequences for some patients.

The drug from NextSource Biotechnology is used to treat glioblastoma and other brain cancers and can cost as much as $1,000 a capsule. The Gleostine patent has expired, but there is no generic version, CBS News reported. The company’s decision—which means there is one less option in a limited number of approved chemotherapies—was criticized by brain tumor experts and patient advocates.

“The decision by the company to withdraw from public health insurance programs weakens the safety net for vulnerable brain cancer patients who already have few treatment options,” David Arons, CEO of the National Brain Tumor Society, told CBS Moneywatch. “We urge NextSource to rejoin these programs and help reduce barriers for patients who require access to this therapy as well as for researchers and clinical trial participants participating in critical, ongoing brain cancer studies.”

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As COVID-19 cases wane, vaccine-lagging areas still see risk

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JACKSON, Miss. – New COVID-19 cases are declining across most of the country, even in some states with vaccine-hesitant populations. But almost all states bucking that trend have lower-than-average vaccination rates, and experts warn that relief from the pandemic could be fleeting in regions where few people get inoculated.

Case totals nationally have declined in a week from a seven-day average of nearly 21,000 on May 29 to 14,315 on Saturday, according to data from Johns Hopkins University. For weeks, states and cities have been dropping virus restrictions and mask mandates, even indoors.

Experts said some states are seeing increased immunity because there were high rates of natural spread of the disease, which has so far killed nearly 600,000 Americans.

“We certainly are getting some population benefit from our previous cases, but we paid for it,” said Mississippi State Health Officer Dr. Thomas Dobbs. “We paid for it with deaths.”

More than 7,300 Mississippians have died in the pandemic, and the state has the sixth-highest per capita death rate.

Dobbs estimated that about 60% of the state’s residents have “some underlying immunity.”

“So we’re now sort of seeing that effect, most likely, because we have a combination of natural and vaccine-induced immunity,” Dobbs said.

Just eight states — Alabama, Arkansas, Hawaii, Missouri, Nevada, Texas, Utah and Wyoming — have seen their seven-day rolling averages for infection rates rise from two weeks earlier, according to data compiled by Johns Hopkins University. All of them except Hawaii have recorded vaccination rates that are lower than the US average of 43% fully vaccinated, according to the U.S Centers for Disease Control and Prevention.

The 10 states with the fewest new cases per capita over that time frame all have fully vaccinated rates above the national average.

Medical experts said a host of factors is playing into the drop in case counts across the country, including vaccines, natural immunity from exposure to the virus, warmer weather and people spending less time indoors.

But Dr. Leana Wen, a public health professor at George Washington University, said she is concerned that the natural immunity of those who have been exposed to coronavirus may soon wane. And she’s worried that states with low vaccination rates could become hot spots.

“Just because we’re lucky in June doesn’t mean we’ll continue to be lucky come the late fall and winter,” said Wen, the former health commissioner for the city of Baltimore. “We could well have variants here that are more transmissible, more virulent and those who do not have immunity or have waning immunity could be susceptible once again.”

In Mississippi, about 835,000 people have been fully vaccinated, or 28% of the population. But despite the lagging vaccination rate, the state’s rolling average of daily new cases over the past two weeks has decreased by about 18%, according to Johns Hopkins.

May 3, 2021: Workers at a mostly empty COVID-19 vaccination clinic located at Cathedral of the Cross A.O.H. Church of God in Birmingham, Ala., are shown in file photo. 
(AP Photo/Jay Reeves, File)

Dr. Albert Ko, who chairs Department of Epidemiology of Microbial Diseases at Yale, said there is no accurate data to show what percentage of the population in “high burden” states such as Alabama or Texas have been exposed to the virus, but he said estimates have put it as high as 50%.

“I think it doesn’t deny the importance of vaccination, particularly because the levels of antibodies that you get that are induced by natural infection are lower than that of what we have for our best vaccine,” Ko said.

Ko said it is important that even those exposed to the disease get vaccinated because natural immunity does not last as long as vaccine immunity and the levels of antibodies are lower.

Wen said research strongly suggests that vaccinations provide a benefit to those who already have some antibodies due to infection.

“I think it is a fallacy that many people have that recovery means they no longer need to be vaccinated,” she said.

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As teen, he made news opposing anti-vax mom. Now, he’s urging COVID shots for youth

As teen, he made news opposing anti-vax mom. now, he's urging COVID shots for youth

Ethan Lindenberger knows what it’s like when you have anti-vaxxer parents: At 18, he gained national notoriety when he sought vaccines in defiance of his mother’s fervent wishes.

Now, the 20-year-old has some advice for teens facing a similar dilemma posed by the pandemic—how to convince their anti-vaxxer parents to let them get the COVID-19 vaccine.

The Pfizer shot is now FDA-approved for everyone age 12 and up, but varying parental consent laws across the country mean that some teens might want the jab but have to convince mom and dad first.

Lindenberger recommends that kids who want the vaccine have an open and honest discussion with their parents—if they have the type of relationship that would allow for such an exchange.

“If you know you can have a loving and understanding conversation with your parents, please do that. Try to have that conversation and vocalize why you want to get vaccinated, your concerns about your own health and safety,” Lindenberger, of Norwalk, Ohio, said in a HealthDay Now interview.

But he acknowledges that not every teen will be able to do that.

“If you are worried about serious consequences—your parents not trusting you, your parents taking away your phone or kicking you out—those are serious concerns for some young people,” Lindenberger said. “Maybe wait and weigh those consequences seriously. It’s not as easy as ‘Go get vaccinated, and then deal with it later.'”

Most states require parents to consent to the vaccination of their children, according to USA Today. The exceptions are North Carolina (all teens can receive vaccinations), Tennessee and Alabama (14 and older don’t need consent), and Oregon (15 and older don’t need consent). Iowa’s consent rules are more difficult to interpret, as the requirement varies depending on your health care provider.

Lindenberger only got the polio vaccine when he was a child, due to his mom’s increasing involvement in the anti-vaccine movement.

Due to consent laws, he didn’t even bother discussing vaccination with his mother as he went through high school, even though his own research had convinced him of the importance and safety of vaccines.

“I knew growing up my mom was very anti-vaccine. Because of the legal restrictions, I really wasn’t trying to fight her on getting me vaccinated. She believed vaccines could kill me, and so it was not going to be an easy time,” Lindenberger said.

When he turned 18, he used the Reddit online discussion board to ask how he should pursue vaccination. Lindenberger’s conflict with his parents then became national news.

“When I turned 18, I said, ‘Hey, this is my decision now, but I’m still going to communicate that. I’m not going to hide it from you. I want you to understand where I’m coming from,” Lindenberger said. “She still didn’t respond great, but the fundamental reason I was talking with her in the first place and saying what I thought was out of respect.”

Lindenberger’s initial decision to get vaccinated, and then become a vaccine advocate, has impacted his relationship with his mom.

“Because of how deep she is in this misinformation and that perspective, it definitely does warp her view of me as a person. What kind of person advocates for [in her view] young people to die and become injured? It’s a pretty bad thing to do,” he said. “It’s definitely caused a divide. Do we talk as much? No. Do we have the same type of relationship? Absolutely not. Do I see her as often? I don’t.”

Because of her firm beliefs, Lindenberger said he hasn’t even bothered to try to convince her to get the COVID-19 vaccine.

“My mom is very anti-vaccine. I mean like the 1% of the 1% that are so deeply ingrained that it’s not just the anti-vaccine conspiracies but the anti-mask, anti-science conspiracy theories, holistic medicine, the whole bunch,” he said. “People who are so deeply down that rabbit hole find other rabbit holes. For her, it’s progressed that much.

“My time and energy is spent talking to people that are hesitant, people that are asking questions, rather than saying they know what’s true. I think that’s more productive,” Lindenberger added.

  • Figure out what they want from the conversation beforehand, whether it’s permission or advice or just a friendly ear.
  • Identify your feelings to them, especially if you are worried that what you’re about to say will anger or disappoint them.
  • Pick a good time to talk, when your parent isn’t busy with something else and can focus on you.
  • Be clear and direct in what you’re saying, always be honest, try to understand their point of view, and resist getting into an argument.

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Vitamin B3 as a possible treatment for glaucoma

eye

Glaucoma involves a high risk of losing sight. Researchers at Karolinska Institutet and St. Erik Eye Hospital, among others, have now studied the effects of nicotinamide, the amide of vitamin B₃, on animal and cell models for glaucoma. The study, published in Redox Biology, may be a future neuroprotective therapy in glaucoma in humans. A clinical trial will start in the autumn.

Glaucoma affects 80 million patients globally and approximately 100,000-200,000 in Sweden.

In glaucoma, the optic nerve, which connects the eye to the brain, is progressively damaged, often in association with elevated pressure inside the eye.

The only treatment strategies currently available target the pressure in the eye using eye drops or surgery.

Despite the availability of these treatments, the risk of blindness in at least one eye is still high.

Most people with glaucoma are over 50 years old and there is an inherited increased risk.

Focus on new treatments

What causes optic nerve degeneration in glaucoma is not entirely known, but there is currently a large focus on identifying new treatments that prevent retinal ganglion cells (the output nerves of the retina) from dying, as well as trying to repair vision loss through the regeneration of diseased nerve fibers in the optic nerve.

Previously, scientists have identified that the molecule NAD declines in the retina in an age-dependent manner and renders retinal ganglion cells susceptible to neurodegeneration.

Preventing NAD depletion via administration of nicotinamide (the amide of vitamin B3, a NAD precursor) robustly prevents glaucoma in chronic animal models.

They also demonstrated that elevating NAD levels through nicotinamide administration can improve visual function in existing glaucoma patients.

Numerous neuroprotective effects

In a large international study, researchers at among others Karolinska Institutet, St. Erik Eye Hospital, Singapore National Eye Center, Singapore, and Cardiff University in the UK have now examined several effects of nicotinamide on the visual system under both normal conditions and in glaucoma.

In the current study, the scientists investigated many of the effects that nicotinamide has on the visual system (in normal conditions and during glaucoma). This is an important step for moving treatments from the lab to the clinic.

“We have confirmed nicotinamide’s neuroprotection in additional cell and animal models that recapitulate isolated features of glaucoma but are also common neurodegenerative features. We also have developed sensitive tools to investigate NAD metabolism, and the metabolism of other essential metabolites, in the visual system,” says the study’s first author James Tribble, a postdoctoral researcher at the Department of Clinical Neurosciences, Karolinska Institutet, and in the Williams laboratory at St. Erik Eye Hospital. “We demonstrated that systemic nicotinamide administration has limited molecular side-effects, but provides a robust reversal of the disease metabolic profile of glaucoma prone animals.”

The researchers’ work has, among other things, resulted in several tools for investigating the protective effect of nicotinamide.

“Using these varied platforms, we determined that nicotinamide provides numerous neuroprotective effects. These include buffering and preventing metabolic stress, and increasing mitochondrial size and mobility to provide an environment where retinal ganglion cells are less susceptible to glaucoma related stresses,” says corresponding author Pete Williams, Assistant Professor and Research Group Leader for glaucoma at the Department of Clinical Neurosciences, Karolinska Institutet, and St. Erik Eye Hospital. “These data support the continued determination of the utility of long-term nicotinamide treatment as a neuroprotective therapy for human glaucoma.”

In autumn 2021, the long-term clinical Swedish Glaucoma Nicotinamide Trial, led by Umeå University, Karolinska Institutet and St. Erik Eye Hospital will begin.

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Spaniards hold their breath as sweeping virus measures end

Spaniards hold their breath as sweeping virus measures end

Spain will relax nationwide pandemic measures this weekend, including travel restrictions, but some regional chiefs are complaining that the six-month-long national state of emergency will be replaced by a patchwork of conflicting approaches.

Now that the country’s contagion rate has stabilized while vaccine rollout continues to speed up, Prime Minister Pedro Sánchez has refused to extend the sweeping order that gave legal coverage to curfews, social gathering curbs and travel bans across the country. The order expires at midnight on Saturday.

His Cabinet is instead handing over full control of the battle against infection spread to the country’s 19 regions and autonomous cities, telling them they can go to the country’s Supreme Court if lower-level judges rule against their attempts to curtail basic freedoms.

But by Friday, just over 24 hours before the end of the state of emergency, each region was taking a different path—and the response from courts was also varied.

Judges approved for the Balearic Islands, a tourist magnet in the Mediterranean Sea, and for the eastern Valencia region to keep a night-time curfew and bans on the number of people allowed to socialize. But a court in the northern Basque region refused to extend localized lockdowns, a 10 to 6 a.m. curfew and a 4-person cap on social gatherings.

The region, home to 2 million people, is grappling with a 14-day contagion rate of 463 new cases per 100,000 population, more than twice the national average of 202 new infections per 100,000.

Madrid, whose lockdown-skeptic regional chief was re-elected earlier this week, announced that there will be no more curfews or travel restrictions in and out of the region starting Sunday, and that the operation of bars and restaurants can be extended from the current 11 p.m. limit to midnight.

“There is no (legal) coverage to adopt restrictive measures such as the curfew,” said Madrid’s health chief, Enrique Ruiz Escudero, whose region has the second-highest infection rate with 323 new cases per 100,000 for the past two weeks.

“We trust in the citizens’ responsible behavior,” Ruiz Escudero said on Friday.



Sánchez’s left-wing coalition has been under fire from opposition parties and regional chiefs for not anticipating the legal mess by launching a legal reform to give regions more powers. The government says that the existing public health law from 1986 allows them enough room to maneuver.

Spain’s rollercoaster of a contagion curve surged sharply in January, coinciding with end-of-year celebrations, but bottomed down in mid-March before mildly picking up again.

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COVID-19 spreads to rural India, villages ill-equipped to fight it

NEW DELHI (Reuters) -Hopes that India’s rampaging second wave of COVID-19 is peaking were set back on Thursday as record daily infections and deaths were reported and as the virus spread from cities to villages that were poorly equipped to cope.

Government modelling had forecast a peak by Wednesday in infections that have overwhelmed the healthcare system, with hospitals running out of beds and medical oxygen.

A record 412,262 new cases and 3,980 deaths were reported over the past 24 hours, taking total infections past 21 million and the overall death toll to 230,168, Health Ministry data showed.

“This temporarily halts speculations of a peak,” Rijo M John, a professor at the Indian Institute of Management in the southern state of Kerala, said on Twitter.

While the capital New Delhi and several other cities have been hardest hit so far, limited public healthcare, including a dearth of testing facilities, means the threat is grave in rural areas that are home to nearly 70% of the 1.3 billion population.

In the town of Susner in Madhya Pradesh state, patients were being treated outdoors under trees, on blankets on the ground.

Prime Minister Narendra Modi’s government welcomed U.S. President Joe Biden’s announcement that he would support waiving intellectual property rights for COVID-19 vaccinations.

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Such a waiver would make vaccines more widely available, although it could take months for the World Trade Organization to hammer out any deal.

VACCINE PRODUCTION STRUGGLES

While India is the world’s biggest vaccine maker, it is struggling to produce enough doses. Its two current vaccine producers will take two months or more to boost monthly output to more than 110 million doses from 70 million-80 million.

Modi stressed on Thursday that Indian states must keep up vaccination rates and that healthcare workers involved in the inoculation campaign must not be diverted to other tasks, the government said in a statement after a meeting between the prime and his top officials.

Modi has been widely criticized for not acting sooner to suppress the second wave, after religious festivals and political rallies drew tens of thousands of people in recent weeks and became “super spreader” events.

Several Indian states have imposed various levels of social restrictions to try to stem infections, but the federal government has resisted imposing a national lockdown.

Slideshow ( 5 images )

The southern state of Kerala announced on Thursday it will impose nine days of curbs on movement from Saturday.

In the office of a Hindu crematorium in Delhi, the floor and shelves were overflowing with earthen pots, plastic packets and steel containers filled with the ashes of people who have died from COVID-19.

Practising Hindus collect the ashes of the dead a few days after the funeral for immersion in a river or sea, one of the rituals that they believe lead to salvation of the soul.

Slideshow ( 5 images )

“Our lockers are full. We cannot store any more ashes. We used to get around 40 COVID-19 bodies a day. We are now telling relatives to take the ashes with them on the same day,” Pankaj Sharma, a manager at the crematorium, told Reuters.

Foreign Minister Subrahmanyam Jaishankar acknowledged the healthcare system “stands exposed” after 75 years of under-funding by successive governments since independence.

“It’s very easy to say today that we should have put in more money. Now that I am in government … I can say it is not as easy as it sounds,” Jaishankar said on Wednesday.

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France reopens schools as virus patients numbers peak

France reopens schools as virus patients numbers peak

Nursery and primary schools reopened on Monday across France after a three-week closure in the first step out of the country’s partial lockdown, despite numbers of COVID-19 patients in intensive care units reaching their highest level since last spring.

French authorities argue that daily numbers of new infections have started decreasing, providing encouraging signs about the impact of restrictions that were imposed at the beginning of the month.

Schools have been closed since April 5 as the government decided to bring forward the date of Easter holidays, in an effort to slow the spread of the virus.

Starting from next week, the ban on domestic travel will be lifted. The nighttime curfew, now in place from 7 p.m. to 6 a.m., will be maintained.

“We’re going to gradually reopen,” President Emmanuel Macron said while visiting a primary school on Monday in Melun, south of Paris. “We will do this very slowly to avoid (the virus) to start spreading again.”

Macron said he is anticipating a better situation next month when a greater proportion of the population will be vaccinated and the expected decrease in numbers of daily infections after the partial lockdown.

Asked by a child about the curfew, Macron said “we will try to delay it a little bit (at night) … because 7 p.m. is early.”

France intends to gradually reopen nonessential shops, some of its cultural venues and cafe and restaurant terraces starting from mid-May.

Authorities are reporting more than 30,000 confirmed virus infections each day, down from about 40,000 earlier this month. Yet French hospitals are still close to being overwhelmed, with nearly 6,000 critically ill patients in French intensive care units. And France has reported more than 100,00 COVID-19 deaths.

More than 14 million people in France have received at least one dose of a vaccine, about 26% of its adult population.

Dr. Eric Caumes, head of the infections and tropical diseases department at Paris’ Pitie Salpetriere Hospital, said he thinks “this is not very reasonable” to start reopening the country now.

“Figures are not very encouraging,” he said on news broadcaster BFM. “They have only started to decrease in certain places, so saying that we’re loosening precautions despite figures not being down yet—we obviously have concerns.”




As schools open again, all French teachers and school employees will be given two self-administered virus tests per week to carry out at home, the Education Ministry said in a statement. In addition, high school students can get tested at school once a week, with more tests progressively rolled out for younger students.

In a Paris school on Monday morning, parents brought their children feeling both relieved and worried.

“To be honest, we are not worried so much about the younger ones in primary schools. We are more worried about the other kids who are in the secondary schools, where I think the situation can be more complicated,” Parisian Jerome Keff said.

Middle school and high school students are attending online classes this week. They will be back at schools on May 3.

France sent all 12 million of its schoolchildren back to class from September through April, so many schools haven’t developed remote learning tools, and national distance-learning sites were saturated or hacked when they first resumed online classes earlier this month.

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PM Modi says India shaken by coronavirus 'storm', U.S. readies help

NEW DELHI (Reuters) -India set a new global record of the most number of COVID-19 infections in a day, as Prime Minister Narendra Modi on Sunday urged all citizens to be vaccinated and exercise caution, saying the “storm” of infections had shaken the country.

The United States said it was deeply concerned by the massive surge in coronavirus cases in India and was racing to send aid to India.

India’s number of cases surged by 349,691 in the past 24 hours, the fourth straight day of record peaks, and hospitals in Delhi and across the country are turning away patients after running out of medical oxygen and beds.

“We were confident, our spirits were up after successfully tackling the first wave, but this storm has shaken the nation,” Modi said in a radio address.

Modi’s government has faced criticism that it let its guard down, allowed big religious and political gatherings to take place when India’s cases plummeted to below 10,000 a day and did not plan on building up the healthcare systems.

Hospitals and doctors have put out urgent notices that they were unable to cope with the rush of patients.

People were arranging stretchers and oxygen cylinders outside hospitals as they desperately pleaded for authorities to take patients in, Reuters photographers said.

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“Every day, it the same situation, we are left with two hours of oxygen, we only get assurances from the authorities,” one doctor said on television.

Outside a Sikh temple in Ghaziabad city on the outskirts of Delhi the street resembled an emergency ward of a hospital, but cramed with cars carrying COVID-19 patients gasping for breath as they were hooked up to hand held oxygen tanks.

Delhi’s Chief Minister Arvind Kejriwal extended a lockdown in the capital that was due to end on Monday for a week to try and stem the transmission of the virus which is killing one person every four minutes.

“A lockdown was the last weapon we had to deal with the coronavirus but with cases rising so quickly we had to use this weapon,” he said.

India’s total tally of infections stands at 16.96 million and deaths 192,311 after 2,767 more died overnight, health ministry data showed.

In the last month alone, daily cases have gone up eight times and deaths by 10 times. Health experts say the death count is probably far higher.

Slideshow ( 4 images )

The country of 1.3 billion people is on the brink of a humanitarian catastrophe, Ashish Jha, dean of the Brown University School of Public Health, warned in an op-ed published Saturday in the Washington Post.

“Our hearts go out to the Indian people in the midst of the horrific COVID-19 outbreak,” U.S. Secretary of State Anthony Blinken said on twitter.

“We are working closely with our partners in the Indian government, and we will rapidly deploy additional support to the people of India and India’s health care heroes.”

Slideshow ( 4 images )

The United States has faced criticism in India for its export controls on raw materials for vaccines put in place via the Defense Production Act and an associated export embargo in February.

The Serum Institute of India (SII), the world’s biggest vaccine maker, this month urged U.S. President Joe Biden to lift the embargo on U.S. exports of raw materials that is hurting its production of AstraZeneca shots.

Others such as U.S. Congressman Raja Krishnamoorthi urged the Biden administration to release unused vaccines to India.

“When people in India and elsewhere desperately need help, we can’t let vaccines sit in a warehouse, we need to get them where they’ll save lives,” he said.

India’s surge is expected to peak in mid-May with the daily count of infections reaching half a million, the Indian Express said citing an internal government assessment.

V.K. Paul, a COVID-task force leader, made the presentation during a meeting with Modi and state chief ministers and said that the health infrastructure in heavily populated states is not adequate enough to cope, according to the newspaper.

Paul did not respond to a Reuters request for comment.

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Japanese region seeks new virus emergency as Olympics near

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Japan’s third most populated region will on Tuesday ask the central government to impose a state of emergency over the coronavirus as infections rise just three months before the country hosts the Olympics.

Osaka prefecture only lifted a state of emergency two months ago and restrictions are expected to be tougher this time, possibly involving store and shopping mall closures.

That would still fall short of the harsh lockdowns seen in many other parts of the world however.

Tokyo and several other areas are expected to follow suit, hoping to avoid the crisis now facing Osaka’s healthcare system, where beds for coronavirus patients in severe condition have run out.

Governor Hirofumi Yoshimura said he had already told the minister overseeing the coronavirus response, Yasutoshi Nishimura, that a state of emergency was needed as measures taken so far “are not enough”.

A formal request is expected to come later today, with official approval from the government following in the evening.

“I believe now is the time to take strong measures for a short period of time,” Yoshimura told reporters.

“The flow of people and the fast pace of the variant strains are causing surges,” he warned, calling for the closure of shopping malls, amusement parks and department stores.

He also urged people to move to teleworking, warning that otherwise “we won’t be able to curb the flow of people”.

Osaka is already under virus restrictions that mostly call for restaurants and bars to close by 8pm and urge residents to avoid unnecessary outings.

Those measures prompted the region to bar the Olympic torch relay from public roads, with the flame instead being carried by torchbearers on a closed track inside a park without spectators.

Nishimura earlier acknowledged the “extremely tough situation” in Osaka, saying the government was coordinating with authorities there “with a strong sense of crisis”.

According to local media, Tokyo also plans to request the government declare a state of emergency this week.

And at least two regions neighbouring Osaka are reportedly planning on requesting the measure.

The surge in cases comes with just over three months until the virus-postponed Tokyo Olympics, which organisers insist can be held safely.

Japan declared a virus state of emergency in early January for several areas, lifting it on March 1 in Osaka and three weeks later in Tokyo.

But infections have ticked back up, driven by more infectious variants, and vaccinations are moving slowly.

Only the Pfizer vaccine has been approved and so far it is being given only to medical workers and the elderly.

Just 25 percent of 4.8 million healthcare workers and slightly more than 13,000 elderly people have so far received a first vaccine dose.

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