The head of an association of the Japan Medical Association has said the government should consider a nationwide state of emergency as a future “option” to prevent the further spread of the novel coronavirus and ease the strain on the medical system. The nation’s cumulative total of confirmed infections topped 300,000 on Wednesday.

Toshio Nakagawa, president of the association, said Wednesday the medical system had been increasingly overwhelmed, with some hospitals forced to turn away patients not seeking care for COVID-19. He also expressed concern that the health care system could collapse if infections continue to surge.

Prime Minister Yoshihide Suga expanded to seven more prefectures Wednesday the state of emergency he’d declared for parts of the Tokyo metropolitan area last week.

“Depending on the situation in the near future, declaring a state of emergency for the whole country is one option. I would like (the government) to act swiftly,” Nakagawa told a news conference.

A total of 11 of the nation’s 47 prefectures are under the state of emergency, which is set to continue until Feb. 7.

The total number of cases has increased by 100,000 in about three weeks, after surpassing 100,000 on Oct. 29 and reaching 200,000 nearly two months later on Dec. 21, according to a Kyodo News tally.

Japan has also confirmed the presence of novel coronavirus variants discovered in the U.K. and South Africa, with infections expected to increase at an even greater rate if they spread throughout the country.

In addition to Tokyo, which confirmed a record 2,447 new infections on Jan. 7, other prefectures that have huge urban populations, including Osaka and Aichi, have similarly been struggling amid a sudden rise in cases through the start of the year.

According to a health ministry panel of experts, the number of people in Tokyo who were unable to find hospitals or other facilities for treatment after testing positive for the novel coronavirus totaled more than 6,000 as of Saturday.

The figure had almost doubled from a week before, the panel said Wednesday. In more and more areas where infections are surging, local authorities are struggling to get COVID-19 patients into hospitals or other facilities, the panel said, adding that it is increasingly difficult to balance the treatment of such patients with those affected by other diseases or injuries.

The panel noted the spread of COVID-19 in Tokyo and other metropolitan areas late last year, mainly through corporate and other year-end parties and gatherings involving eating and drinking among young people, and expressed concerns over a possible further increase in infections among older people.

One possible factor behind the nationwide surge in infections after the turn of the year was people making trips to their hometowns and dining with relatives during the year-end and New Year’s holiday period, it said.

The effective reproduction number, or the average number of people to whom an infected person transmits the virus, was estimated at 1.14 nationwide as of Dec. 27 last year. A reading of over 1.0 indicates that the infection is spreading.

The figure stood at an estimated 1.09 each in Tokyo and Kanagawa Prefecture, 1.06 in Saitama Prefecture and 1.23 in Chiba Prefecture.

Yasutoshi Nishimura, who is leading the government’s efforts to contain the health crisis, told a Diet committee meeting on Wednesday that measures necessary under Stage 4, the worst level on the government’s four-tier scale to assess the spread of the novel coronavirus, also seem to be required in some prefectures outside of Tokyo and the prefectures of Kanagawa, Saitama and Chiba. Stage 4 indicates that the virus is spreading explosively.

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