What began in late June as a COVID-19 rebound in Tokyo has escalated within weeks into a nationwide surge, forcing the central government to enact the country’s strictest measures in more than a dozen of its largest prefectures.

Prime Minister Yoshihide Suga on Tuesday expanded the country’s state of emergency from six to 13 prefectures, and extended it from the end of August until mid-September, as current measures fail to pacify an unprecedented surge in coronavirus cases.

While the central government has made efforts to bolster the health care system by streamlining the hospitalization of severely ill COVID-19 patients, pandemic fatigue and the waning influence of voluntary countermeasures are casting serious doubt on the country’s ability to fight back the current wave of new infections.