Japan has reported more than 2,000 coronavirus cases so far on Friday, reaching a level not seen in one and a half months. In rural areas, some worry the surge could bring communities to the point of disaster.
The northern prefecture of Yamagata went from reporting no cases at all in the first week of March to recording its second highest daily count ever on Friday.
The 34 cases come as neighboring Miyagi Prefecture remains under an independently-called State of Emergency. Their capital cities are separated by just an hour's drive.
And the head of the Yamagata Medical Association says that means their situations are linked.
Yamagata Medical Association's Nakanome Chiyuki said, "Here in Yamagata, we don't have medical resources like they have in big cities. We already had to postpone regular hospital visits and surgeries. Yamagata is on the brink of a crisis."
The infections are also spreading in urban areas.
Osaka reported 300 new cases, for the first time in two months. The western prefecture has decided to extend its request for bars and restaurants in Osaka City to close by 9 p.m. until April 21. It's also expanding the request to the entire prefecture.
The uptick comes as Japan is planning the next phase of its vaccine rollout and examining early data.
The health ministry says 47 cases of a severe allergic reaction called anaphylaxis were reported for people who received the Pfizer-BioNTech vaccine.
That equates to 81 cases per million, a number that far outstrips rates reported in the US and UK. But officials caution that differing reporting standards make it hard to compare the numbers.