SEOUL, South Korea — Japan's government extended a state of emergency covering major cities until at least until June 20 — roughly a month before the start of the Tokyo Olympics, which polls show an overwhelming number of Japanese do not want to proceed as scheduled.

It's Japan's third state of emergency of the pandemic and the second extension since the current emergency began on April 25. The emergency shortens some businesses' hours, and caps attendance at large events. It covers the capital Tokyo, second city Osaka and seven other prefectures. Less stringent "quasi-emergencies" will be extended to June 20 in five other prefectures.

"New coronavirus cases have been declining nationwide since mid-May, but the situation remains highly unpredictable," Prime Minister Yoshihide Suga told a government task force Friday after finalizing a decision that had been requested by several local governments.

The spread in Japan of variant strains of the virus has slowed the decline in case numbers. Some hospitals remain overstretched by COVID-19 patients, and some people have died at home without being able to access medical care.

Japan's vaccine rollout remains the slowest among developed economies with just 6% of residents having received at least one dose. Partially because Japan had relatively few COVID-19 cases compared to other countries last year, it entered into vaccine purchasing agreements with foreign vaccine-makers months later than experts say it should have.

What's more, Japan requires that imported vaccines undergo domestic clinical testing, slowing down the approval process. And it has had several vaccine scares, which have damaged trust between residents and the government.

In spite of all this, the government's insistence that the games will proceed, safely, has only become more adamant.

"I'm aware many people are anxious or worried," Suga told reporters, sticking to the organizers' pledge that athletes would be strictly segregated from Japan's population and countermeasures against the virus would keep both groups safe.

International Olympic Committee President Thomas Bach told a conference on Thursday that athletes should "come with full confidence to Tokyo and get ready," lauding the Japanese capital as "the best-prepared Olympic city ever."

The IOC has asked Olympic athletes to sign waivers absolving the organizers of legal liability for COVID-19-related risks. Bach acknowledged this was an issue of concern for some athletes, but the IOC calls it "standard practice."

The organizers' unyielding position has been met this week by a crescendo of criticism in Japan and abroad.

"Since the emergence of COVID-19 there has not been such a dangerous gathering of people coming together in one place from so many different places around the world," Dr. Naoto Ueyama, chairman of the Japan Doctors Union, told reporters Thursday.

One possible result, he added, "is if a new mutant strain of the virus were to arise as a result of this, the Olympics."

An article this week in the New England Journal of Medicine, meanwhile, questioned organizers' fundamental argument that the games can be held safely. "We believe the IOC's determination to proceed with the Olympic Games is not informed by the best scientific evidence," the authors wrote.

The authors note that when organizers decided in March 2020 to postpone the games, Japan had only 865 active COVID-19 cases. It now has more than 70,000, while active cases worldwide have gone from 385,000 to 19 million in the same period.

Also this week, Japan's second-largest newspaper by circulation, The Asahi Shimbun, became the first major Japanese media outlet to publish an editorial calling for the games to be canceled. The 142-year-old publication, one of Asia's oldest newspapers, is also an Olympic sponsor.

Sponsors are especially jittery about the prospect of the games' cancellation, which could cost Japan an estimated $17 billion. But, as a report by an economist at the Nomura Research Institute pointed out this week, another state of emergency in response to a fresh wave of infections after the Olympics could cost the country several times that amount.

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