Japan has announced that it is extending a coronavirus state of emergency in Tokyo and 18 other areas until the end of September as health care systems remain under severe strain, reports AP.

The current state of emergency, which was to end on Sunday, was issued first in Okinawa in May and gradually expanded. Despite the prolonged emergency, the largely voluntary measures have become less effective as the exhausted public increasingly ignores them.

Prime Minister Yoshihide Suga said serious cases remain high and are still overwhelming many hospitals. He called on the people to continue to work remotely and observe other social distancing measures “so that we can return to safe and prosperous daily lives.”