Japan, which was praised for keeping its coronavirus cases and deaths largely under control earlier in the pandemic, is experiencing its most severe coronavirus wave so far and has become a hotspot for the virus in East Asia.
The country still has restrictions on the number of foreign tourists allowed to enter and has only just announced it will relax strict rules that limit movement for those willing to visit.
At 1,476,374, Japan reported the world's highest number of weekly cases during the week to August 21, according to the World Health Organization's (WHO) latest epidemiological update on the COVID-19 pandemic.
It also recorded the second-highest number of deaths in the world after the United States, with 1,624, the WHO said in its weekly update.
Kentaro Iwata, a professor of infectious diseases at Kobe University, told the ABC the seventh wave has been driven by the BA.5 Omicron variant, a lack of immunity and low vaccination among young people.
Professor Iwata said Japan managed to keep outbreaks of previous Omicron variants under control, unlike the US and many European countries, meaning there was less immunity in the community.
"We protected ourselves from the infections up until recently, which means we lacked the immunity given by the natural infection. Therefore we are very susceptible to many infections," he said.
He said most of the cases were spreading among young adults who have generally been more complacent and have lower vaccination rates than other age groups.
On Japan's COVID-19 death rate during this wave, Professor Iwata said Japan struggled to distribute enough anti-viral medication, like Paxlovid, to vulnerable people, resulting in a higher death rate.
"Japan's government failed to distribute this medicine very well. So we use this medicine only for 60,000 people, whereas in Korea more than 300,000 received this medicine by now with about half the population size comparing to Japan."
Can I travel to Japan?
As the country experiences another wave of coronavirus cases, the government has made cautious moves to relax border restrictions that came into place at the start of the pandemic.
In June, Japan started allowing foreign tourists back in but capped the total number of travellers at 20,000 a day.
Visitors can only travel in small organised tours, must strictly follow their guides and can only leave their accommodation for planned outings.
But overnight, Japan's Prime Minister Fumio Kishida announced the cap would be lifted to 50,000 and the requirement to travel on organised tours only would be dropped from September 7.
Some travellers are still required to be vaccinated and provide a negative PCR test on arrival, depending on which country they are coming from.
But the requirement to present a negative PCR test will be dropped entirely from September 7.
Australian passport holders, unlike previously, also need a valid visa to enter.
But the moves to slowly open up aren't enough to attract large groups of people back, according to one local business dependent on tourists.
'We don't need a babysitter'
Omakase Tour CEO, Takeshi Sakamoto, told the ABC foreigners enquiring for trips to Japan with his company had postponed trips or were put off travelling there altogether after learning about the country's strict tourist travel rules.
He said his company has only been able to take a few tourists, because most had either postponed or reconsidered travelling to Japan.
"[It is] completely not sustainable and helpful. Due to those kind of rules, we have been losing a lot of business opportunities," Mr Sakamoto said.
"In an email, some American customers said 'we don't need a babysitter' … so it's really annoying for them."
Mr Sakamoto said he welcomed an announcement last week from the Prime Minister that removed the need to have a PCR test on arrival.
He told the ABC, before yesterday's announcement on group tours, that while testing was one less thing for tourists to worry about at the border, he hoped other rules forcing guides to accompany customers throughout their trip would end soon.
Alcohol sales fall and so does government revenue
Monica Chien, senior lecturer in tourism and business at the University of Queensland, told the ABC that the restricted number of tourists filtering through Japan's tightly controlled border wasn't enough to support businesses, like Mr Sakamoto's, that relied heavily on international travellers.
Dr Chien said the Japanese government's "test tourism" was a compromise that aims to balance economic recovery with voter concerns about reintroducing foreigners and the risk of further spreading COVID-19.
"While it may benefit some tour companies, it doesn't really have a widespread impact on the entire tourism community … because test tourism is very restricted," Dr Chien said.
She said the rules ended up actually resulting in a decrease in the number of in-bound tourists.
"[They] actually discouraged people from coming to Japan," she said.
She said if the measures drag on for too long, it could have an impact on the country's reputation as a business and tourism destination.
COVID-19 restrictions have also led to a drop in alcohol sales in Japan, so the National Tax Agency has invited people to help them find ways of encouraging younger Japanese people to drink more alcohol.
Japanese bars and Izakayas have been hit hard by the pandemic — alcohol sales halved from 2019 to 2020, according to the Ministry of Economy, Trade and Industry.
The ministry said nearly 8 per cent of people in their 20s drank regularly, compared with 30 per cent of people aged in their 40s to 60s.
Revenue from alcohol sales is decreasing, so the government wants the the "Sake Viva!" campaign to "stimulate demand among young people" for alcohol, according to CNN.
