Japan has expanded its coronavirus state of emergency for a second week in a row, adding eight more prefectures as a surge in infections fuelled by the Delta variant strains the country’s health care system.

With four new prefectures added to a separate “quasi-emergency” status, 33 of Japan’s 47 prefectures are now under some type of emergency measures.

Eight prefectures were upgraded from quasi-emergency status to a full emergency. They include Hokkaido and Miyagi in the north, Aichi and Gifu in central Japan, and Hiroshima and Okayama in the west, according to an AP report.

“In order to protect the people’s lives, the priority is to maintain the health care system,” Prime Minister Yoshihide Suga said as he announced the emergency.