About 850,000 people could be seriously sickened by the coronavirus in Japan and almost half of them could die if no social distancing or other measures are followed, according to a government-commissioned estimate released on Wednesday.
Japan has the world's oldest population, and the virus can be especially dangerous for the elderly.
And there are concerns that Japan's government has done too little to stave off high numbers of badly ill patients.
Japan's current state of emergency is voluntary and doesn't compensate workers for lost earnings.
Japanese companies also have been slow to introduce remote work, and people have continued to use public transit to commute to large offices in the densely populated capital region.
Already, patients are being moved to non-specialist hospitals and even hotels as infections surge in the capital, where medical experts warn the health care system is on the brink of collapse.
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The projection is a worst-case scenario, said Hokkaido University professor Hiroshi Nishiura, an expert on cluster analysis.
He urged people to cooperate in the social distancing effort.
"We can stop the transmission if all of us change our activity and significantly reduce interactions," he said.
The report projected 420,000 deaths if no preventive measures were taken.
Japan has more than 8,800 confirmed coronavirus cases and 131 deaths, including about 700 cases from a cruise ship that was quarantined at a port near Tokyo earlier this year.
The health ministry reported 457 new cases on Wednesday. Tokyo has about a quarter of Japan's total cases.
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