Tokyo Gov. Yuriko Koike is asking senior citizens 65 or older and those with underlying health conditions not to use the government’s GoTo discount campaign to travel in and out of Tokyo.

New cases in Tokyo and other major cities have spiked in recent weeks, with serious cases rapidly filling hospitals and impacting the treatment of other patients.

Koike says she is focusing on how to stop serious cases and prevent the medical systems from collapsing.

She has issued a request for restaurants serving alcohol, bars and karaoke chains to close early until mid-December. Aichi, Osaka and Hokkaido have taken similar steps.

Prime Minister Yoshihide Suga’s government has been criticized for being slow to curb social and economic activity. Suga hasn’t taken tougher steps beyond basic safety precautions and wearing masks.

Japan managed to avoid a high number of cases with stay at home and business closure requests under a non-binding state of emergency in the spring. Some experts say it’s time to scale back business activity and urged the government to act quickly to avoid another state of emergency.

The health ministry says Japan has nearly 149,000 confirmed coronavirus cases and more than 2,100 deaths.