Asahikawa is located about 140 km (87 miles) north of Sapporo on the northern island of Hokkaido and its currently ridden with clusters of the coronavirus as the winter season draws closer. On Sunday, the number of cases recorded on the island was more than 10,000 while Asahikawa had accounted for a whooping 16% of the 256 deaths.

With the sharp number increase, government officials announced a plan on Monday to send in nurses from Self Defense Forces to the region as well as western metropolis of Osaka in order to combat the spread.

“Hokkaido is a place where due to the climate conditions people tend to have the heater on very high and in very closed spaces as well,” said Haruo Ozaki, president of the Tokyo Medical Association.

“In places such as Tokyo and Osaka, it will also be getting colder from now. When we add this coldness factor, it shows that we need to express a lot more caution or we could face a further spread of contagion.”

The number of residents in the city of Asahikawa totals 340,000 and this region has the lowest temperature of -41C (-41.8F) back in 1902 making researchers warn about the potential airborne transmission of the virus increase when people spend more time in closed-up rooms while breathing dry air.

“Asahikawa and including Sapporo are in a various serious condition in terms of the pandemic,” said Dr. Yasutaka Kakinoki at Asahikawa City hospital. The burgeoning caseload has brought the health system in Asahikawa to “near collapse”, he said.

Asahikawa Kosei Hospital has been the site of 224 infections of patients and staff, prompting the facility to turn away all but the most critical cases.

Yoshida Hospital, a private facility in the city, has 184 cases and has had difficulty transferring patients to other hospitals.

“It’s a difficult situation we are facing,” Asahikawa mayor Masahito Nishikawa said in a recent online briefing, asking citizens to avoid the city’s major hospitals.

There were also increase in the number of cases in recent weeks in neighboring city Sapporo and Osaka as well as Japan’s main island Honshu which opted out of a domestic tourism campaign but requires those two cities to be on some sort of lockdown in order to control the outbreak according to Kenji Shibuya who is the director of the Institute of Population Health at King’s College in London.

The city of Hokkaido was the first to declare the state of emergency early this year when the first wave of the virus swept through the country. Winter cold nd dry air are some of the factor in the Hokkaido’s cluster, there is need for an aggressive testing and containment in order to curb the spread of the disease according to Shibuya.

Others caution against predicting the contagion pattern seen in Hokkaido could be repeated elsewhere in the country.

“The kinetics of pandemic differ between Hokkaido and Honshu,” he said.