With less than a week to go until the Paralympics, organisers are warning that the event will be held in challenging circumstances.
Host nation Japan is currently battling its worst outbreak of the coronavirus driven by the highly infectious Delta variant.
Hospitals in the capital Tokyo are at a crisis point, with local media reporting that one of them declined the organisers' request to take emergency cases from the Games, putting priority on domestic COVID-19 patients.
Tokyo 2020 Games delivery officer Hidemasa Nakamura:
"Looking at the medical situation, we cannot help but say we will hold the Paralympics in the middle of a very difficult situation... what do we do if we have a case becoming seriously ill, when the hospital beds are in short supply?"
There were 12 new cases confirmed on Friday among Paralympic participants, including one athlete.
Games organisers say they are employing the same tactics as used for the Olympics to keep infections down.
That means regular testing, limiting the movement of athletes and officials, and a general ban on spectators.
While fewer athletes and officials from abroad are travelling for the Paralympics, the health situation in Japan has grown worse with record-high daily case numbers reported.