The Olympics’ Covid-19 dilemma

It’s complicated.

The Olympic torch was making its way across Japan last week to herald the upcoming Tokyo Games, scheduled to start in late July after being postponed last year due to Covid-19, when it hit a snag: The governor of Hiroshima prefecture, the next destination on the route, announced he was pulling the relay off the streets of his city because of a surge in Covid-19 cases in the country. The governors of Hyogo and Okayama did the same.

It wasn’t the first setback for the torch relay. Earlier this month, eight staffers who worked on the relay contracted Covid-19.

The realities of the pandemic are now crashing up against the Summer Olympics schedule.

Japan is experiencing its worst coronavirus surge since a peak in January, with daily case rates now topping about 6,000. The Japanese government recently extended a state of emergency in the games’ host city of Tokyo and a few other prefectures through the end of May.

A successful inoculation effort was widely seen as an important benchmark for Japan’s hosting of the games, but so far only a little more than 1 percent of Japan’s population is fully vaccinated against Covid-19. Outside of Japan, global Covid-19 cases are still near all-time highs, with places like India in the middle of catastrophic surges. And vaccination access is far from equal among the countries participating in the competition.

Japan and the International Olympic Committee (IOC) have promised “safe and secure” games, with stringent health protocols. Foreign fans are banned from attending the Tokyo games, but the event will still draw some 15,000 athletes, along with thousands of coaches, trainers, support personnel, and members of the media. A decision on whether local spectators will be allowed isn’t expected until June, but the event will still require thousands and thousands of staff and volunteers.

And without foreign fans, some of the economic benefits for Japan are already blunted, which is why more and more people in Japan are questioning the need for the games to go on. A recent poll found 60 percent of Japanese people want the games canceled.

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“I don’t know if the international prestige of holding the Olympics is worth it for a potential domestic public health event,” Timothy Mackey, an associate adjunct professor in the global health program at University of California San Diego, said of the Japanese decision to go forward with the games. “So why risk it now?”

At the same time, Japan has a lot riding on these games — particularly Prime Minister Suga Yoshihide, whose ability to host the Olympics is seen as a political test of his handling of the pandemic. And this is really the last chance to host the 2020 games; there will be no postponing it another year.

Olympic organizers have announced strict measures to try to contain Covid-19, but some public health experts worry the games could still become a superspreader event, with people bringing Covid-19 infections to Tokyo from all around the world and taking them back to their own communities when they leave.

And while some countries are starting to see the benefits of vaccinations and the crisis receding, that is far from true for much of the rest of the world. And that makes a massive global celebration, and the resources it will take to pull off, seem risky — and maybe a bit unseemly — in the pandemic age.

Japan’s new prime minister has a lot riding on the Olympics

Tokyo 2020 was supposed to be Japan’s international and regional coming out party, a way to show the world that “Japan is back.”

T.J. Pempel, a professor of Japanese history and politics at UC Berkeley, said regional competition is also part of Japan’s Olympic plan: China hosted a great Olympics in 2008, and Beijing is supposed to host the Winter Games in 2022; South Korea also pulled off the Winter Olympics in 2018. “It’s kind of a regional embarrassment for Japan if they can’t do this,” he said.

The Tokyo Olympics are already the most expensive on record at more than $25 billion, with a couple of extra billion added because of the delay. Even if Japan won’t benefit from foreign visitors, business interests and media have huge stakes in these games. A lot of money is riding on this. Meanwhile, as Pempel said, the public is basically asking, “Who needs this?”

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Suga said that he is prioritizing public health and would never “put the Olympics first,” public opinion is against him right now. If the Olympics move forward and there is a Covid-19 outbreak, the backlash will be even more intense. At the same time, he’s facing pressure from business interests if he cancels. “It’s a no-win situation for Suga,” Pempel said.

It would also signal Japan’s failures against the Covid-19 pandemic. Japan has fared better than the US or countries in Europe against the virus — and pursued a big stimulus package to boost its economy. But canceling the Olympics might spotlight the country’s inability to get this latest wave under control, and its struggles to ramp up its vaccination campaign.

This could make Suga vulnerable to other politicians in his party, who would see an opening to challenge him for leadership — and the premiership.

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Of course, it’s not all about money and politics. For many Olympic and Paralympic athletes, this summer’s games may be their last and only chance to compete. If the 2020 Olympics get canceled, that’s likely it until 2024.

Last year, many athletes were frustrated with the IOC’s indecision around the games. Many had concerns about training, qualifying, and anti-doping tests, all interrupted by lockdowns and quarantine measures. Facilities and qualifying matches are largely going forward, though Covid-19 has caused some complications, interrupting competitions in places that are seeing big surges of cases, like India, or forcing athletes to bow out because of positive Covid-19 tests.

Over the past year, many athletes have adapted to the uncertainty, tweaking their training routines based on the requirements and restrictions of the pandemic. But the overriding sentiment seems to be that athletes are training as if the games will go on.

“You wake up and read an article,” Joe Delagrave, co-captain of the US Wheelchair Rugby team, told NPR in March, “and you’re like ‘yeah, it’s probably going to be canceled’ and [then] everyone comes out from the [organizing committees] and [they’re] going, ‘no, it’s definitely going to happen.’”

“Some of that’s out of our control, so, the old cliché of ‘control what you can control’ is so true in this situation,” he added.

Other athletes have brought up the dilemma of wanting to go to Tokyo while also recognizing the risk. “Of course I would say I want the Olympics to happen, because I’m an athlete and that’s sort of what I’ve been waiting for my entire life,” tennis player Naomi Osaka, who represents Japan, told reporters earlier this month.

“But I think that there’s so much important stuff going on, and especially the past year,” she added. “I think a lot of unexpected things have happened and if it’s putting people at risk, and if it’s making people very uncomfortable, then it definitely should be a discussion, which I think it is as of right now.”

Kei Nishikori, another Japanese tennis player, said he agreed with Osaka. “I’m an athlete, and of course my immediate thought is that I want to play in the Olympics,” Nishikori said. “But as a human, I would say we’re in a pandemic, and if people aren’t healthy, and if they’re not feeling safe, then it’s definitely a really big cause for concern.”

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The Olympic Games have only been canceled three times, all because of world wars. In 2016, some 150 public health officials and other experts signed a petition to cancel the Rio de Janeiro Olympics over the Zika outbreak in Brazil. Ultimately, the World Health Organization concluded the games wouldn’t greatly alter the international spread.

So far, only North Korea has said it won’t attend the Olympics because of Covid-19, and that’s not exactly going to sway anyone. At this point, it looks like the question is less whether the games will go on, but what Tokyo can do to make them as safe as possible.

“It’s more than likely the Olympics are going to go on, and the key is making sure the mitigation measures are enough to keep it at bay, to keep the virus from totally disrupting the games,” Amesh Adalja, an infectious disease specialist at Johns Hopkins University, told me.

Japan wants to try to create a sort of athlete “bubble.” Is that enough?

Compared to last year when the Tokyo Games were postponed, the world knows a lot more about how to mitigate the spread of Covid-19. Large sporting events have since gone forward, from the NBA to the Australian Open to the Super Bowl.

But the Olympics are another feat entirely. As Lee Igel, a clinical professor at the NYU Tisch Institute for Global Sport, said, they’re really more a festival than an athletic competition — which means they have different challenges, and a lot more people.

Mass gatherings like the Olympics often present public health challenges (see: free condoms in the Olympic Villages) simply because you’re bringing a lot of people from around the world and packing them all in together.

Some of the festival atmosphere isn’t going to exist with Covid-19. But even without the influx of foreign fans this year, thousands of athletes and all their coaches and support staff, and global media and all their crews, will be arriving in Tokyo. They’ll be flying in from all over the world, some from places experiencing severe outbreaks. And they’ll arrive in Japan where, right now, cases are close to their January peak and the country’s fully vaccinated rate is around 1 percent.

“Is that a set of circumstances where you open a country to travelers bringing new variants from, well, everywhere?” Amir Attaran, professor of law, epidemiology, and public health at the University of Ottawa, wrote in an email.

Once the games are over, all those people will be flying back home, too. If there’s a coronavirus outbreak among athletes, or exposure, they could bring those cases back home. In other words, it could become a superspreader event.

Of course, Japan and the IOC are trying to prevent that. But the question is whether their measures will be enough to do it.

They’ve published their Covid-19 strategies, which they updated late last month and have said they’ll continue to update based on the state of the pandemic. Anyone traveling to the games is required to have a negative Covid-19 test within two days of departure, and athletes will undergo daily testing and be asked to download a contact-tracing app.

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Athletes don’t have to quarantine before they arrive, but they’re supposed to wear masks and maintain social distance — no hugging or handshakes — and avoid public transit and tourist sites. Officials, media, and others must follow similar restrictions. The venues themselves will take precautions like temperature checks and additional sanitation requirements.

Overall, it’s an attempt to create a kind of bubble for thousands of athletes.

“If you could do an NBA or NHL season without a vaccine and have zero cases, this can be done if people actually put the resources into place to do it,” Adalja, at Johns Hopkins, told me.

The NBA bubble was successful, with zero positive Covid-19 tests. But the Olympics bubble can’t replicate that experience exactly. For one, NBA players and coaches were basically full-time quarantined in the Walt Disney World Resort in Orlando.

According to Bloomberg, just about 1,000 people were involved in that bubble, compared to thousands and thousands more — from all over the world — expected to attend the Olympics. Plus, the Olympics is not going to mandate that everyone quarantines, and though athletes will be discouraged from leaving the campus, they won’t be walled off from the rest of Tokyo.

The Olympics also won’t mandate that athletes be vaccinated to participate in the games, which raises the issue of whether athletes can or should get a vaccine before the Olympics.

Athletes, coaches, and media in places like the United States, which is approaching a vaccine glut, will likely have no trouble getting a shot. The US Olympic and Paralympic Committee is encouraging all of its athletes to get vaccinated, though it is not mandating it.

Other countries, like Australia and Italy, are also vaccinating their Olympic teams. Pfizer and BioNTech announced earlier this month that they reached an agreement with the IOC to distribute vaccine doses to athletes and delegates from participating countries, starting in late May to allow the two-dose regimen to be completed before the games.

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But it’s unlikely everyone making the journey will be vaccinated. And there is a global shortage of vaccines, with poorer countries lacking enough doses to inoculate their health care workers or their vulnerable elderly populations.

“We’re still in a global pandemic with cases higher than they’ve ever been,” said Krutika Kuppalli, an assistant professor with the division of infectious diseases at the Medical University of South Carolina. “Is it appropriate for people from Brazil to go and compete in the Olympics when you have thousands of people dying?”

Kuppalli added that she understood that so many of these athletes have a life-long dream at stake, but that the world is still very much facing a global emergency. Putting resources and investment into an athletic competition, as exciting and important as it is, seems a bit misplaced when countries in need don’t have enough vaccines or oxygen concentrators.

It makes the Olympics, a celebration of international sport and cooperation, seem a bit hollow, whether or not they go forward.