POST 164. May 26, 2021. CORONAVIRUS. On Wednesday, health minister Norihisa Tamura warned Olympic organizers they would have to “secure their own” hospital beds for anyone falling ill at the Games, explaining the government would not release beds set aside for Japanese covid-19 patients.”

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“U.S. health officials and the State Department on Monday warned Americans against travel to Japan because of a surge in coronavirus cases in the country, which is preparing to host the Olympics in just two months.

The twin alerts don’t ban U.S. citizens from visiting the country, but they could have an impact on insurance rates for travelers and may factor into decisions by Olympic athletes and spectators on whether to compete in or attend the games, which are due to start in July. There was no immediate indication as to what effect the warnings might have on would-be Olympic-goers.

“Travelers should avoid all travel to Japan,” the Atlanta-based Centers for Disease Control and Prevention said in a new Covid-19 update. “Because of the current situation in Japan even fully vaccinated travelers may be at risk for getting and spreading COVID-19 variants and should avoid all travel to Japan.”

The State Department’s warning, which followed the CDC alert, was more blunt. “Do not travel to Japan due to Covid-19,” it said in the announcement, which raised the department’s travel alert from Level 3 — Reconsider travel — to Level 4 — Do not travel. The previous alert was issued on April 21.

The United States Olympic & Paralympic Committee said it still anticipates that American athletes will be able to safely compete at the Tokyo Games.

“We feel confident that the current mitigation practices in place for athletes and staff by both the USOPC and the Tokyo Organizing Committee, coupled with the testing before travel, on arrival in Japan, and during Games time, will allow for safe participation of Team USA athletes this summer,” the committee said in a statement Monday.” (A)

“The Japanese government Tuesday was quick to deny a U.S. warning for Americans to avoid traveling to Japan would have an impact on Olympians wanting to compete in the postponed Tokyo Games…

Most metro areas in Japan are under a state of emergency and expected to remain so through mid-June because of rising serious COVID-19 cases that are putting pressure on the country’s medical care systems. That raises concern about how the country could cope with the arrival of tens of thousands of Olympic participants if its hospitals remain stressed and little of its population is vaccinated.

Chief Cabinet Secretary Katsunobu Kato said at a news conference Tuesday that the warning does not prohibit essential travel and Japan believes the U.S. support for Tokyo’s effort to hold the Olympics is unchanged.

“We believe there is no change to the U.S. position supporting the Japanese government’s determination to achieve the games,” Kato said, adding that Washington has told Tokyo the travel warning is not related to the participation of the U.S. Olympic team…

Fans coming from abroad were banned from the Tokyo Olympics months ago, but athletes, families, sporting officials from around the world and other stakeholders still amount to a mass influx of international travelers. In opinion polls, the Japanese public has expressed opposition to holding the games out of safety concerns while most people will not be vaccinated.” (B)

“The International Olympic Committee this week unveiled updated plans for holding the Summer Games in Japan, meticulous “playbooks” that promise to ensure the safety not only of the athletes taking part but also of the Japanese public during a global pandemic.

They represent “very hard work” and “determination, a lot of determination” to stage the Games safely and successfully, the IOC’s sports director, Christophe Dubi, said at a news conference, and they are based on the latest scientific expertise as well as considerable experience with holding global sporting events during the pandemic. IOC President Thomas Bach said his confidence the Olympics can go ahead also is based on his admiration for the “great resilience and spirit” of the Japanese people…

The meticulous planning, meanwhile, has one potentially fatal flaw: Japan’s already overloaded health system can’t cope with the additional demands the Games will bring without putting more lives at risk, doctors and nurses say. The Olympics would involve more than 11,000 athletes plus tens of thousands of officials, coaches, media members and support staffers converging on Tokyo, which is closed to most foreign visitors.

“Most health workers say even thinking about the Olympics is just ridiculous,” said Kentaro Iwata, an infectious-disease expert and doctor at Kobe University Hospital, which is in a city in western Japan where 1,700 people with covid-19 need hospitalization but can’t get a bed.

“We are really fighting a life-and-death situation,” he said. “How the hell can you speak of a sports event gathering so many spectators, staff, volunteers, nurses and doctors? Who could enjoy the Games in this situation?”..

On April 23, just three months before the scheduled Opening Ceremonies, Japan’s government declared a third state of emergency for Tokyo and several other regions as it battles a surge in infections that is being supercharged by the rapid spread of coronavirus variants and shows no sign of abating.

Japan’s caseload is still a fraction of what many countries are experiencing, but the death toll has doubled in just three months and crossed 10,000 this week. The daily rate of new infections approached 6,000, the highest level in three months. On the day the Olympics were postponed, March 24, 2020, Japan recorded just 65 new infections…

On Wednesday, health minister Norihisa Tamura warned Olympic organizers they would have to “secure their own” hospital beds for anyone falling ill at the Games, explaining the government would not release beds set aside for Japanese covid-19 patients…

Vaccines will not be mandatory, but most athletes and officials probably will be vaccinated. Yet within Japan, just 3.2 million vaccine doses have been delivered, the equivalent of two shots for just 1.3 percent of the population, reflecting a combination of the country’s slow efforts to develop its own vaccine or source one from others and skepticism among many citizens about foreign drugs.

The Games organizers have asked the Japanese Nursing Association for 500 nurses to help out during the 17-day event. On social media, nurses soon began tweeting under the hashtag “nurses opposed to being dispatched to the Olympics,” arguing they had to prioritize existing patients. The hashtag attracted nearly 200,000 retweets within days.

“We are not disposable pawns,” one nurse wrote on a placard that she held up in a tweet.

Others have taken to the streets, asking why IOC officials will get regular testing for the coronavirus while many health workers still can’t access tests.

Nurse Konoka Shibata, 25, said it was “unreasonable” to expect nurses to volunteer for the Games, putting themselves at additional risk when many hospitals are short-staffed and struggling to cope with the pandemic. Kobe University’s Iwata said he also is concerned that delegations from Brazil and India could bring more dangerous variants to Japan.” (C)

“A senior member of the International Olympic Committee has said the Tokyo 2020 Games can go ahead even if the host city is under a state of emergency because of the coronavirus.

“All the measures we are undertaking will ensure a safe Games regardless of whether there is a state of emergency or not,” John Coates, an IOC vice-president who is in charge of preparations, told reporters after a virtual meeting with organisers on Friday.

“Provided that we can protect the Japanese public, the most important thing is giving athletes a chance to compete.”

The IOC and Tokyo 2020 organisers have insisted the Games will go ahead, despite widespread public opposition in Japan and warnings from health experts that the arrival of tens of thousands of athletes, officials, journalists and support staff this summer risked spreading Covid-19.

Japanese doctors and medical workers have called for the Games to be cancelled to relieve pressure on overwhelmed health services, while a recent poll found that 83% of the public want the event to be either called off or postponed for a second time.

While most athletes are expected to be fully vaccinated by the time the Games open in two months’ time, only 4.1% of Japan’s population has received at least one jab – the lowest rate of any advanced economy – and only 30% of medical workers in Tokyo are fully protected, the Nikkei business newspaper said.

Seiko Hashimoto, the president of Tokyo 2020, said up to 230 doctors and 310 nurses would be needed each day during the Olympics and the Paralympics. The number of officials, journalists and other Games-related staff due to arrive in Tokyo has been cut from 180,000 to 78,000, she added.

“I can say it’s now clearer than ever that these Games would be safe for everyone participating and, importantly, safe for the people of Japan,” Coates said, adding that the IOC was working with organisers to send medical personnel to Tokyo. “After eight years of hard work and planning, the finish line is within touching distance.”…

On Friday, Shigeru Omi, who heads the government’s coronavirus advisory panel, told MPs that organisers must consider the impact the Games could have on Japan’s medical infrastructure before deciding whether to go ahead.”  (D)

“The United States Olympic & Paralympic Committee said it still anticipates American athletes will be able to safely compete at the Tokyo Games.

Fans coming from abroad were banned from the Tokyo Olympics months ago, but athletes, families, sporting officials from around the world and other stakeholders still amount to a mass influx of international travelers. The Japanese public in opinion surveys have expressed opposition to holding the games out of safety concerns while most people will not be vaccinated.”  (E)

“The Tokyo 2020 Olympics and Paralympics will take place under strict conditions to limit exposure to COVID-19

The IOC has asked all accredited personnel at the Olympics and Paralympics to sign a waiver indemnifying them for any ‘loss, injury or damage’ suffered by people at the games

Human rights lawyer and former Canadian Olympic swimmer, Nikki Dryden, says questions remain about the process for athletes who register a false COVID positive in Tokyo

As Australian cricketers and commentators have found out in the past week, getting an exemption to leave does not mean you can automatically return.

Should the Olympic and Paralympic Village suffer an outbreak of COVID-19 during the Games will all athletes and officials be quarantined in Japan unable to return home?..

The snap decisions don’t always make sense and by their nature discriminate against someone.

The International Olympic Committee has asked all accredited personnel heading to the games to sign a waiver removing all liability from the IOC, the International Paralympic Committee, and the Tokyo organisers, despite them not yet being able to provide definitive countermeasures as the existing precautions may still change.

The Olympic and Paralympic Games Tokyo 2020 Addendum distributed this week states:

“To the fullest extent admissible under applicable laws, the Responsible Organisation agrees to irrevocably release Tokyo 2020, the IOC, the IPC (and their respective members, directors, officers, employees, volunteers, contractors or agents) from any liability for any kind of loss, injury or damage that the Responsible Organisation, including any Accredited Person under its responsibility, may suffer or be exposed to in connection with their participation in the Games.”

On top of this athletes must sign a hard copy of a ‘written pledge’ and present it to immigration officials on arrival guaranteeing they will follow all the countermeasures despite not knowing the final requirements…

Human rights lawyer and former Canadian Olympic swimmer Nikki Dryden says athletes are single-minded in their preparation for the games, for that reason they are not going to put their health and safety first.” (F)

“Organizers are relying on a series of six playbooks of rules that detail how participants of the Olympics and Paralympics can compete, move around and socialize, in order to manage the risks of what will be the world’s biggest COVID-19 bubble. While those involved in the games will be somewhat isolated from the Japanese public, Tokyo has ruled out using two core tenets of containment: quarantines and vaccinations. Without those, experts say infections could spread.

If it does, not only could the Olympics become the site of a sizable outbreak that spreads into Japan, it could become a cauldron of novel variants gathered from around the world. The risk is that athletes could bring them home, potentially fueling the pandemic.

While Japan has seen much lower transmission rates compared with other rich nations, its vaccination campaign is only just starting, months behind places like the United Kingdom, the United States and even other parts of Asia. There are still many unknowns, including exactly how many people will be coming into Japan, and organizers haven’t decided yet on how many domestic spectators will be allowed into venues.

Depending on how infection rates develop, there’s still a possibility that more stringent measures will be adopted, with the final version of the playbooks due in June.

“The situation surrounding the coronavirus is constantly changing, and it’s our hope that the efforts of the government, the city of Tokyo and other stakeholders will help to mitigate spread of infections,” Tokyo 2020 said in an emailed statement.

Sporting events have gone on around the world this past year — with both success stories and cautionary tales.

The Olympic organizers are set to emulate the NBA, which saw no infections during its three-month run in the summer and fall of 2020. But the NBA bubble saw just a few hundred athletes cordoned off together at the Walt Disney World Resort in Orlando, Florida. Including staff and coaches, there were fewer than 1,000 people involved…

The extent of the risk also varies depending on the sport. A study of the NFL’s latest season in the U.S. found that players didn’t transmit the virus during game play, while matches for a high school wrestling tournament turned into deadly superspreading events. The Olympics will feature 33 sports across 42 venues across Japan.

Further complicating the task is the social nature of the Olympics. Places such as the Athlete’s Village were designed to have people meet and socialize. Although long conversations and collective meals will be off limits, how those rules will be enforced is unclear. Some of the athletes are teenagers and the average age of an Olympian is usually in the 20s — groups where virus spread has been harder to control…

It’s not just the athletes. The games will require thousands of volunteers to help the events run smoothly, as well as local staff who will need to go in and out of the Olympic bubble regularly to do things such as cook meals, clean facilities and run the proceedings. It’s not clear how such staffers — which the Olympic Organising Committee and Tokyo Metropolitan Government say will probably number more than 150,000 — will be handled, and the playbooks don’t offer explicit instructions.

Even in normal times, disease outbreaks are common at the Olympics. During the Winter Games in Pyeongchang in 2018, around 200 athletes caught norovirus. Two years earlier, the Rio Summer Olympics were held amid the specter of Zika. More than 300 athletes caught respiratory illnesses out of 10,568 competing in the London Olympics in 2012.” (G)

“Is there a level playing field for all nations expected to attend? To date, more than 458 million vaccine doses have been administrated worldwide. And while this is good news, there is a lack of global equitable access to vaccines, and even within countries, not everyone is being included in national vaccination plans.

COVAX is currently the only initiative working to deliver vaccines equitably to 92 lower-income countries. The World Health Organization argues that there will be “no end to the pandemic without equitable distribution.”

According to the IOC playbooks, being vaccinated is not a requirement for anyone attending the Games. IOC member Dick Pound suggested athletes must be given priority access to the coronavirus vaccine. IOC President Thomas Bach, however, argued that the IOC is not in favour of athletes jumping the queue and it was to be determined by governments.

Some countries — like Lithuania, Hungary, Serbia, Israel, Mexico and Russia — have already announced commitments to allowing their athletes priority or voluntary access to the vaccine. Other countries — like Canada, Germany, Britain and Italy — have announced vaccines will be given to the most vulnerable populations first.

The Chinese Olympic Committee has even gone so far as to offering to vaccinate Tokyo 2020 and Beijing 2022 athletes in territories that have approved the Chinese vaccine for use. So access for athletes is unevenly distributed…

Money over health?

But Japan is currently behind on vaccinations compared to other countries since it only started in February 2021. According to survey by Kyodo News, 80 per cent of Japanese residents would rather see the Games cancelled or further delayed.

Last April, the IOC argued that the Games could not be delayed to 2022 as the Japanese partners and the organizing committee could not manage it. This was due to the availability of the Olympic Village, sports venues and the need for people to carry on working.

The decision to continue with the Games during a global pandemic makes it clear that finances are driving decisions, not the health of those involved.

The Olympic Charter proclaims that the Games are about “promoting a peaceful society concerned with the preservation of human dignity.” The question becomes: who will be the voice of reason?” (H)

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….

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 are not going to mandate that everyone quarantine, 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.

But it’s unlikely everyone making the journey will be vaccinated. And there is a global shortage of vaccines, with lower-income countries lacking enough doses to inoculate their health care workers or their vulnerable older 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.” (H)

“The time has come to press pause and reimagine the Olympics. It might even be time, I’ve come to believe, for the entire endeavor to close down for good.

What say you?

First, consider the near term.

In July, yet another wildly overbudget Summer Games, originally slated for 2020 but postponed because of the pandemic, will begin in Tokyo.

The timing remains awful.

Japan has worked hard to tamp down the coronavirus, but now cases are creeping up, and the nation’s vaccination rate is lagging. Organizers just rerouted the torch relay planned this week to reach the streets of Osaka, where one health official said the spread of new variants had pushed the medical system to “the verge of collapse.”

Into this troubled environment, 11,000 athletes from all corners of the globe will descend, along with coaches, officials, Olympic support staff, media workers and more. The Tokyo Games could end up being a three-week superspreader event that leads to death and illness across Japan and far beyond.

The Japanese public has grown wise to the health risk. It is also aware of the estimates that show the cost for the Games has swollen to a record $15.4 billion, up $3 billion in the last year alone. Recent surveys show close to 80 percent of Japanese say the Games should be postponed again or canceled.” (I)

“One of the latest warnings came Tuesday in an article published by The New England Journal of Medicine, in which a group of public health specialists harshly criticized the International Olympic Committee’s so-called playbooks — the colorfully illustrated packets detailing countermeasures designed to keep athletes, other Olympic visitors and the broader Japanese population safe from the virus.

In the article, the specialists suggested the playbooks — created by the I.O.C. in consultation with the World Health Organization — lacked transparency, were insufficiently detailed, and focused at times on science that was outdated or irrelevant to ensuring the event could be safe. The authors stopped short of arguing for a cancellation of the Games, but said the risk was too high to ignore.

“All along the way there’s been an ignorance of science,” Dr. Annie Sparrow, a global health specialist and the lead author of the article, said of the I.O.C. in an interview. “It’s not rocket science to hold a safe Olympics. It’s basic medical science. But that’s what the I.O.C. has ignored, and I don’t know if they’re going to start paying attention now.”…

The I.O.C., which will publish the third and final iteration of its playbook next month, has trumpeted the partnership it established last year with the W.H.O. in an attempt to build confidence in the viability of its health protocols.

But Sparrow, a former adviser to Dr. Tedros Adhanom Ghebreyesus, the director-general of the W.H.O., and her three co-authors urged the health organization’s membership to convene emergency committee meetings before the Tokyo Games, just as it did before the 2016 Rio Olympics amid widespread outbreaks of the Zika virus…

Among other things, they criticized the playbooks’ focus on countermeasures like disinfecting surfaces and temperature checks, which they called ineffective; the lack of specialized guidelines for different competition venues, common spaces and sports; the use of contact-tracing and health-reporting apps, which they called inferior to wearable trackers; and the possibility that athletes were at a higher risk of infection by sharing rooms in the athletes’ village.

The authors also laid out in stark terms how little the landscape had improved in the past year.

“When the I.O.C. postponed the Tokyo Olympics in March 2020, Japan had 865 active cases of Covid-19 against a global backdrop of 385,000 active cases,” the article said, noting that many people had assumed the pandemic would be under control by 2021. “Fourteen months later, Japan is in a state of emergency, with 70,000 active cases. Globally, there are 19 million active cases.”

Such troubling numbers were behind the State Department’s decision on Monday to warn Americans not to travel to Japan. (The recommendation was mostly symbolic; nonresident foreigners have largely been banned from entering Japan since the middle of last year.)

Still, the alarming advisory — Level 4 is the highest possible warning — did not immediately change the United States Olympic and Paralympic Committee’s outlook on attending the Games.

“We feel confident that the current mitigation practices in place for athletes and staff by both the U.S.O.P.C. and the Tokyo Organizing Committee, coupled with the testing before travel, on arrival in Japan, and during Games time, will allow for safe participation of Team USA athletes this summer,” a spokesman for the U.S.O.P.C. said in a statement…

Amid all this, the unyielding march of the calendar toward the opening ceremony continues: Wednesday marks 58 days until the start of the Games.” (J)