The Olympics, which will begin next week under a state of emergency, has been under scrutiny from health experts, many of whom have called for re-evaluating the risks of the games.

The Tokyo Medical Practitioners Association wrote an open letter in May to Japan’s Prime Minister Yoshihide Suga calling for the games to be canceled. The association cited health concerns like potential COVID-19 outbreaks associated with the event, which would place a disproportionate burden on Japanese doctors. 

While the letter gained attention from local and foreign press, the games’ start date remained unchanged. Suga declared that Japan could still host a “safe and secure” Olympics," Reuters reported.

Organizers require visiting athletes and officials to follow a three-day quarantine upon arrival, participate in daily COVID-19 testing, and confine themselves to a “bubble” — limiting the places they go to and people they interact with, according to Nikkei Asia. In addition, spectators are banned from most events.

But the extent to which the current safety measures are being followed is questionable. Grace Lee, a reporter for CTV News in Japan, wrote on her Twitterthat the three-day quarantine for Olympic travelers seemed relaxed. She reported that people were mingling at places like breakfast buffets and convenience stores.

Lee is the “Olympic COVID-19 Liaison” for her organization, which means she is in charge of getting crew members from CTV News into Japan and ensuring that they follow COVID-19 protocols throughout their stay. She mentioned that the process is cumbersome, having been required to use a health monitor app that failed to work and lacking proper access to resources.

Concerns About the Spread of Delta Variant

William Lang, MD, MHA, chief medical officer at WorldClinic and former White House physician, says that he supports the continuation of the Olympics, but has fears about the event’s impact on Japan’s unvaccinated population.

“We’re probably at or past the point of being able to call [the Olympics] off,” Lang tells Verywell. 

Less than 10% of Japan’s population is fully vaccinated, according to the most recent data from the World Health Organization (WHO). Disparities between vaccination rates in the United States and Japan may mean that American athletes and officials may need to respect heavier social distancing and masking measures while overseas.

About 85% of athletes in the Olympic Village are “vaccinated or immune” and between 70% to 80% of international media are vaccinated, the International Olympic Committee President Thomas Bach told the press.

In the U.S., high vaccination rates make it more important to evaluate numbers of hospitalizations, Lang adds, but risk assessment in Japan should still be based on case numbers. For the week of July 12, Japan recorded 12,503 cases and 66 related deaths, per WHO’s data tracker.

Lang is most concerned about the highly transmissible Delta variant, which has infected vaccinated and unvaccinated people across the globe. The variant has accounted for more than 30% of cases in Japan with a potential to rise above 75% by the end of July, according to NHK World Japan.

Vaccine Rollout Delays in Japan Heighten COVID-19 Risks

Many health experts claim vaccination is the ticket to immunity, but full immunity can take two weeks to kick in. People in Japan who are just receiving their vaccinations may not be protected during the games. Vaccine shortage has also dampened the government’s rollout efforts before the games.

Rochelle Kopp, a health and environmental advocate who runs a consulting firm in Japan, was supposed to get her second shot of the Pfizer vaccine on June 16, but says her appointment was cancelled due to a supply shortage.

“They really should have done vaccination much earlier if they wanted to make the country more prepared to have so many people coming in,” Kopp tells Verywell, adding that the Olympics and slow vaccination rates are a “terrible combination.”

Japan has been criticized for its vaccine rollout mostly because local governments were unprepared for the task, she says. In addition to appointment cancellations, Kopp says she and other residents had trouble scheduling the appointments and navigating logistical issues. 

The post-vaccination immunity time frame may be longer for protection against the Delta variant. A study on the AstraZeneca vaccine found that people are protected against the Delta variant until four weeks after inoculation, as opposed to a 15-day threshold for other variants.

The AstraZeneca COVID-19 vaccine is not yet approved in the U.S. It is approved in Japan, though the government initially refrained from using it in mass vaccination drives due to risks of rare blood clots, according to Reuters.

“Almost no people in Japan are going to be ready if people are bringing in Delta variants,” Kopp says. 

Rethinking Future Olympics Games

NBCUniversal Chief Executive Jeff Shell said in June that the Tokyo Olympics could be the station’s most profitable Olympics yet.

The company had already sold 90% of its advertising inventory by March 2020, hitting a record of $1.25 billion by the onset of the pandemic in the U.S, according to Bloomberg. To date, NBC’s most profitable Olympics was the 2016 Olympics in Rio, which recorded a $250 million profit.

But from Kopp’s perspective, this profit comes at a steep price from Japanese tax payers. 

A recent Asahi Shimbun survey reported that 83% of people in Japan thought the Olympics should be cancelled or postponed.

“It’s the money that’s driving all of this,” Kopp says. “This whole thing, watching it up close, has made me frankly really sour on the Olympics.”

She says environmental factors, like Tokyo’s hot summer, will add to the risks of the games. Experts have noted that COVID-19 along with heat-related illnesses could overwhelm Tokyo healthcare professionals during the games.

Rethinking the timing and placement of the Olympics could be essential for future games, even after the pandemic is over, Kopp says. She also suggests hosting different sports in different countries and cities as well as paying attention to climate and weather conditions of the chosen area.

“[The pandemic] really should stop and make us re-evaluate how the Olympics actually works because it’s not fit for purpose for the 21st century and the challenges we have today,” Kopp says. “Doing it the same way it just doesn’t make sense anymore and the Tokyo Olympics makes that really clear.”

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