Image from Getty, published in Age article.
The International Olympic Committee’s push for the Tokyo Olympics to proceed in July despite Japan’s massive third wave of COVID-19 defies public health logic writes Professor Mike Toole AM in the Fairfax media.
Tokyo Olympics plan is tempting disaster
By Michael Toole
The International Olympic Committee’s announcement that “there is no Plan B” for the Tokyo Olympics and they will proceed in July, despite Japan’s massive third wave of COVID-19, defies public health logic. The very best that we can expect is a XXXII Olympiad in front of empty stadiums and a torch relay on empty streets.
Japan’s third wave has not yet reached its peak. The country’s testing rate is also the lowest in the developed world, meaning the actual number of cases could well be higher than the official figures.
The measures the government has taken to control spread of the virus are inadequate and hopes that mass vaccination will solve the problem are unrealistic.
Japan’s third wave is much more severe than its previous two. On March 24, 2020, when the Olympics were postponed by a year, just 16 new COVID-19 cases were reported in Tokyo and 47 cases across the country. On Thursday, 973 cases were reported in Tokyo and 3537 nationwide. Recent daily totals have been as high as 7800 and the seven-day average is 3858.
Japan effectively managed the first wave back in April through a combination of border closures and targeted, innovative testing and contact tracing. However, this third wave has overwhelmed contact-tracing teams.
Since the beginning of the pandemic, Japan’s testing rate has been extremely low by global standards. So far it has tested just 52 per 1000 of its population, compared with 499 per 1000 in Australia. That is, Australia has tested almost half its population. Impoverished Myanmar has a test rate just lower than Japan’s.
All along, Japan has resisted national lockdowns to keep its economy open. Although a state of emergency has been declared in 11 prefectures, including Tokyo, it continues to rely on voluntary measures such as suggesting that bars and restaurants close at 8 pm and asking people to avoid indoor gatherings. Such an approach did not work in Sweden and does not compare with the restrictions imposed in countries that have effectively controlled their outbreaks.
Let’s compare the responses to the second wave in Melbourne and the third wave in Tokyo. About July 5, Melbourne reported 135 new cases. That’s the equivalent of 1000 cases in Tokyo, given its larger population, which is what the city has been reporting daily. On July 7, two days later, Melbourne imposed Stage 3 restrictions: people could only leave their homes for four reasons; bars, cafes and restaurants were limited to takeaway; and people could only leave the metropolitan area for essential work. These restrictions were more stringent than those in place in Tokyo today and yet cases continued to climb in Melbourne until even stricter measures were employed. Based on this comparison, Tokyo is not on track to control its outbreak anytime soon.
Comparisons with the Australian Open don’t stand up. Just over 1000 players and their entourages have arrived in Melbourne by 17 charter flights and all were in strictly controlled hotel quarantine. Nine have tested positive for COVID-19, consistent with the 1 per cent of returning travellers testing positive. The Olympic Games will be in a different category, bringing together more than 11,000 athletes from 206 countries, at least 5000 coaches and officials, 20,000 journalists and 60,000 volunteers.
Japan’s quarantine system does not match the tight systems in place in Australia. Arriving Japanese nationals and foreign residents are requested to pledge to: refrain from using public transport for 14 days; quarantine at home for 14 days; and share location data when quarantine authorities request it.
The other mechanism to protect the athletes, their entourages and the Japanese public is vaccination. While the former may have access to vaccines in their home countries, such as Australia, it is unlikely that a majority of Japan will be vaccinated by July. While Japan has ordered large quantities of vaccines, its program will start modestly in February with 10,000 medical workers. Production and distribution delays have hindered vaccine rollouts across the world and Japan already lags behind most major economies in starting its inoculation campaign. It is unlikely to achieve population immunity by July.
A successful Olympics would provide a welcome boost to the world’s morale but it could lead to quite the opposite, given the situation in Japan. While a major super-spreading event is possible, even a lower level of transmission could cause chaos. Officials and volunteers would suddenly be absent. Athletes may miss crucial races. Team sports could be cancelled. And restaurants may be shuttered.
The realities of this pandemic are hard to swallow but they cannot be ignored. The very best we can expect in Tokyo is a sporadic series of events in silent stadiums, devoid of loud and passionate fans.
Professor Michael Toole is a leading Burnet epidemiologist in the COVID-19 response, including the Know-C19 program.