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The U.S. softball team arrives in Japan ahead of the Summer Olympics. STR/JIJI PRESS/AFP via Getty Images
  • Olympic athletes are arriving in Japan as the country is dealing with a major surge in COVID-19 cases.
  • While many U.S. athletes will be vaccinated, experts have raised concerns about the spread of the delta variant.
  • We talked with experts about how Olympic officials are planning to avoid a COVID-19 outbreak.

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With only week until the start of the Tokyo Olympic Games, a surge of COVID-19 cases has put current protocols under scrutiny.

Experts talked with Healthline about the Olympic officials’ plan to prevent turning this premier, international athletic competition into an unprecedented superspreader event.

Dr. Annie Sparrow, pediatrician, public health specialist, and assistant professor in population health science and policy at the Icahn School of Medicine at Mount Sinai Hospital in New York, writes of an urgent need for risk management at the games.

Her perspective article, published in the New England Journal of Medicine on July 1, points out when the International Olympic Committee (IOC) postponed the Tokyo Olympics in March 2020, Japan had only 865 active COVID-19 cases against a global backdrop of 385,000 active cases.

“Some athletes may choose not to be vaccinated because of worries about the effects of vaccination on their performance or ethical concerns about being prioritized ahead of health care workers and vulnerable people,” she wrote.

According to Sparrow, it was assumed that the pandemic would be controlled in 2021, or that vaccination would be widespread by then.

Yet 14 months later, Japan is in a state of emergency, with 70,000 active COVID-19 cases and 19 million active cases globally.

About 15,000 foreign athletes, along with tens of thousands of officials, sponsors, and journalists from around the world, will attend and potentially interact with a mostly unvaccinated Japanese population, Dr. Naoto Ueyama, a physician and the head of the Japan Doctors Union, told The Associated Press (AP).

AP also reported that 70 percent of the population in Japan will still be unvaccinated by the start of the games.

According to the Olympic Committee’s “playbook” for athletes and officials: “To stop the spread of COVID-19, it is vital to break the chain of human-to-human transmission. That is why it is important to have stricter protocols to identify who has the COVID-19 virus as early as possible, through testing.”

Dr. Gary Schoolnik, chief medical officer at Visby Medical and professor of medicine at Stanford University specializing in infectious diseases, told Healthline that PCR testing should play a central role in preventing disease spread.

“PCR testing, the most accurate testing method, should be used to test each athlete and wider team before they enter the Olympic site each day,” he said, “as Visby’s test was used for the U.S. Olympic trials.”

He explained that less accurate methods, like antigen tests, only have an accuracy of about 50 to 70 percent for asymptomatic infections.

“Can you imagine feeling safe if a metal detector could only detect 50 to 70 persons out of 100 persons carrying a dangerous item into the arena?” Schoolnik said.

“For this reason, it makes no sense to screen persons with an antigen test and then only test the antigen-positive persons with a more accurate PCR test,” he said.

The Olympic playbook specifies that participants will require a negative test before leaving their home countries, another one upon arrival in Japan, and regular screening during the games.

Dr. Theodore Strange, interim chair of medicine at Staten Island University Hospital in New York, commented on the playbook for Healthline.

“Honestly, I think there’s a concern, obviously, and keeping spectators away and trying to protect the athletes, masking and testing is clearly very important as we can see around the world,” Strange said. “So, I do believe they’re doing everything possible to protect the athletes, and obviously to protect the integrity of the games.”

“It appears from what I’m reading in the playbook they put together that they’re going to be doing a lot of testing and isolating, so I think if they follow what they’re saying [in the playbook] that [testing] within 72 hours of their flights in and out of the country, this should be sufficient to prevent any real spread of disease,” he said.

Asked whether there’s a risk that assembling people from around the world in Japan could risk creation of a new coronavirus variant, Strange said it’s too early to say.

“So, that is a question that I don’t think there’s an answer to yet,” he said. “We would hope that the vaccination program itself has done enough to isolate the hosts to make the virus more difficult for it to mutate, because the immunity in those that had the vaccine should be significant enough in enough people.”

However, Strange warned that the possibility still exists.

“Obviously we’re seeing some infections that do occur, even in patients who are vaccinated, although those are small,” he said. “So, I don’t know that there’s a real good answer to that question, and I think that’s something to be monitored over the course of the next weeks to months.”

Strange added that he hopes encouraging vaccinations in athletes (although they’re not required), no interactions with spectators, and limiting interactions with anybody else will significantly reduce the risks.

“[It] should be enough to minimize as best as we can, the risk of transmission, and the risk of further development of new strains of this virus and risk the further development of bringing this back home once the Olympics are done,” he said.

The Tokyo Games, already postponed due to COVID-19, will be held in a Japan that’s still mostly unvaccinated and experiencing a surge of COVID-19 cases.

Experts say this could risk the creation of a new virus variant that participants take back to their home countries.

However, other experts believe the protective measures being taken, like vaccination, testing, tracing, and masking, will significantly reduce, but not eliminate, the risk of disease spread.