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Record infections stoke fears of unprecedented Tokyo virus spread from Olympic complacency

Crowds are seen packed in close together during the same time as the opening ceremony for the 2020 Tokyo Olympic Games was held, in Shibuya Ward, Tokyo, on July 23, 2021. (Mainichi/Yoshiyuki Hirakawa)

TOKYO -- On July 27, five days after the 2020 Tokyo Olympics officially began, Japan's capital announced a record 2,848 new daily coronavirus infections. The current state of emergency declaration's effect on reducing the movement of people appears dulled, and some are saying that holding the games has led to "complacency" about infection prevention. Concerns of pressure on Tokyo's medical system are running high.

    On the morning of July 27, representatives from the International Olympic Committee (IOC) and the Tokyo Organising Committee of the Olympic and Paralympic Games attended a press conference where a reporter for a foreign news media outlet asked whether the games' timing was good amid a high likelihood that a record number of daily coronavirus cases in the capital would be announced.

    IOC Director of Communications Mark Adams responded shortly, saying, "It's not my job to comment on domestic cases, and that would be something for the health authorities." Some five hours later, the Tokyo Metropolitan Government announced 2,848 new daily coronavirus cases; the highest at the time.

    At the end of the fourth day of Olympic competition, Japan's medal haul stood at 13: eight gold, two silver and three bronze. Among figures connected to the government came statements welcoming the rush of medals, like, "It's been more exciting than expected. You don't get tired of it no matter how often you hear it."

    Some within the government also indicated that they thought that so long as new daily infections could be kept to around the 2,500-people level, the situation would endure. But reality has exceeded those projections. One organizing committee senior official said, "A record high makes things look bad."

    The IOC has hailed the Athletes' Village, where around 18,000 participants, organizers and others are staying during the Olympic Games, as the safest place on Earth. The "bubble system" fast becoming a norm for international sporting events is in use to separate athletes from the outside world. Over 80% of athletes and other games-related individuals are fully vaccinated.

    Since July 1, a total of 239,418 coronavirus tests have been administered on games-related people. Of them, 52 have returned positive -- just 0.02%. Even so, athletes in disciplines including taekwondo and skateboarding have been forced to pull out.

    But since the games have gotten underway, complacency in athletes' and others' normative consciousness has been visible. Of note have been actions undermining the Olympic Playbook rules drawn up by the organizing committee and others as a key part of infection prevention measures.

    On July 24, the first day of full competition, Japanese Olympic Committee President and organizing committee Vice President Yasuhiro Yamashita was seen conversing without a mask at the Nippon Budokan judo venue. Although his actions broke rules in the playbook regarding the wearing of masks at most times, the organizing committee avoided explaining his actions, saying, "We are not aware of how the situation was responded to."

    Athletes at competition venues were also seen hugging one another, and in places people have been seen completely removing their masks to cheer on competitors, among other acts. The organizing committee says it is "making strict calls for awareness," but it hasn't considered going as far as exercising its powers as described in the playbook to strip athletes of their right to compete.

    Under the state of emergency declaration, the capital's eateries are being asked to stop serving alcohol. But some bars are still serving booze, and there have been noticeable instances of young people drinking in the street. Another person connected to the government told the Mainichi Shimbun, "The Olympics have become a get-out-of-jail-free card, and people are totally relaxed."

    The IOC and the organizing committee have stated that in the event of a major change in the state of infections, a meeting of the "five parties" that also include the national and metropolitan governments would be held quickly to review the situation.

    But a games-connected individual struck a different tone, saying, "Once it starts it's hard to stop it. Now all we can do is keep charging ahead." On Aug. 24, the Paralympic Games will begin in Tokyo. The same official said, "It's worrying to think what will happen with the Paralympics if the number of infected people keeps going up like this."

    (Japanese original by Shun Iwakabe, Kazuhiro Tahara and Hitoshi Kurasawa, Sports News Department)

    -- The 'unknown world' drawing near with higher infection numbers

    "If we reach 3,000 cases a day, I don't know what will happen," said a visibly concerned Satoru Takahashi, head of the Nihon University Itabashi Hospital in Tokyo's Itabashi Ward. The hospital accepts COVID-19 patients with medium to severe symptoms.

    With July 27's 2,848 new coronavirus infections reported, what Takahashi describes as an "unknown world" is drawing closer. As of July 27, 2,864 patients had been hospitalized for COVID-19 in Tokyo, already more than the 2,431 hospitalized patients recorded on May 16, the peak of the fourth wave of infections. With the fifth wave emerging as the capital hosts the Olympic Games, potential pressure on the health system is starting to seem a reality.

    To prepare for future infection surges, the hospital renovated a 95-bed ward into a specialist coronavirus one in April. Now the space is used for six intensive care units and 50 beds in high-level care rooms. On July 27, four of the six beds for people with severe COVID-19 symptoms were filled, and an over 50% rate of occupancy was seen among beds for people with moderate symptoms.

    Takahashi said, "If we didn't increase available beds, we'd probably already be at full capacity. This week we've entered an unpredictable situation where patient numbers are rising."

    Work at public health centers, the frontlines of the fight against the virus, is already under pressure. While the institutions manage adjustments to ensure infected people can be hospitalized, and identify other people they have had close contact with, public health centers in the heart of the capital are constantly receiving reports from medical institutions and other establishments of infections.

    With progress in vaccination efforts, cluster infection rates in care homes for elderly people have fallen, but a remarkable number of cases reportedly involve individuals who have received their first shot and contracted the coronavirus after eating out with a number of people.

    A public health center official said, "In the recent infected persons announcement there would have been people who couldn't get tested over the long public holiday. They would have been tested on July 26, and that might have pushed the numbers up."

    But they expressed serious concern, saying, "There are no factors that can push down infections, and in time it may become difficult to not only get hospitalized but also stay at hotels to recuperate. With community infections spreading, identifying people they have had close contact with is getting harder."

    In the capital, there have been more and more cases of hospitals needing time to accept patients when requests for their emergency conveyance are made. Because health care centers ready to accept unwell individuals cannot be found, there were between July 19 and 25 a total of 1,121 cases where hospital searches took four or more checks, known as "emergency service difficulties cases." The numbers were some 30% up on the week prior. Until early July, the average weekly figure had been around 500 to 600, meaning a huge rise has been witnessed.

    Toru Kakuta, vice chairperson of the Tokyo Medical Association, asserted: "The number of patients with moderate level symptoms who need high-concentration oxygen provision has increased. They require a level of medical resources similar to that for severe cases, so the idea some have that 'if we just reduce severe COVID-19 cases we'll be fine' is, when looked at here from the ground, reckless."

    Tetsuya Matsumoto, an expert in infectious diseases and a professor at the International University of Health and Welfare, said that a reason infection numbers haven't fallen is that "although we're under a state of emergency declaration, there are no limits on people's movements. Although infections are rising, the sense of crisis felt up until now has been lost.

    "The Olympics are being held, and the summer vacation period is beginning in earnest. The delta variant of the coronavirus has also played a part, and it means a range of factors conducive to infections have come together to create a situation where infections aren't going down."

    Minister of Health, Labor and Welfare Norihisa Tamura told a group of reporters on July 27: "We're seeing a number of establishments (in the capital) that are not complying with requests, and choosing to serve alcohol. We ask that they please act in accordance with the requests that we have made."

    But it seems no effective infection-reducing plan to replace the state of emergency declarations has been found. A senior health ministry official also said, "People are making fewer trips out of their homes, so perhaps if we observe the situation a little bit longer we might see infections come down." The remarks gave the sense of a government bereft of options.

    (Japanese original by Shunsuke Kamiashi, Naomi Hayashi and Takashi Kokaji, Lifestyle and Medical News Department)

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