Categories: COVID-risks

COVID Risks at the Tokyo Olympics Aren’t Being Managed, Experts Say

more transmissible Delta variant spreads, experts warn that those measures may not be enough. Already, several athletes have tested positive for COVID-19 after arriving in Japan, raising concerns of a possible outbreak.

“It’s a perfect opening scene for a thrilling movie where everyone gets sick with Delta all over the world, and they trace it to the Olympics,” says Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco. “The Olympics are not only just a local potential superspreading event in a poorly vaccinated country but [could perhaps become] a global superspreading event.”

Brian McCloskey, chair of an independent expert panel advising the IOC on COVID-19 countermeasures, says that while individual cases are inevitable, the goal of the regulations is to prevent transmission chains and clusters from forming. But experts interviewed point to risks for viral transmission tied to individual sports and arenas, life in the Olympic Village and seeded infections from the broader community. Altogether, they indicate that without stricter mitigation measures than the ones introduced by the IOC, clusters of infection are likely to propagate.

Sport-Specific Guidance

As it stands, all Olympic athletes must abide by the same guidelines laid out in the official playbook for the games. If flying internationally this month, they must be tested twice in the 96 hours before their flight with an approved polymerase chain reaction (PCR) or antigen test.  (Those flying earlier than July 1 were only required to take one test within 72 hours of their departure.) Upon arrival, they will be given a rapid saliva-based antigen test that is processed as they go through immigration and claim their baggage. A positive or inconclusive result will need to be confirmed with a PCR test at the Olympic Village. If athletes test negative, they will be allowed to continue to their accommodations. Daily, they are required to complete a health check using an app and to give saliva samples for an antigen test, followed by a PCR test on the same sample if results are unclear or positive.

When it comes to transmitting a respiratory virus that spreads through fluids, droplets and aerosols, not every sport is created equal. In the New England Journal of Medicine, Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, co-authored a perspective, first published online in May, that called for a tiered risk-management approach. He and his co-authors wrote that the IOC should have designated different sports as having high, moderate or low COVID transmission risk.

According to the paper’s authors, outdoor events that naturally space out competitors—such as sailing, archery and equestrian competitions—can be considered low risk. Moderate risk events include those that are held outdoors but in which close contact is unavoidable, including rugby, field hockey and soccer. Indoor sporting events that involve close contact, such as boxing and wrestling, are high risk. As a rule of thumb, any indoor sports event is riskier than one held outdoors.

Annie Sparrow, an assistant professor of population health science and policy at the Icahn School of Medicine at Mount Sinai and a co-author of the NEJM perspective, says there are sports that fall into gray areas, too: swimming, for example, could be considered low risk for individual events but moderate risk for relays. Water polo, which requires close contact, would be a high-risk sport. These risk assessments could have informed changes in the way certain competitions will be held. For instance, the transmission risks of aquatic events would be lower if they were planned to take place in outdoor pools, Sparrow says.

Simply making these designations is not enough, however, Osterholm says. Organizers should have required more precautions for athletes competing in riskier events. These might include more accurate testing using only PCR assays rather than antigen-based ones or greater restrictions on socializing with anyone other than teammates and coaches. Olympic organizers recently barred spectators from most events after Japan declared another state of emergency in Tokyo over a spike in new COVID cases and fears about the Delta variant.

In the absence of these measures, a one-size-fits-all policy is worrisome, says Joseph Fauver, an associate research scientist at the Yale School of Public Health, who worked on testing strategies for the National Basketball Association (NBA) and National Football League (NFL). “The risk of transmission brought on by team sports that practice together is inherently different from something like doing archery outside,” he says.

McCloskey says the policies were designed not to rely on players’ vaccination status, which varies by country because of access and wealth disparities. He adds that organizers do plan to allow for a sliding scale when it comes to isolation and quarantine. Some athletes who test positive or are identified as a close contact of a case may undergo an “adaptive quarantine” in which they isolate themselves from teammates and staff but are still permitted to train, he says, depending on the nature of the test result and contact.

With regard to whether some high-risk, indoor contact sports events might be canceled, IOC adviser McCloskey says the evidence of transmission events from professional contact sports leagues is w

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