Sports and Fitness in the COVID Era: Lessons from the Tokyo Games

In March 2020, when the International Olympic Committee (IOC) decided to postpone the Tokyo 2020 Olympic Games, the announcement marked the first time the Games had been postponed since their debut in 1896. The Games’ schedule had only been altered three other times – during World War I and World War II. At the time, IOC President Thomas Bach stated in a video posted to the IOC website, “ We are facing an unprecedented challenge because this postponement is the first ever postponement of Olympic games in Olympic history.” He went on to describe the games as “the most complex event on this planet” given the over 200 national Olympic committees and more than 11,000 athletes who participate. In the face of the postponement, he urged athletes to demonstrate cooperation and understanding as they prolonged their preparations. Bach concluded his message with the hope that the occurrence of the Tokyo Games in 2021 would serve as a “light at the end of this dark tunnel we are all going through now.”

Fast forward to August 2021. With the closing ceremonies just days away, Thomas Bach’s hopes for the postponed Olympics have been partially fulfilled. The Tokyo Games have delivered many inspiring moments, seen new records set, and sparked important conversations about athlete mental health. However, with new COVID variants emerging around the globe, it is clear that the Games are a flicker of hope in this ongoing pandemic tunnel rather than the beacon of light at the end of it. Here’s a snapshot of how the pandemic has played out during this Olympiad:

As the Tokyo 2020 Olympics draw to a close this week, it is worth reflecting on the protocols that made them possible (even in the midst of a global pandemic), the impact of these unprecedented Games, and the implications for future sporting events of this magnitude. The Beijing 2022 Winter Games are only 185 days away, with many international qualifier events scheduled in the intervening months. What should athletes, coaches, organizers, and national team committees learn from Tokyo?

Unprecedented COVID Conditions Call for Unprecedented Protocols

When Tokyo declared a preemptive state of emergency just weeks prior to the Olympic Games, one prior protocol had already been in place to help control the influx of outsiders to the host city: no spectators at events. Furthermore, the organizers and the IOC had aligned on a number of other requirements and processes to ensure participant and volunteer safety. Sports Illustrated reported on the following protocols designed to create an Olympic “bubble” for participants:

  • Prior to traveling to Japan: all Games participants were required to produce two negative COVID tests before being permitted to board a flight bound for Japan. One test had to be taken at least 96 hours prior to departure, and the other had to be taken at least 72 hours prior to departure.
  • Upon arrival in Japan: games participants (athletes, staff, coaches, and even journalists) were required to take a saliva test at the airport upon landing in Japan and could not leave until a confirmed negative result. If they received a positive result, they had to either enter isolation or go to a hospital for treatment.
  • Once in Tokyo: athletes have been required to take daily saliva tests. If they are staying in the Olympic Village, they must have their temperature taken every time they re-enter the Village.
  • During the Games: everyone is required to wear masks at all times (except when competing) and to engage in standard mitigating behaviors like appropriate social distancing and frequent hand washing. Athletes are only allowed to leave their accommodations to attend events in official Olympic venues.
  • Additional precautions: some sport-specific guidelines like clapping rather than cheering aloud have been implemented. Furthermore, athletes are not allowed to use Tokyo public transportation.

The consequences for not abiding by these protocols have been disqualification and loss of Games credentials. As of August 1st, USA Today reported that 14 athletes had received suspensions or loss of accreditation for violating the COVID guidelines.

Quantifying COVID Impacts from the Games

With protocols starting before Games participants left their home countries and continuing throughout the Games’ duration, many positive COVID cases have made headlines. As the games began, CNN reported on at least 25 athletes from 10 countries who had dropped out due to COVID-19 health and safety protocols. Six of those athletes were from the U.S., impacting the teams for men’s basketball, men’s beach volleyball, women’s gymnastics, women’s tennis, women’s basketball, and men’s golf.

Once the Games were underway, some athletes who passed pre-arrival protocols ultimately tested positive after arriving in Japan. NPR reports that at least 23 athletes had tested positive about halfway through the Games. These positive test results have meant being whisked away to a “quarantine hotel” (a local Tokyo hotel designated as an isolation facility) for approximately 10 days. One of the athletes who tested positive upon arrival was U.S. beach volleyball player Taylor Crabb. Despite having been vaccinated prior to the Games, his positive test meant he was unable to compete. Speaking to NPR, he said, “It was without a doubt the hardest 10 days of my life. Obviously with the devastation of testing positive, but also being in that sort of quarantine. I had a window in my hotel room, but they lock it, so I didn’t breathe fresh air for 10 days straight.” When NPR asked about what it was like to watch his event rather than compete in it, Crabb acknowledged, “It’s the weirdest feeling because when I watch and see them playing, of course thoughts in my head are like, ‘That should be me. I should be out there.’ But there’s nothing more that I want than to see them succeed and help them succeed. It’s bigger than me.”

While Taylor Crabb is just one of many Games participants whose Olympic dreams were dashed, or at the very least, deferred, by COVID, his “bigger picture” attitude hints at the broader implications of the Games outside the tenuous “Olympic bubble.” For the host city and country, the Olympics have brought public health, economic, and sociopolitical implications. On Friday, July 29, Japan extended the COVID-induced state of emergency already in place in Tokyo to four additional areas: the Tokyo-adjacent prefectures of Saitama, Kanagawa, and Chiba as well as Osaka prefecture approximately 250 miles to the west. When announcing the extended state of emergency declaration, Prime Minister Yoshihide Suga explained, “Infections are expanding in the Tokyo and western metropolitan areas at an enormous speed that we have never experienced before.” NPR summarized the current COVID situation in Japan as follows: “Japan saw new COVID-19 cases surpass 10,000 for two days in a row, while Tokyo cases broke records for three days in a row through Thursday [July 29]. The capital’s seven-day rolling average jumped 80.5% over the previous week. The number of hospitalized COVID-19 patients has doubled over the past month, and experts estimate that the current fifth wave of infections still has a week or two to go before reaching its peak.” These predictions come at a time when, according to the Johns Hopkins Coronavirus Resource Center, just over 30% of Japan’s population has been fully vaccinated.

As host country Japan and host city Tokyo ride out the public health implications of this latest COVID wave, the economic impact of COVID also bears mentioning. In January of this year, the Japan Times reported a prediction  that not having spectators at the Tokyo Games would lead to economic losses for Japan approaching ¥2.4 trillion (approximately 21.9 billion USD). More recent estimates have suggested losses of 1.3 billion USD from having no domestic spectators and 1.4 billion USD from banning foreign spectators. These losses come on top of the costs of staging the Games, which Fast Company reports to have been around 15.4 billion USD (up from a 2019 estimate of 12.6 billion USD), with increases incurred by the postponement and necessary implementation of COVID safety measures and protocols. Whatever the final numbers, it is clear that staging the Tokyo Games has come with a hefty price tag for the organizers. 

The public health and economic obstacles associated with the Games have prompted other challenges for the host city and nation. Billed on the official Olympics website as the “Recovery and Reconstruction Games,” the Tokyo 2020 Olympics bid became a symbol for hope and  renewal following the 2011 Tohoku earthquake disaster. This earthquake was the strongest in Japan’s recorded history, triggering a tsunami that killed over 15,000 people and leading to the meltdown of three nuclear reactors at the Fukushima Daiichi Nuclear Power Plant. The fresh memory of those tragedies informed the selection of the Tokyo Games motto, “United by Emotion.” Unfortunately, these hopeful sentiments began to fade as costs mounted and COVID threats worsened. With weeks to go before the Games, about 10,000 of the 80,000 registered volunteers had quit, and protesters were taking to the streets. PBS recently reported that in a poll of the Japanese public, 78 percent of respondents said the Games should have been postponed again or canceled altogether. With these sentiments in mind, sponsors like Toyota have chosen not to air Olympics-themed ads in Japan during the Games

The one factor that has helped heal public sentiment has been the performance of Japanese athletes during the Games. Japan has garnered a record 19 gold medals thus far in Tokyo – more than the previous Japanese Summer Games record of 16 gold medals, set in Athens in 2004. A particular point of pride has been that nine of those 19 gold medals have come in judo, a martial art that originated in Japan in the nineteenth century.

Lessons for Future Events

With the 2022 Winter Games less than 6 months away and COVID showing no sign of waning, questions remain about how to carry on sporting events of this scale in the shadow of a global pandemic. In a May article for The New England Journal of Medicine, a group of experts spoke out regarding the IOC’s plans for managing risk at the Tokyo Olympics. The authors opined, “The IOC’s playbooks are not built on scientifically rigorous risk assessment, and they fail to consider the ways in which exposure occurs, the factors that contribute to exposure, and which participants may be at highest risk.” While the Tokyo Games organizers went on to announce further precautions in the lead-up to the games, the NEJM authors nevertheless offer a useful structure for thinking about risk. Rigorous risk assessment, clear understanding of exposure factors, and appropriate mitigation of human elements will be crucial to future events’ success.

While we cannot know today what the state of the pandemic will be in February 2022 (nor how it may impact the decisions of the Winter Games organizers), we have some directional indicators. According to The Washington Post, France, Germany, and Italy have adopted “near-mandates” for vaccination by “granting privileges to people who have been vaccinated and making daily life difficult for those who aren’t.” This week, New York City became the first U.S. metropolis to adopt a similar approach. Mayor Bill de Blasio announced today that vaccination would be required to work in and patronize New York City spaces like indoor restaurants, gyms, and performance venues. In a news conference, he declared, “If you want to participate in our society fully, you’ve got to get vaccinated.”

Geographically-driven mandates are one way to increase vaccination rates. Another driver can be mandates from governing bodies or organizations. The IOC said early on that they would encourage but not require vaccination in order to participate in the Games while also facilitating vaccine access for athletes who wanted to receive a jab. By contrast, some sport-specific organizations have instituted vaccination requirements. Forbes reported in July that although the U.S. Olympic team had not required vaccination for athletes and staff, the USA Track & Field organization had mandated vaccination for staff accompanying the team bound for Tokyo.

USATF is not the only sports league or governing body to mandate vaccination. In U.S. domestic sports circles, the NFL recently warned teams of consequences for COVID outbreaks during the coming season. NFL Commissioner Roger Goodell told the league in a July memo, “If a game can’t be rescheduled and is canceled due to a COVID outbreak among non-vaccinated players on one of the competing teams, the team with the outbreak will forfeit and will be deemed to have played 16 games for purposes of draft, waiver priority, etc.” In the UK, The Athletic reported that Premier League players and club staff “face compulsory vaccination against COVID-19 as part of government plans to keep football going even in the event of the UK being forced into a winter lockdown.” It is likely other national and international sports organizations may follow suit.

In the coming months, we can expect to see a rise in vaccine mandates and increasingly strict testing protocols to help keep COVID at bay. However, the requirements put in place may vary widely by country and governing body and will likely rely on the compliance and honest self-reporting of individuals. To mitigate the unpredictability of this human element, environmental risk management will also be crucial. With future large-scale sporting events both domestic and international on the horizon, teams, governing bodies, and other sporting organizations can manage environmental risk by investing in disinfection solutions that can be incorporated into their venues and equipment lists and even transported with teams to competitions and venues. R-Zero’s flagship disinfection device, Arc, is one such portable solution that places the power of UV light disinfection at teams’ fingertips. With the R-Zero Arc on their equipment list, teams and sporting organizations can actually live out the motto of the Tokyo Games, “United by Emotion,” in future events. United by the peace of mind that comes from knowing their environments are free from pathogenic threats, these athletes and teams can perform at their best on a national and world stage – even in the shadow of an ongoing pandemic.

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