Canceling Tokyo Olympics May Be 'Safest Option,' US Scientists Say

Carolyn Crist

May 26, 2021

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

With rising COVID-19 cases in Japan and the Tokyo Olympics less than 2 months away, canceling the Summer Games "may be the safest option," according to a new editorial published Tuesday in The New England Journal of Medicine.

Several U.S. public health experts called for officials to protect Olympic athletes from COVID-19 and urged a risk-management approach to reduce potential spread of the virus.

"With less than 2 months until the Olympic torch is lit, canceling the Games may be the safest option," according to the editorial written by Michael Osterholm and Lisa Brosseau from the University of Minnesota, Annie Sparrow from the Icahn School of Medicine at Mount Sinai in New York, and Robert Harrison from the University of California at San Francisco.

"We rally around the torch because we recognize the value of the things that connect us over the value of things that separate us," they wrote. "For us to connect safely, we believe urgent action is needed for these Olympic Games to proceed."

In July, about 11,000 athletes and 4,000 support staff from more than 200 countries will gather for more than 2 weeks at the Tokyo Olympics. A month later, another 5,000 athletes and staff will attend the Paralympics.

According to the International Olympic Committee Tokyo 2020 playbooks, athletes are instructed to provide their own face masks, are encouraged but not required to be vaccinated against COVID-19, and must undergo testing at certain times after they arrive in Japan.

However, Japan now has more than 70,000 active cases, and there are 19 million active COVID-19 cases worldwide, the authors wrote. Variants are circulating, and vaccine availability varies across countries. For instance, less than 5% of Japan's population is vaccinated, they wrote.

Pfizer and BioNTech have offered to donate vaccines for all Olympic athletes, the authors wrote, but more than 100 countries haven't authorized the vaccine. Some athletes may also choose not to be vaccinated because they may worry that the side effects could affect their performance.

"Although several countries have vaccinated their athletes, adolescents between 15 and 17 years of age cannot be vaccinated in most countries," they wrote. "As a result, few teenage athletes, including gymnasts, swimmers, and divers as young as 12, will be vaccinated."

Athletes could become infected during the Olympics and then potentially infect others when they return home to their countries, the authors wrote. Other professional leagues, such as the NFL and NBA, implemented strict guidelines to prevent the spread of the coronavirus, including single hotel rooms, daily testing and wearable technology for contact tracing. Even with these protocols, COVID-19 outbreaks caused multiple game cancellations, the authors wrote.

"To be sure, most athletes are at low risk for serious health outcomes associated with COVID-19, but some Paralympic athletes could be in a higher-risk category," they wrote. "In addition, we believe the playbooks do not adequately protect the thousands of people — including trainers, volunteers, officials, and transport and hotel employees — whose work ensures the success of such a large event."

The playbooks should classify events as low-, moderate-, or high-risk activities based on the activity and venue, such as indoor versus outdoor sports, the authors wrote. Outdoor events that are spaced out could be considered low-risk, such as sailing, archery and equestrian events. Outdoor events with close contact could be moderate-risk, such as rugby, hockey and soccer. Indoor events with close contact could be high-risk, such as boxing and wrestling.

The authors suggested that the WHO immediately convene an emergency committee with public health experts to create a risk-management approach, as it did when the Zika virus was spreading in Brazil before the 2016 Olympic and Paralympic Games.

"A global health security strategy relies on understanding the interconnectedness among countries," they wrote. "If our experience facing COVID-19 represents a moment of truth, it also provides an unrivaled opportunity for the realization of human values and collective human interests … and for preparing to defeat future threats."


New England Journal of Medicine: "Protecting Olympic Participants from Covid-19 — The Urgent Need for a Risk-Management Approach."

International Olympic Committee: "Tokyo 2020 and Tokyo 2020 Paralympic Games playbook."