How Japan’s Olympic success has been followed by Covid-19 failure

By Paul O'Shea for The Conversation,

From a sporting perspective, the Tokyo Olympics were a massive success for Japan.

Finishing third behind the Olympic behemoths of the US and China, Japan secured a record 27 gold medals.

Yet, as the closing ceremony reached a crescendo, on the Tokyo streets ambulances were taking patients from hospital to hospital in a desperate search for available beds.

During the first week of August, there were 2,897 cases of ambulances unable to admit patients to hospitals nationwide, a sharp increase from previous weeks. And with the delta variant now dominant, each day is currently seeing a record-breaking number of new Covid-19 cases.

Just before the Olympics, everything had seemed to be on track: Japan’s vaccination programme had just reached the impressive milestone of one million vaccinations per day, case numbers were manageable, and both the International Olympic Committee and Japanese government had promised a “safe and secure” games. Since then, though, Japan’s situation has nosedived.

Operating in ‘disaster mode’

Japan is now facing not only record cases, but also record numbers of severely ill patients: 1,974 as of August 26 2021. In Tokyo alone, daily infections have topped 4,000 throughout August, including more than 270 severe cases at the time of writing.

New guidelines stipulating that only high-risk patients be hospitalised mean that more than 20,000 infected individuals in Tokyo are staying at home. Unsurprisingly, reports are emerging of patients whose conditions have deteriorated rapidly, in some cases ending in death.

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To deal with this spike of patients unable to receive medical care, the prime minister, Yoshihide Suga, has outlined plans to set up “oxygen stations” to give supplemental oxygen outside of hospital and to offer the Ronapreve antibody cocktail treatment for patients to use at home.

The government’s expert panel has described the situation as “out of control”, with the capital’s hospitals now operating in “disaster mode”. The panel is advising that at this stage, the public should take its own measures to protect itself from the virus. Public attention has fixed on the Tokyo metropolitan area, but the virus has now spread and is rampant throughout the country.

The role of the Olympics

There was widespread opposition to the staging of the Olympics before they began, as the public was sceptical of the claims of a “risk-free” games. Undoubtedly the event helped the virus spread.

In the end it was not the athletes that were the problem, but rather the mixed messaging of staging the world’s biggest mega-event in the middle of a pandemic. Despite spectators not being allowed into Olympic venues, people still gathered to watch the games in parks and bars across the country. Public compliance with government measures deteriorated.

As the Suga government’s own chief Covid-19 expert, Shigeru Omi, has explained, the Olympics “affected the public’s perception” of the crisis, weakening the government’s own stay-at-home message and undermining the declaration of a state of emergency.

Vaccinations to the rescue?

Taro Kono, the minister in charge of Japan’s vaccine rollout, has trumpeted his country’s success in inoculating its population. Japan went from vaccine laggard to one million doses per day in an astonishingly short time, and the majority of the elderly population have received two doses.

Still, with only 43% of the population fully vaccinated (approximately 54% had received at least one shot as of August 26), Japan is near the bottom of the OECD vaccination table.

So far Japan’s death rate has not increased in tandem with the infection rate. While there is likely some degree of lag, other countries have shown that high vaccination rates do help to erode the link between infection and death – meaning the climbing vaccination rate may have spared the country from an worse outcome.

Nonetheless, the dominance of the more infectious delta variant, together with Japan’s still relatively low vaccination rate, bodes ill for the coming months.

Where is this all going?

Japan’s current wave has begun to slow but is yet to crest. Its impact on the health system is already visible and will likely worsen. The fallout in terms of long Covid will reveal itself in time.

A key problem is that the government has lost credibility. Staging the Olympics was only the latest in a series of mixed messages on Covid-19 – last year the government’s “Go To” travel campaign encouraged tourism in the middle of the country’s third wave, while the delayed vaccination campaign is partly the result of prioritising domestic-vaccine development over imports. The recent cover up of Japan’s first case of the lambda variant, as it was related to the Olympics, has added to public distrust.

The government meanwhile has expanded the scope of the current states of emergency that are in place, adding more prefectures. Suga’s top adviser Omi has called for a 50% reduction in mobility to flatten the curve and to relieve pressure on hospitals. Experts have also demanded legal changes to allow for stricter lockdown measures, like those implemented in Europe. Yet legal changes will require time.

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With a general election scheduled for October, growing frustration over the government’s crisis management is threatening Suga and his Liberal Democratic Party’s electoral prospects. In post-Olympic polls, support for the government slipped below 30%, the lowest since the prime minister took office.

For various reasons, his party’s victory had seemed preordained. Although the opposition has so far failed to take advantage of the government’s failures, with two potentially devastating months ahead, now Suga’s position has never been more precarious. If the situation becomes dire, the challenge may even come before the election from within his own party.

Right now, it is hard to see the government regaining the public’s trust, and the short-term outlook is bleak. However, as the situation deteriorates, the Japanese public itself may sufficiently alter behaviour to slow the virus’s spread.

(The author works at the Lund University and Sebastian Maslow, Sendai Shirayuri Women’s College)