Abstract
Previous studies have not assessed the causal effect of the Olympic Games on the spread of pandemics. Using the synthetic control method and the national public city data in Japan recorded from February to September 2021, we estimated the causal effects of the Tokyo 2020 Olympic and Paralympic Games on the number of coronavirus disease 2019 (COVID-19) cases. The difference between the number of COVID-19 cases in Tokyo and a counterfactual “synthetic Tokyo” (created using synthetic control method) after the opening of the Tokyo 2020 Games (23 July 2021) widened gradually and then considerably over time. It was predicted that the Tokyo 2020 Games increased the number of COVID-19 cases in Tokyo by approximately 469.4 per 100,000 population from the opening of the event to 30 September. However, sensitivity analysis of the ratio of the pre- and post-game root mean square prediction errors using regression weights did not suggest robustness. Our results showed that the Tokyo 2020 Games probably increased the number of COVID-19 cases even under preventive regulations; however, the extent of this increase was difficult to estimate clearly due to an overlap with the fifth wave associated with the Delta variant.
Highlights
The Olympic Games are a large-scale international sporting event, wherein many international competitors and spectators visit the host country for a limited period
In 2021, the Tokyo 2020 Olympics and the Tokyo 2020 Paralympic Games were held in Japan during the coronavirus disease 2019 (COVID-19) pandemic [1]
The synthetic control weights indicated that a combination of the three prefectures, namely Ishikawa, Osaka, and Okinawa, reproduced the COVID-19 case trends in Tokyo before the Tokyo 2020 Games
Summary
The Olympic Games are a large-scale international sporting event, wherein many international competitors and spectators visit the host country for a limited period. The Olympic Games have been conducted during other pandemics; examples include the 1920 Antwerp Olympics (held during the Spanish flu pandemic) and the 2016 Rio Olympics (held during the Zika virus outbreak in Brazil). In 2021, the Tokyo 2020 Olympics and the Tokyo 2020 Paralympic Games were held in Japan during the coronavirus disease 2019 (COVID-19) pandemic [1]. During the Olympic Games, each host country needs to delegate public health resources to the event. Because pandemics cause severe medical and financial difficulties throughout the world, the decision to host the Olympics under a pandemic is an important political judgement. Studies have not systematically analyzed the association between the Olympic Games and the spread of infectious diseases
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