COVID-19 and Heat Illness in Tokyo, Japan: Implications for the Summer Olympic and Paralympic Games in 2021.

Kazuki Shimizu,Stuart Gilmour,Hiromi Mase,Ayaka Teshima,Haruka Sakamoto,Phuong Mai Le,Shuhei Nomura

doi:10.3390/ijerph18073620

Abstract

The 2020 summer Olympic and Paralympic Games in Tokyo were postponed to July–September 2021 due to the coronavirus disease 2019 (COVID-19) pandemic. While COVID-19 has emerged as a monumental health threat for mass gathering events, heat illness must be acknowledged as a potentially large health threat for maintaining health services. We examined the number of COVID-19 admissions and the Tokyo rule for emergency medical care, in Tokyo, from March to September 2020, and investigated the weekly number of emergency transportations due to heat illness and weekly averages of the daily maximum Wet Bulb Globe Temperature (WBGT) in Tokyo in the summer (2016–2020). The peak of emergency transportations due to heat illness overlapped the resurgence of COVID-19 in 2020, and an increase of heat illness patients and WBGT has been observed. Respect for robust science is critical for the decision-making process of mass gathering events during the pandemic, and science-based countermeasures and implementations for COVID-19 will be warranted. Without urgent reconsiderations and sufficient countermeasures, the double burden of COVID-19 and heat-related illnesses in Tokyo will overwhelm the healthcare provision system, and maintaining essential health services will be challenging during the 2021 summer Olympic and Paralympic Games.

Highlights

Considering that excess/exiguous heat illness transportations were not observed in Tokyo in 2020 [26], it can be assumed that similarities of some initial clinical symptoms between COVID-19 and heat illness [27] might have worked as challenges for ambulances to deliver patients to appropriate healthcare institutions in a timely fashion, increasing the number of Tokyo rule transportations; but reasons behind this must be closely investigated for ensuring patients’ fast access to emergency rooms and early intervention
The COVID-19 pandemic posed a host of issues in maintaining essential health services, including emergency medical services
COVID-19 has emerged as a monumental health threat for holding mass gathering events, it should not be conceptualized as a sole threat

Summary

Introduction

The ongoing coronavirus disease 2019 (COVID-19) pandemic significantly affected the livelihood of citizens at an unprecedented scale, and second and third waves of the virus have shocked many countries. Japan has so far mitigated the worst epidemiological impact of COVID-19 relative to other high-income countries, weak coordination among health systems, an increase in nosocomial COVID-19 infections, insufficient financial assistance for healthcare institutions, and social discrimination against healthcare workers affected the maintenance of overall health services during the first wave of COVID-19 [1,2,3,4,5]. A resurgence of COVID-19 in Japan from July 2020 overlapped with the increasing demand for healthcare in the summer, especially due to heat illness.

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Discussion

Conclusion