A perfect storm is brewing in Tokyo as the capital struggles to smother a burgeoning COVID-19 surge just weeks before the opening ceremony of the Olympics.

Infections were expected to rebound after the capital’s state of emergency was downgraded last month to less restrictive quasi-emergency measures, but perhaps not so quickly.

New cases have been climbing steadily for more than three weeks, municipal officials said Thursday, due in large part to growing pedestrian traffic in public places as well as the increased transmissibility of the delta variant of the coronavirus.

The situation is beginning to resemble precisely what organizers, officials and the public have been afraid of since the games were first postponed in March 2020: a wave of infections spreading through the capital leading up to and during the games.

“The virus is rebounding in Tokyo,” said Norio Ohmagari, a top adviser to the Tokyo Metropolitan Government and the director of the Disease Control and Prevention Center at Japan’s National Center for Global Health and Medicine.

“There’s reason to believe this surge will spread further than the fourth wave,” Ohmagari said. “To stop variants from spreading further, containing and reducing pedestrian traffic is paramount.”

Prime Minister Yoshihide Suga is expected to announce next week whether contingency measures in the capital will be lifted on July 11, as planned, or extended. With COVID-19 spreading in the capital, an extension seems likely.

Shibuya Scramble Crossing on a warm evening on June 25 | RYUSEI TAKAHASHI
Shibuya Scramble Crossing on a warm evening on June 25 | RYUSEI TAKAHASHI

As the countdown to the Summer Games marches on, virus countermeasures in place in Tokyo will shape how the quadrennial sporting event is held, especially when it comes to limits on spectators at competition venues.

Last month, the Tokyo Organising Committee announced its decision to limit venue attendance to 10,000 spectators or 50% capacity, whichever figure is lower. Organizers plan to reduce the number of domestic ticket holders — currently at 3.6 million — by up to 25% through a lottery.

But the results of the ticket lottery may be deferred, according to media reports earlier this week, owing to the worsening outbreak in the capital. And if infections continue to spread, the Olympics and Paralympics could be held behind closed doors.

“As I have said before, it is possible the games will be held without spectators,” Suga said Thursday, reiterating remarks he made last month.

Under quasi-emergency coronavirus measures, attendance at large events is capped at 5,000 people or half capacity. If those measures are expanded in the capital beyond the opening ceremony and remain in effect during the games, organizers will need to decide between further reducing the number of spectators or banning them altogether.

The capital’s advisers said Thursday that a number of indicators — namely the flow of people in the city’s most popular districts, as well as the number of new infections and symptomatic patients — have surpassed levels the capital saw in late March, just before the onset of the fourth wave of the pandemic.

Tokyo reported 660 new cases Friday after logging 673 on Thursday and 714 on Wednesday.

New cases have been climbing from week to week in Tokyo — sometimes by more than 20% — and the delta variant is being detected in a growing number of individuals who have tested positive for COVID-19.

Following a brief hiatus to recover after being hospitalized due to fatigue, Tokyo Gov. Yuriko Koike attends a meeting online at the Tokyo Metropolitan Government building on Thursday. | RYUSEI TAKAHASHI
Following a brief hiatus to recover after being hospitalized due to fatigue, Tokyo Gov. Yuriko Koike attends a meeting online at the Tokyo Metropolitan Government building on Thursday. | RYUSEI TAKAHASHI

The city has also seen a steady increase in COVID-19 patients requiring hospitalization over the past two weeks.

“It’s not certain at this time why that’s happening, but the inoculation of older people and the ability for COVID-19 variants to spread faster among young people could explain that trend,” Masataka Inokuchi, vice president of the Tokyo Medical Association and an adviser to the city, told reporters Thursday.

New cases in the capital could reach 1,000 infections a day and eventually 2,000 a day “in the most optimistic scenario,” according to a report published on June 27 that was authored by four scientists including Hitoshi Oshitani, an epidemiologist at Tohoku University and one of the central government’s top infectious disease advisers.

In that scenario, the country’s vaccine rollout could help keep the coronavirus hospital bed occupancy rate in Tokyo below half, since older people have been prioritized for shots and young people are less likely to require hospital care even if they contract the virus. However, if the situation escalates, the report said hospital bed occupancy could reach 70% within weeks and surpass 100% during the Tokyo Games as the virus spreads throughout the city and into neighboring prefectures.

In June, one of the central government’s most prominent advisers warned that another state of emergency in Tokyo might be necessary as early as August.

A team of scientists led by Hiroshi Nishiura, an epidemiologist from Kyoto University and a member of the government’s coronavirus subcommittee, submitted a report to the health ministry in early June that said that by early August a fourth state of emergency in the capital may become necessary even if all those age 65 and above are inoculated by the end of July.

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