Activities of a Medical Clinic for the General Public at the Olympic Mountain Bike Competition during the COVID-19 Pandemic

Sir,

The 2020 Tokyo Olympics were moved to 2021 due to the developing global situation in light of the COVID-19 pandemic. On March 22, 2021, international spectators were banned from attending the 2020 Tokyo Olympics as new, more infectious variants began to circulate. The Tokyo Organizing Committee of the Olympic and Paralympic Games (TOC) established an isolation bubble system, obliging Olympians to comply with the rules in place to mitigate any disease spread.[1] They had to undergo regular screening tests for COVID-19 and were asked to commute only to and from the Olympic Village to their competition site. On July 8, 2021, all spectators were banned from the Tokyo venues after the government declared a COVID-19 state of emergency for the capital. Only three prefectures, including Shizuoka, holding events within the three cycling categories of the mountain bike, road, and track allowing spectators during the COVID-19 pandemic.

There were two medical clinics established for the mountain bike competition: One for the Olympians and their associates and one for spectators and volunteers. Each medical clinic had two separate buildings. One was for individuals suspected of having COVID-19, and the other was for those deemed unlikely to have COVID-19. This is the first report to describe the preparation and activities of a medical clinic for spectators and volunteers. After the start of the 2020 Tokyo Olympics, 17 patients were treated over the 2-day Olympic mountain bike event. The details of the patients are summarized in Table 1. There were two patients who were transported to Juntendo Shizuoka Hospital for 2 days. One was a middle-aged Japanese woman who found she could not move just after entering the venue. After receiving a diagnosis of heatstroke and dehydration, she was transferred to Juntendo Shizuoka Hospital. A COVID-19 test was negative, and she returned home by herself. The other was a young male foreigner who was volunteering. He had come from Tokyo and had a fever of 38.0°C, tachycardia. The previous day, he had received his second injection of the COVID-19 vaccine. Whether the fever and tachycardia were side effects of the vaccination or due to COVID-19 infection could not be determined there, and he was transported to Juntendo Shizuoka Hospital. However, he refused any treatments and tests. He returned home after receiving advice not to have close contact with other people. Fortunately, there were no positive results of Olympians of the mountain bike for the COVID-19 test during the 2020 Tokyo Olympics. However, after the start of the 2020 Tokyo Olympics, Japan warned that COVID-19 infections were surging at an unprecedented pace, as new cases hit a record high in Tokyo and Shizuoka Prefectures, overshadowing the Olympics. The Delta variant has led to a spread of infections unseen in the past. It was difficult to control the explosive spread of COVID-19 infection at the Olympics in the middle of the pandemic, despite the TOC's efforts to instate a variety of countermeasures for controlling the situation.

Table 1.

Findings from 2 days of medical service at a clinic established at the mountain bike competition site in Izu city

Variable	Value
n	17
Sex
Male	11
Female	6
Age (average) years old	2-60 (35.1)
Nation
Japan	14
Foreign	3
Diagnosis
Insect related
Gnat sting	6
Centipede bite	1
Injury
Contusion/sprain	2
Cut wound	2
Shoe sore	2
Abdominal pain	2
Heat stroke	1
Fever	1
Chemical keratoconjunctivitis	1
Urticaria	1

Research quality and ethics statement

The authors followed applicable EQUATOR Network (http://www.equator-network.org/) guidelines, notably the CARE guideline, during the conduct of this report.

Financial support and sponsorship

This work was supported in part by a Grant-in-Aid for Special Research in Subsidies for ordinary expenses of private schools from The Promotion and Mutual Aid Corporation for Private Schools of Japan.

Conflicts of interest

There are no conflicts of interest.