Covid Japan: Olympics could increase outbreaks in vulnerable populations

Like the US and other countries, the impact of the COVID-19 pandemic on Japan has been shaped by socioeconomic inequalities – and outbreaks resulting from the Olympics could continue this trend.

In Japan, regions with lower incomes, higher unemployment, more essential workers and other conditions have experienced higher COVID-19 cases and death rates, according to a recent Harvard TH Chan School of Public Health article.

These findings challenge assumptions that Japan’s success in containing the coronavirus so far is related to the country’s homogeneous population.

With the Olympics kicking off in Tokyo on Friday, only 23 percent of Japan’s population has been fully vaccinated.

Experts are concerned that the Games could accelerate the already rising number of cases in Tokyo and the country as a whole.

The country’s vaccination campaign must prioritize vulnerable populations during this peak in the case, Dr Ichiro Kawachi, one of the paper’s authors, told DailyMail.com.

Covid outbreaks started by the Olympics may hit underprivileged communities in Japan harder, a new article suggests. Pictured: An employee cleans dividing walls in the Olympic Games media center

Tokyo is currently seeing a spate of Covid cases as the Olympics begin on July 23 23

Tokyo is currently seeing a spate of Covid cases as the Olympics begin on July 23 23

The 2021 Summer Olympics were postponed from 2020 due to the Covid pandemic, but even with the games starting on Friday, concerns about Covid are far from allayed.

While Tokyo declared a state of emergency on July 8 due to the increasing number of Covid cases, the games are still going on – with no spectators and intense precautions for athletes.

Some experts are concerned that these precautions are not enough to prevent the Olympics from turning into a super spreading event.

Indeed, with only 23 percent of Japan’s population fully vaccinated — and many Olympic staffers and volunteers working on just one dose — an outbreak may seem inevitable.

In the US, when Covid rises, underprivileged populations are at greater risk of infection and death.

This included low-income Americans who cannot work from home, many of them people of color.

Japan, on the other hand, is more homogeneous – and therefore the risk appears to be lower. The country has a low Covid death rate, with only 15,000 deaths since the start of the pandemic.

But in fact, according to a new article, Japan has also faced Covid differences related to socioeconomic status published on July 14 in JAMA Network Open.

“Until now, the low burden of COVID-19 cases in Japan has led to speculation about Japan’s exceptionalism,” author Dr. Ichiro Kawachi, a professor of social epidemiology at Harvard, told DailyMail.com.

“But when it comes to who is most vulnerable to getting sick, the data from Japan is very similar to the US and Europe.

“We found that lower family income, primary care occupations, smoking and obesity were all associated with a higher risk of infection.”

Kawachi and his colleagues analyzed total COVID-19 cases and deaths in Japan, with data through February 2021.

They stratified the data according to the country’s 47 prefectures — similar to US states.

Prefectures with lower household incomes had higher infection rates, the researchers found, as did those with higher unemployment rates.

Japanese prefectures with higher unemployment rates and higher shares of workers in 'essential' industries - such as restaurant workers - had higher Covid cases

Japanese prefectures with higher unemployment rates and higher shares of workers in ‘essential’ industries – such as restaurant workers – had higher Covid cases

The greatest risks were associated with the occupation. Regions with more restaurant workers had 6.5 times higher Covid infections than those with fewer restaurant workers.

Workers in the transportation and postal industries also had higher risks – these prefectures had 3.4 times and 3.3 times higher infection rates, respectively.

Those who lived in busy households were also at high risk – 5.3 times more likely to become infected than those in less crowded households.

Meanwhile, prefectures with higher education levels and more health care workers had lowercase letters.

When controlling for these socioeconomic factors, the researchers found that high smoking rates and obesity were associated with a higher risk of dying from Covid.

“Our data suggest that obesity and smoking are associated with a higher incidence of COVID-19,” Kawachi said.

“That’s why the biology of the coronavirus in Japan is the same as elsewhere.”

“In addition, although rates of obesity in Japan are much lower than in the United States, we see the same socioeconomic disparities in obesity, that is, high rates in lower-income groups.”

Japan's leaders failed to adequately protect some vulnerable groups from the effects of Covid, said Dr.  Kawachi.  Pictured: A sign showing Covid protocols at the Tokyo Olympics

Japan’s leaders failed to adequately protect some vulnerable groups from the effects of Covid, said Dr. Kawachi. Pictured: A sign showing Covid protocols at the Tokyo Olympics

Kawachi told DailyMail.com that Japan’s leaders have done a relatively good job of protecting residents of the country’s nursing homes, with about 14 percent of all Covid deaths in Japan occurring in nursing homes, compared to 35 percent in the U.S.

But Japan left other vulnerable groups unprotected. He cited single, working mothers as an example.

“The persistent gender pay gap, insecure income and employment, as well as inadequate childcare facilities, create enormous tensions for this group, as evidenced by their rising suicide rates,” said Dr. Kawachi.

As the number of cases in the Olympics increases, the risk of the event is clear to Dr. Kawachi and other experts. More than 70 cases have been identified as of July 20.

“Tokyo is in the midst of another wave of cases, with only a third of the population being vaccinated, despite huge efforts to catch up,” Kawachi said.

As of July 20, about 35 percent of the Japanese population has received at least one dose of a Covid vaccine and 23 percent are fully vaccinated.

As of July 20, just over a third of Japanese residents have received at least one dose of a Covid vaccine — and about 23 percent are fully vaccinated

As of July 20, just over a third of Japanese residents have received at least one dose of a Covid vaccine — and about 23 percent are fully vaccinated

The country’s vaccination rate has soared in the weeks leading up to the Olympics. But many of those staffers and volunteers who work at the games only have one dose.

In fact, Tokyo officials have asked the Olympic workers to delay their second dose until after the event, according to The Daily Beast.

These workers are not undergoing the same intensive testing and other precautions as Olympic athletes, increasing the likelihood that they can bring Covid from Olympic events back home to their communities.

“While precautions have been taken to form a protective bubble around athletes, it is epidemiologically speaking.” [an outbreak] appears to be an avoidable and unreasonable risk,” Kawachi said.

Such an outbreak could easily spread outward and affect the same populations that were vulnerable in Japan during the pandemic.

As a result of their findings, Kawachi and his co-author, Dr. Yuki Yoshikawa, notes that Japan’s vaccination campaign is prioritizing the underprivileged groups that their paper says are at higher risk.

“One way to do this is to allocate special efforts to regions (in the case of Japan, prefectures) with higher population concentrations in these categories,” Kawachi told DailyMail.com.

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