TOKYO -- The prospect of Olympians competing in an empty stadium this summer is now a distinct possibility as Japan extends its third state of emergency and makes little progress on vaccination.
An Olympics without spectators is a scenario Japan desperately wants to avoid. For starters, 90 billion yen ($824 million) in ticket revenue will go up in smoke, and public interest will plunge, disappointing sponsor companies. A final decision is expected in June.
The games were initially expected to draw a total of 10 million people. But in March, the government and organizers decided against letting foreign spectators in.
Still, Japan was hoping to fill seats with Japanese fans by taking precautions. Seiko Hashimoto, who took over as president of the Tokyo organizing committee in February, said she did not anticipate holding the games with no spectators.
Then Japan was hit by the fourth wave of COVID-19, forcing Prime Minister Yoshihide Suga to declare the third state of emergency for Tokyo and other regions. The emergency decree, initially intended for 17 days, has been extended through the end of the month. Experts believe securing enough health care professionals for the games, due to open July 23, will be a challenge.
The medical staffers' duties will go beyond coronavirus response. They will provide care for not only sick and injured athletes at both the Olympic Village and competition venues, but also spectators with heatstroke.
How many medical professionals will be required at the peak? The Tokyo organizing committee estimates daily numbers at roughly 300 doctors and 400 nurses. The plan is to set up one medical clinic for every 10,000 spectators.
The Tokyo organizing committee says it is on track to secure enough medical staff for athletes after negotiating with medical institutions and relevant organizations. But there is little prospect of fielding enough health care workers for spectators.
Vaccine rollout is due to take place concurrently with the Olympics, meaning that the likelihood is slim that the epidemic will die out soon. There is no extra capacity to allocate health care professionals to spectators, experts have warned.
"I'm prepared for the possibility of no spectators," Hashimoto said at last week's news conference. If that happens, both Tokyo and the central government will have to come up with plans to make up for lost revenue.
For sponsors, a fanless Olympic means a loss of promotional opportunities. Any economic benefit from the games would be limited.
The best-case scenario for now is allowing spectators into venues at half capacity. In Tokyo and the three other prefectures under the emergency declaration, professional sports and other events will ban spectators through Tuesday.
After that, venues can take in up to 5,000 people or operate at 50% capacity, whichever is fewer.
J.League soccer matches and professional baseball games have allowed spectators since last summer, yet no clusters of infections have emerged from those events.
"We are seeing scientific evidence that we can host [the Olympics] safely," an expert said. Capping venue seating at 50% capacity is expected to accommodate most people who have already paid for their tickets without relying on a lottery.
Even with fewer spectators, risks remain. Fans could leave the venues in crowds or gather at nearby restaurants, for example. The Tokyo organizing committee plans to release guidelines for fan behavior.
Another option is to let local governments decide how many spectators to accommodate in venues, depending on local conditions, though the 50% cap will still be in place. The Olympics will be held in 42 venues across Tokyo and eight prefectures, including ones under the state of emergency.
"Local governments will make decisions based on the spectator limits set by the central government," said Tamayo Marukawa, the minister in charge of the Tokyo Olympics, indicating that spectator restrictions could change based on the locality.