Aug. 1, 2024 – Shortly after the Olympics opened in Paris, social media buzzed with triumphant posts celebrating athletes' victories.
"Katie Ledecky was so fast, no other swimmer was in the frame when she finished," one tweet said about the U.S. swimmer's 1,500-meter freestyle record. Another post highlighted, "Simone Biles now has the most Olympic medals ever for a USA gymnast."
Then came moments of heartbreak and tension. British swimmer Adam Peaty missed the gold in the 100-meter breaststroke by 0.02 seconds and later tested positive for COVID-19. Australian swimmer Lani Pallister withdrew from the 1,500-meter freestyle after testing positive to conserve her energy for the upcoming 4x200-meter freestyle relay on Thursday.
The International Olympic Committee (IOC) has not provided an official count of Olympians with COVID-19, but media reports indicate at least eight infected athletes as of July 31. About 11,000 athletes are competing in Paris, according to the IOC.
News of COVID at the Games has sparked a fierce debate online about whether COVID protocols in place are enough. It’s also triggered memories of Olympics past, including the 2021 Tokyo Games, when COVID was so rampant, spectators were banned.
To global public health experts, the emergence of COVID at the Summer Games is not a surprise, just as the summer surge in the U.S. and other countries isn’t either.
A New World
“I would say ‘Welcome to the new world,’” said Carlos del Rio, MD, a professor of medicine, global health, and epidemiology and an infectious disease doctor at Emory University. “The COVID of today is not the COVID of the past.”
“It’s to be expected,” agreed Amesh Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security in Baltimore. Not only are athletes training and living in close quarters, he said, but much of the world, including the U.S., is having the summer surge, when cases rise for a variety of reasons.
“Any number of cases [reported from the Olympics] is likely an undercount,” Adalja said.
“Four years from now, COVID will be at the Games,” he said. “You can assume this is going to occur.”But even so, it’s important for policies to control the disease to be in place, he said.
Quantifying the Summer Surge
According to a CDC update posted July 29, positive tests totaled 14.3% for the week ending July 20, up from 13% the prior week; 1.9% of emergency department visits were diagnosed as COVID, up from 1.6% the previous week; and 1.1% of deaths were due to COVID, up from 1%.
Omicron variants KP.2, KP.3, and LB.1 were circulating as of July 15, according to the Infectious Diseases Society of America, and the CDC estimates 37% of new COVID cases are KP.3.
Summer Surge, Explained
An increase in travel is one reason for the summer surge, del Rio said. Many people returning from a European vacation or trip this year arrive home with COVID symptoms, including him after returning from a business meeting in Lebanon. The symptoms are often short-lived, he said; just a couple of days.
The spike is also linked with changes in behavior, said Krutika Kuppalli, MD, an infectious disease specialist and spokesperson for the Infectious Diseases Society of America.
“Three or four years ago, people were masking, being careful.” Many people aren’t doing that anymore, she said. “People have basically gone back to their normal life.”
The continued evolution of the virus also accounts for the surge, with the new variants of Omicron circulating now.
“We don’t see it as severe disease, but people are still getting infected,” Kuppalli said.
Immunity wanes over time, even in those who have kept up with updated vaccinations as recommended. The vaccines are good at preventing severe disease, even though they’re not as good at preventing infection to begin with, del Rio said.
Policies
The strict IOC protocols from previous Olympics are not in place in Paris. Anne Descamps, chief communications director for Paris 2024, told Reuters: “We have a protocol (that) any athlete that has tested positive has to wear a mask, and we remind everyone to follow best practices, but in terms of monitoring COVID, cases are quite low in France."
The U.S. Olympic & Paralympic Committee updated the way it prevents the spread of COVID-19, effective in 2022 and in place for the current Games. It does not require COVID-19 testing for athletes without symptoms, regardless of vaccination status. It follows CDC guidelines for testing, quarantine, and isolation. Unvaccinated athletes are not required now to have a 5-day quarantine with two tests before going to the Olympic training center. Space is allotted there for quarantine and isolation.
It’s all a far cry from 3 years ago, when there was substantial concern about a superspreader event, Adalja said.
“That concern no longer exists. It’s more about disrupting athletic performance. An athlete who has COVID is not going to be performing at peak levels.The [number] of tools we have has increased,” he said, referring to vaccines and antiviral treatments. “And the alarm has considerably diminished.”
But athletes have posted on social media that they are focusing more on masking and other precautions as more of them report positive tests.Those who are feeling up to it are still training but isolating when sleeping, Australian Olympic team chief Anna Meares told Reuters.
As the COVID-19 situation has changed, the CDC has changed its guidance, now giving comprehensive advice about respiratory viruses, including COVID-19, the flu, and RSV (respiratory syncytial virus).It says you should stay home and away from others until at least 24 hours after your symptoms are improving overall and you have not had a fever and are not using fever-reducing medications. At this point, you are less likely to spread the infection. It also says you should do things to prevent spreading the disease over the next 5 days, including wearing a mask, staying a distance from others, and/or getting tested. Those at higher risk for severe illness should seek medical care so they can get testing and/or treatments.
