Understanding the development and analyzing the implementation of the Tokyo 2020 and Beijing 2022 Playbooks to mitigate COVID-19 spread: recommendations for future Games

Objectives: To examine how decision-makers managed the planning process of the Tokyo 2020 and Beijing 2022 Olympic Games, identifying challenges and lessons from planning events during a respiratory pandemic. Design: Multi-method qualitative case study. Methods: This study conducted a document review of Olympic Playbooks, which outline the COVID-19 countermeasures for Tokyo 2020 and Beijing 2022, and key informant interviews with 12 participants who were directly involved in planning one or both Games. Findings were analyzed using inductive and deductive coding strategies. Results: Content analysis of the Olympic Playbooks highlighted mitigation strategies and measures such as bubble approaches, regular testing programs, quarantine and isolation measures, masking and vaccination. Analysis of interviews identified four themes that represent challenges encountered during the development and implementation of the Playbooks for Tokyo 2020 and Beijing 2022. Themes include navigating complexities of multi-stakeholder environments; ensuring feasibility and equity; responding to uncertainty and opposition; and strengthening operational systems for the event and within the host country. These themes reflect the complexities of organizing a global mass gathering during a respiratory pandemic and contribute to the overarching theme of negotiating public health priorities amid uncertainty and complexity. Conclusions: Synthesizing insights based on individual experiences from high-profile events such as the Olympics provides a unique perspective into balancing the requirements for hosting mass gatherings under normal conditions and under epidemic or pandemic contexts. Findings highlighted the importance of evidence-informed planning, transparent decision-making, sustained stakeholder engagement and investing in operational data and surveillance systems.