JONATHAN M. METSCH, Dr.P.H. – Tracking Emerging Public Health Challenges – June 30, 2026 – L.A. SUMMER OLYMPICS
“The event’s official clinical provider, Cedars-Sinai, interviewed on Monday Casey Batten, chief medical officer for the Los Angeles Games, about the care plan designed for the sporting spectacle, covering everyone from athletes to fans and volunteers.
The medical organisation of the LA28 Olympic and Paralympic Games is moving forward on a central premise: it is not simply about reacting to injuries, but about building a healthcare network capable of operating simultaneously in the Village, the training centres and the competition venues spread across the region. Batten, also co-director of Nonoperative Orthopaedics and Sports Medicine at Cedars-Sinai Orthopaedics and Sports Medicine, explained that his task is to oversee the entire medical infrastructure that will provide coverage for the various groups involved. “Ultimately, the role of the chief medical officer is to oversee all of the medical infrastructure delivered to all stakeholders—including athletes, coaches, their entourages and spectators”, he said.
One of the core elements of such system will be the polyclinic located in the Olympic and Paralympic Village, designed primarily to care for athletes and those staying there during the Games, including coaches and support staff. But the model does not end there. The care plan will extend to training sites and competition facilities, each with its own staffing, coordination and preparation needs. For Batten, the challenge lies in ensuring that all these spaces function as parts of a single system, connected and ready to respond to very different scenarios.”
In strictly clinical terms, the team expects the usual conditions seen at elite sporting events, from overuse injuries to strains and sprains, especially as athletes intensify their preparation in the final stretch towards the Games. However, Batten stressed that one of the main threats does not necessarily come from a traumatic injury, but from illness. “But one of the biggest concerns isn’t injury—it’s illness. When you think about it, most of these athletes have been training their entire lives for this moment”, he warned.” (1)
“PREQUELS” (2)
New York City 2022 – Polio (wastewater detection) – Silent spread detected through environmental surveillance
Tokyo Olympics 2020 – COVID-19 – Games delayed a year; 800+ cases despite extensive protocols
PyeongChang Winter Olympics 2018 – Norovirus – 1200+ workers quarantined; military deployed to fill gaps
London Athletics Championships 2017 – Norovirus – Athlete withdrawals; venue disinfection
Rio Olympics 2016 – Zika Virus- 100+ athletes withdrew; global travel fears; $7–18B in economic losses
Super Bowl XLIX 2015 – Measles – Linked to Disneyland outbreak; transmission fears at major event
Brazil World Cup 2014 – Dengue, Malaria, Chikungunya – Vector control ramped up; dengue clusters reported
Vancouver Olympics 2010 -STIs – Spike in STI screenings; public health condom campaigns
South Africa World Cup 2010 – Measles – Regional outbreak raised global concerns; spotlight on – vaccination gaps
Germany World Cup 2006 – STIs – Notable surge in testing demand across clinics
A Proactive Blueprint for Olympic Public Health Preparedness:
Leverage Academic, Scientific, and Local Expertise. • Establish formal partnerships – core collaborators. • Tap into the deep well of local expertise• Fill workforce and capability gaps • Develop standing working groups and an academic advisory council
Conduct Comprehensive Risk Assessments. • Baseline health indicators. • Identify disease and illness hotspots • Assess vulnerabilities at Olympic venues • Anticipate climate-related risks • Coordinate with global health security experts
Strengthen Surveillance Systems. • Implement enhanced surveillance. • Deploy wastewater and air monitoring • Launch participatory surveillance platforms (e.g., mobile apps or SMS systems) • Partner with academic institutions to analyze and act on real-time data
Deploy Onsite Diagnostics and Prevention Infrastructure. •Establish mobile diagnostic hubs at Olympic venues •Provide on-the-spot testing for COVID, flu, norovirus, RSV, and foodborne pathogens •Offer pre-arrival vaccination (flu, COVID, MMR, etc.) for athletes, teams, and volunteers• Pre-position PPE, sanitation kits, and multilingual signage •Pilot and refine these setups during smaller mass gathering events
Create a Unified Public Health Messaging and Prevention Team. •Launch a multilingual, multimedia public health messaging campaign •Develop evidence-based travel health advisories •Ensure real-time updates and rumor control mechanisms are in place through trusted channels •Craft specific messaging for high-risk populations •Make all health guidance accessible and centralized
Engage the Private Sector. • Establish a Public Health Resilience Fund • Emphasize the reputational and economic stakes • Encourage the adoption of shared IPC protocols • incentivize technology innovation • Collaborate with business improvement districts and tourism networks Institutionalize Preparedness •Create and fund a standing Olympic Public Health
Preparedness Task Force beginning in 2025. •LA28 as a template for Mass Gathering Health Infrastructure •Document lessons learned and share •Incorporate One Health, climate resilience, and equity •Ensure Public Health investments made for LA28 leave a lasting legacy
“The Los Angeles 2028 Olympics and Paralympics will be held from July 14th to 30th July and August 22nd to September 3rd, respectively, where extreme heat events have occurred during recent years. Being a coastal city, the temperature fluctuates across the Los Angeles area with different expected conditions across the various venues meaning conditions for athletes may vary both between and within days. …Athletes at the 2028 Games are likely to experience high heat, particularly at inland venues, which combined with high humidity that will exacerbate the risk of heat-induced performance decrements and health issues. Moreover, the past 5 years have seen very little rain at these locations, with a 5-year total rain fall of 4 mm and 2 mm during the Olympic and Paralympic dates at the coastal weather station and 0 mm during both periods at the inland weather station. Coupled with typically low wind speeds and the likelihood of high air pollution, it is likely that athletes at the LA games will face severe conditions. Furthermore, in the coming years, several other major sport events will take place in hot climates, including the 2025 and 2027 World Athletics Championships in Tokyo and Beijing, respectively, and the 2026 Football World Cup in Mexico, United States and Canada. Therefore, heat mitigation strategies need to be front and centre in the minds of athletes, practitioners, and coaches to protect the health of athletes and mitigate performance declines.” (3)
1.LA28 prepares co‑ordinated health roadmap, https://www.insidethegames.biz/articles/la28-prepares-a-coordinated-health-roadmap
2. Public Health Preparedness for Global by Anne W. Rimoin, MPH, PhD, https://ens.lacity.org/clk/commissionagend/clkcommissionagend3412190319_07142025.pdf
3.From Tokyo through Paris to Los Angeles and beyond – Preparing athletes to face the heat of a warming world, by C.C.W.G. Bongers, https://www.jsams.org/article/S1440-2440(24)00256-1/fulltext
curated by Jonathan M. Metsch, Dr.P.H.
Clinical Professor of Environmental Medicine, Icahn School of Medicine at Mount Sinai