The head of the Tokyo Medical Association (JMA) has added his voice to speculation that the Tokyo Olympics, now due to be held next summer, could again be delayed by the coronavirus pandemic.

“Unless an effective vaccine is developed I think it will be difficult to hold the Olympics next year,” JMA president Yoshitake Yokokura told reporters in Tokyo on Tuesday. “I’m not saying at this point that they shouldn’t be held. The outbreak is not only confined to Japan … it’s a worldwide issue.”

Several health experts have cast doubt on plans to hold the Games next July and August. Last week, Kentaro Iwata, a specialist in infectious diseases, said he thought it “unlikely” that the Games would be held just over a year from now.

“To be honest with you, I don’t think the Olympics is likely to be held next year,” Iwata, a professor at Kobe University, said. “Holding the Olympics needs two conditions; one, controlling Covid-19 in Japan, and controlling Covid-19 everywhere.”

“I am very pessimistic about holding the Olympic Games next summer unless you hold the Olympic Games in a totally different structure such as no audience, or a very limited participation.”

Japan’s organisers and the International Olympic Committee (IOC) agreed in March to postpone the Games by a year as the coronavirus spread across the globe. They have since said there is no “Plan B’’ other than working for the Olympics to open on 23 July, 2021.

But IOC member John Coates, who is overseeing preparations of the Tokyo Olympics, said this month it was still “too early to say” if the outbreak could further impact the Games. Coates said the IOC believed it had given itself “as much time as possible,” but conceded that the situation remained unpredictable. “It may be there is still an issue about the number of people congregating and those things, testing on athletes,” he said. “It’s too early to say.”

Japan has so far avoided a catastrophic coronavirus outbreak seen in the US and some European countries, with about 13,600 cases and 394 deaths, according to the health ministry. Those numbers do not include infections and deaths linked to the Diamond Princess cruise ship, which was quarantined in Yokohama, near Tokyo, in February.

On Monday, Tokyo saw the number of daily confirmed cases drop below 100 for two days in a row, with 72 cases reported on Sunday and 39 on Monday, public broadcaster NHK said. The numbers of cases reported at the weekends and on Mondays tend to be lower because some testing facilities are not open throughout the week. Tokyo has reported almost 4,000 infections, by far the highest number among Japan’s 47 prefectures.

“We have indeed seen a decrease in new cases including here in Tokyo,” Yokokura said during an online briefing at the Foreign Correspondents’ Club of Japan. “I would like to think this is a genuine decrease, but we are still facing a situation in Japan in which the number of tests is insufficient. So I think we need to wait a week or so to see how things develop.”

The prime minister, Shinzo Abe, declared a state of emergency in Tokyo and six other areas in early April that has since been widened to cover the entire country. Local governors can request that people stay home and that nonessential businesses close, but there are no fines or other penalties for non-compliance.

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