Olympic marathon events were initially moved from Tokyo to the cooler northern city of Sapporo to avoid the intense summer heat in the Japanese capital.
But two years on, critics say Tokyo 2020 organizers have effectively leapt from the frying pan into the fire.
Hokkaido, the northernmost island where Sapporo is the main city, has the second-highest per-capita COVID-19 rate in Japan, even higher than Tokyo.
Opposition from residents is growing, and officials in the city - like Takashi Okugi who is in charge of Olympic preparations - say they still don't have key information, including the number of athletes to expect and details on health facilities.
"For example, if a foreign athlete gets infected (with COVID-19), how can we support them when they need to go to a quarantine facility or a hospital? Or how can we communicate and cooperate with Tokyo 2020 organizers? We still need to meticulously discuss these things (with Tokyo 2020)."
The Tokyo 2020 Organising Committee did not immediately comment.
Sapporo hosted a half marathon as a test event in May for the upcoming games.
All participants, including six international athletes, had to log their temperature and answer a health questionnaire daily in the week leading up to the event.
Organizers hailed it a success.
But this week, more than a dozen civic groups in Hokkaido prefecture submitted a petition to demand the governor cancel all events scheduled to take place in the city.
Masamichi Nishio is a doctor representing the campaign.
"There are no hospital beds (in Sapporo). The medical system has collapsed. We have other patients besides COVID patients. For example, when there's a cancer patient that needs an operation, we can't do it because the intensive care unit is not available. "