When you live on an island and tourism is your economic lifeline, do you keep letting visitors come or do you play it safe and call a halt so as to protect residents from the scourge of the new coronavirus pandemic?

That's the dilemma facing authorities in the far-flung Izu and Ogasawara island chains south of Tokyo as local fears mount about COVID-19 infections.

While island life allows for a measure of isolation from the frantic pace of Japanese cities, other factors come into play in such situations.

For example, about 25,000 people reside on the 11 inhabited islands in the two chains, but there are only two beds at a hospital on one of th 11 islands in the entire region capable of caring for COVID-19 patients.

While medical clinics operate in the other inhabited islands, anyone who becomes infected would have to be airlifted to Tokyo to receive proper medical treatment.

The Hachijojima Tourism Association posted a message on its website calling on potential visitors to refrain from coming if they feel unwell.

Although it is under the jurisdiction of the Tokyo metropolitan government, Hachijojima island, blessed with turquoise waters and unique flora and fauna, is located about 300 kilometers south of the capital.

The COVID-19 pandemic has hit the island's tourism industry hard. The request to refrain from visiting the island was lifted on June 19, but there were only 3,512 visitors in July, a 60-percent decrease over July 2019.

Also, because it is part of Tokyo, Hachijojima was kept off the government’s “Go To Travel” tourism promotion campaign.

“The effect has been huge because tourism is a core part of the island economy,” said Shingo Tamura, secretary-general of the tourism association.

To prepare for the return of visitors, the association distributed pamphlets to hotels and restaurants that include instructions on ways to prevent the spread of COVID-19. Local public health officials also held explanatory meetings on measures to take.

“The only thing we can do is take steady measures to somehow allow for both helping the economy while keeping infections down,” Tamura said.

The Ogasawara islands further south asked visitors to refrain from visiting from April 6 until late June. That was prime scuba diving season so the request led to a drastic reduction in tourists from the 3,300 or so of last year to just 20 this year.

Chichijima island is part of the Ogasawara chain, roughly 1,000 km south of Tokyo. The only way to reach it from the main Honshu island is the Ogasawara Maru ferry.

From Aug. 11, as part of a trial measure, passengers were asked to cooperate with polymerase chain reaction tests by providing saliva samples before boarding the ship. The results are known in 24 hours when the ferry reaches the island.

Ogasawara Kaiun Co., which operates the ferry, also set the maximum number of reservations at about 400, or less than half of the ship’s passenger capacity.

The company is also taking special care to ensure crew members do not become infected. The ferry also transports food and other supplies to the Ogasawara islands, so if the ferry has to be canceled due to infections, islanders could face a shortage.

Chichijima and neighboring Hahajima island are also both about 1,000 kilometers from central Tokyo, so if an islander is infected with COVID-19, Self-Defense Forces aircraft would be needed to airlift the patient to a Tokyo hospital.

So far, only one islander has been confirmed with COVID-19, and that was on Mikurajima island in May.

“The most important thing is to keep the virus out of the islands,” said an official with the Tokyo metropolitan government handling infectious diseases. “If an islander is infected, we want to prevent a spread by quickly transporting the patient outside of the island.”

Other outlying islands have had less luck with keeping out the novel coronavirus.

On Yoronjima island of Kagoshima Prefecture in southern Japan, about 50 of the 5,000 or so residents were confirmed with COVID-19. SDF helicopters airlifted the patients to hospitals in Kyushu.

A number of outlying islands of Okinawa Prefecture have also reported infection clusters, leading prefectural authorities to ask residents of the main Okinawa island to refrain from visiting the outlying islands. They also requested residents of the outlying islands to keep visits to other islands to a minimum.

(This article was written by Chiaki Ogihara and Yuki Okado.)