Simone Biles withdrew from the individual all-around competition at the Tokyo Olympics on Wednesday, a day after she shocked the world by pulling out of the team event.
Olympians past and present flooded the U.S. gymnast with messages of support as the mental health of athletes -- and the extra pressures brought by the COVID-19 pandemic -- were in sharp focus at the Games.
"The advice I would give is to reach out, to colleagues and friends," said Sebastian Coe, president of World Athletics. "Don't be afraid to show vulnerability, it's a badge of honour in a way to want that help."
The International Olympic Committee admitted "more could be done" around athlete mental health. IOC spokesman Mark Adams said it was a matter the organisation had been working on for some time.
As the U.S. Team adjusted to a Games without Biles securing her 10th gold medal, host city Tokyo grappled with a record surge in coronavirus infections. Fears over rising cases cast a shadow over Japan's on-field performance.
The host nation continued to top the medal standings with 13 golds and 22 in total. China had 12 golds with a total of 27 medals, with the United States in third position on 10 golds and 31 medals in all at about 10:30 p.m. Tokyo time.
Japanese swimmer Yui Ohashi won her second gold in the 200m individual medley during a morning dominated by champion women in the pool. It was also a day of firsts for countries around the world with historic victories and losses in various sporting arenas.
'Broken hearts' for Biles'
American Biles will be evaluated to see if she can take part in the individual apparatus competitions, USA Gymnastics said in a statement on Twitter. Biles made the decision so she "can focus on her mental health," the organisation said, adding that it supported her "wholeheartedly".
"It broke my heart," U.S. swimmer Michael Phelps told broadcaster NBC. "But also, if you look at it, mental health over the last 18 months, is something that people are talking about."
Phelps, the greatest swimmer in history and the winner of 23 Olympic gold medals, has publicly discussed his own battle with depression, including contemplating suicide.
The 24-year-old Biles said the pressure of living up to expectations around her quest for a record gold medal had prompted her to drop out of the team competition after receiving a low mark in her opening vault.
"We have to protect our mind and our body rather than just go out there and do what the world wants us to do," Biles told reporters.
Japan battles COVID-19, heat
The host city recorded 3,177 new coronavirus cases on Wednesday, a daily record high for a second straight day as a spike in infections puts pressure on hospitals, and a new state of emergency was expected in three prefectures neighbouring the capital city.
Organisers have reported 169 COVID-19 cases related to the Games, a miniscule number given the tens of thousands of people visiting for the event.
While unprecedented restrictions and spectator bans have kept numbers down in the Olympic village, athletes voiced concerns about the heat on Wednesday.
World number two tennis player Daniil Medvedev, who struggled to breathe during his match against Italian Fabio Fognini, gave a frank assessment when asked by a concerned chair umpire if he was all right.
"I'm fine. I can finish the match but I can die. If I die will the ITF (governing body International Tennis Federation) take responsibility?" Medvedev replied.
The governing International Tennis Federation later said matches at the Olympics would be pushed back to start from 3 p.m. local time beginning on Thursday.
Australian Ariarne Titmus, American Katie Ledecky and Ohashi clinched gold medals in swimming, their powerful showing underscoring how women have emerged as the most commanding figures of the first week of the Tokyo Olympics.
Titmus won a second gold medal at her first Olympics in the 200 metres freestyle.
"I'm just from a small town in Tasmania and it just goes to show if you believe you can do something, you can 100% do it if you work for it," Titmus told Australia's ABC News.
Ledecky took gold in the 1500m freestyle, the first time the event has been held for women. Diversity is a focus for the Tokyo Olympics with women's events being added in other sports, including boxing.
Ledecky, who has 15 world titles and multiple gold medals, stressed there was more to life than winning. She said she was at peace with her performance in Tokyo, after a run of rare defeats by Titmus that may signal the end of the American's near-decade of freestyle dominance.
"I kind of laugh when I see things like 'settles for silver'," Ledecky said. "I don't want anyone to feel sorry for me or feel like silver or any other medals besides gold is a disappointment."
"I would much rather people be concerned about people who are really, truly struggling in life."