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Nakajima announced on Monday that Makino has been forced to withdraw as he is currently undergoing treatment for meningitis.
A representative from the team told Motorsport.com that the 23-year-old developed the condition shortly after the previous race at Suzuka, and has suffered from fever and headaches as a result. He has however tested negative for COVID-19.
It brings a premature end to a disappointing second season in the Japanese single-seater series for Makino, who won this year's SUPER GT title alongside Naoki Yamamoto but has managed only a single podium finish in Super Formula this year at Autopolis.
He lies 12th in the points ahead of this weekend’s Fuji finale, two places behind Nakajima teammate Toshiki Oyu, who scored his first victory last time out at Suzuka.
Otsu meanwhile will be making his Super Formula race debut a little over a year on from appearing in the post-season rookie test for Nakajima at Suzuka.
The one-time All-Japan Formula 3 race winner has spent this year racing for the Honda squad in SUPER GT alongside Takuya Izawa, helping it to two pole positions and a podium.
The 26-year-old has also attended every Super Formula race as a reserve driver for Nakajima after losing out in the fight for a 2020 race seat to Oyu.
Hiroki Otsu watches from the pits
Photo by: Masahide Kamio
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