The @CDCgov recommendations to institutions of higher education are a mess. While some universities are struggling with how often to test, we get this zinger from CDC: "CDC does not recommend entry testing of all returning students, faculty, and staff." 1/ https://www.cdc.gov/coronavirus/2019-ncov/community/colleges-universities/ihe-testing.html

It's clear that congregate settings like universities & colleges are great places to be if you're a pathogen. Lots of people in close and frequent contact. Better yet, the young get to mix with the old, the locals with the out-of-towners. 2/

So, why the hell does CDC say we don't recommend testing returning students, staff and faculty, when we know that #SARSCoV2 used international and domestic travel routes to establish itself all over the the world and in the US? 3/

CDC should be saying: if you can teach online, teach online. First, rule of disease control: don't make it easy for the virus. 4/

If you are hell bent on re-opening, we don't recommend it, but you can reduce harm by not letting all students back at the same time, trying to re-arrange housing, teaching schedules to minimize the number of people on campus and in crowded quarters together. 5/

Then you're going to have to figure out how to do REGULAR testing, optimally 2x a week, at least 1x a week, otherwise the chance for an outbreak is real. Can't do that? Well you have no business re-opening. 6/

Can you isolate those infected, take care of them, trace their contacts and isolate them too? Can't do that? You have no business re-opening. 7/

Do you have a game plan to keep infections from spreading out into the communities that you are based in? Yale should not be an institutional amplifier for the epidemic in New Haven, for example. 8/

How are you going to incentivize social distancing for risk-taking adolescents and young adults? Don't know? You have no business re-opening. 9/

Do you have enough tests, masks, gloves and other PPE? If you don't...you have...OK, you get it already. 10/

Really @CDCDirector, you don't have to take my tone with colleges and universities, but you DO have to provide real, practical guidance, and operational advice, figure out how you're going to assist educational institutions with what they are facing this fall. 11/

This is just an abdication of leadership. Every institution needs advice right now. You don't get to say there is no evidence so we don't recommend, you can make recommendations & rate them by strength of what we know, just like we do w clinical guidelines. 12/

If you can't do it, won't do it, or @realDonaldTrump might get made if you do, call in outside experts to do it. We can't have @CDCgov stumbling around basic public health guidance this late in the game. 13/