key: cord-0704140-y1efx3rj authors: Donahue, Donald A.; Burkle, Frederick title: A University COVID-19 Experience: A Primer for Mass Gatherings? date: 2021-07-23 journal: Disaster Med Public Health Prep DOI: 10.1017/dmp.2021.240 sha: 7c48c0252f300e6d938684cab3c2d0bfb4945b27 doc_id: 704140 cord_uid: y1efx3rj nan We find the prospect of conducting the summer Olympics by emulating Baylor University's approach to COVID-19 intriguing and valuable but falling somewhat short of validation sufficient for an event of the Tokyo games' scale. 1 At the same time, the stated importance of the games and the host nation's commitment to their happening demand the application of imperfect information in a practical sense. The methodology employed by Baylor is time-tested: public health measures of testing, surveillance, reporting, tracking, isolation, and consistent and frequent messaging. This has proven successful in Waco (home to Baylor), as well as at Purdue University and several other educational institutions. If we may quibble over wording, we suggest this represents a successful template, but has yet to achieve status as a "proven" technique. It would be a mistake, we believe, to equate Waco or West Lafayette (Indiana, home to Purdue) with Tokyo without modification to meet Olympiad parameters. Baylor and Purdue Universities adjoin moderately sized population centers, 130 000 to 140 000 inhabitants. Tokyo proper contains nearly 14 million residents and is a famously crowded urban area. The 2012 London games hosted 10 960 athletes from 205 nations. Tokyo welcomed a similar number, but under extraordinary restrictions of movement. Recent games have also demonstrated that this population is young, independent, social, and (shall we say) "frisky." Convening diverse groups from around the globe into a densely populated city might offer a "perfect storm" scenario for further spread and accelerating expected mutations of the novel virus. Such cautions notwithstanding, there is value to the suggested approach. It is possible that SARS-CoV-2 will be with us forever. The world must find a path toward resumption of routine activities. There will also be future outbreaks and pandemics of various diseases. The Baylor approach offers a workable first step to conducting large scale events in as safe a manner as possible. The challenges that faced Tokyo were daunting. The number of required support staff was significant. Protocols, facilities, and locations for testing and isolation demanded robust execution, while shielding other athletes and the surrounding population. Likely undetected were asymptomatic cases and spread. The success of domestic sports "bubbles" and intercollegiate events has not been universal, as currently evidenced by the exiting of collegiate basketball teams from various conference tournaments. Still, Japan has a strong history of industriousness, ingenuity, and remarkable resilience. The Baylor "Swiss Cheese" model offers a tool for plotting the path forward for international events of mass scale. It must − before the next Olympic flame is lit − be subjected to rapid, detailed planning and robust "what if" analysis to ensure it produces a plan for the future and not a lesson in disaster. Such meaningful occasions born out of perverse, widespread risk are thankfully rare. It would be a disservice to humanity to allow this to pass without developing a feasible solution. Sustaining university operations during the COVID-19 pandemic