CDC says vaccine could be ready by November, but experts urge caution
The U.S. Centers for Disease Control and Prevention issued new guidelines Friday saying people who have had close contacts with someone with a coronavirus infection need a test, even if they don’t have symptoms.
The change came after a controversy in late August, when the agency suggested those people didn’t need COVID-19 screenings.
People who don’t have symptoms and aren’t close contacts of an infected person still don’t require a screening, unless it’s recommended by a medical provider or public-health official, according to the latest CDC advice.
The August shift on testing asymptomatic individuals had said testing might not be needed for close contacts. It was slammed by public-health experts, who said it could cut the amount of testing in the U.S., and several states said they wouldn’t follow the guidance. The New York Times, meanwhile, reported on Thursday that the guidelines were rewritten by the Department of Health and Human Services, and released in spite of opposition from CDC scientists.
Brett Giroir, a top administration official overseeing testing, defended the change in a briefing last month. He said it was meant to illustrate the limitations of the virus screenings, and that the guidelines were “a CDC action.”
The revised testing guidelines issued Friday were also changed by HHS and didn’t go through the CDC’s typical review, according to the Times report.
HHS said in a statement that “as always, guidelines receive appropriate attention, consultation and input from the medical and scientific experts on the Task Force,” referring to the White House Coronavirus Task Force. “This was the case then, and will continue to be the case in the future.”
The CDC didn’t immediately return requests for comment.
Public-health experts have advocated for mass testing as a means of identifying virus cases and preventing further spread, but the U.S. has yet to achieve a system of widespread, easy-to-access, quick-turnaround screenings. While availability of testing to people with symptoms has improved significantly over the course of the pandemic, those without symptoms can still face barriers.
Experts worried the CDC guidance -- which applied to both asymptomatic close contacts as well as those who attended large, risky gatherings but had no symptoms -- would exacerbate those challenges.
“We’re at a time that we need far more testing, not less. And the continuing changes causes mass confusion,” said Leana Wen, a physician who formerly served as Baltimore’s health commissioner and is a visiting professor of health policy and management at George Washington University.
She said that new Friday guidance was a positive step forward but warned of episodes like this undermining the CDC’s reputation as a premier public-health institution.
“This will have long-term consequences on trust in the CDC,” Wen said. “And it not only puts their Covid guidance under suspicion, but people may be skeptical of other advice and guidance coming out of the CDC, too.”
The revised guidance represents “the return to a science based-approach to testing guidance” and “good news for public health and for our united fight against this pandemic,” Thomas File Jr., president of the Infectious Diseases Society of America, said in a statement.
“We urge officials to support the work of controlling this pandemic by following medical guidance of experts in the field,” File said.
According to the new recommendations, those who are in an area of high virus transmission and go to a large gathering with spotty public-health precautions may be advised to get a COVID-19 test by their doctor or a public-health official.
“Due to the significance of asymptomatic and pre-symptomatic transmission, this guidance further reinforces the need to test asymptomatic persons, including close contacts of a person with documented SARS-CoV-2 infection,” a note on the CDC’s website said, explaining the Friday changes.