Public health officials and experts — in Georgia and around the country — continue to question a recent change in coronavirus testing guidance from the Centers for Disease Control and Prevention. Earlier this week, the Atlanta-based agency quietly changed its recommendations for which individuals should get tested for the virus.
The CDC previously said anyone who’d been exposed to someone with a confirmed infection should get tested. The new guidance, which was changed Monday, says people who have been exposed “do not necessarily need a test” if they don’t show symptoms of COVID-19, unless testing is recommended by state or local public health officials.
“I don’t think that there’s any really justifiable reason to explain this new guidance from the CDC, and I don’t say that lightly,” said Dr. Jay Varkey, associate professor of infectious diseases at the Emory University School of Medicine.
A key strategy in slowing the spread of infection, Varkey says, is identifying people who have contracted the coronavirus and isolating them and their contracts. He’s worried the new policy could hinder those efforts.
Varkey also called on the CDC to be more transparent about why it changed the policy — a request made by two national public health groups this week.
On Friday, the National Association of County and City Health Officials and the Big Cities Health Coalition, which represent local public health leaders all over the U.S., sent a letter to CDC director Dr. Robert Redfield asking him to reverse the testing policy change.
“Changing testing guidelines to suggest that close contacts to confirmed positives without symptoms do not need to be tested is inconsistent with the science and the data,” the letter reads.
It points out that the CDC’s own guidance says that the coronavirus can be spread by people without symptoms and that as many as 40% of those who are infected have no symptoms.
The groups also worry the policy change will put local public health officials — some of whom disagree with the change — “in a position to say they will not be following the CDC guidelines.” That, they say, could lead to confusion about who should get tested.
“And we’ve seen over the course of the pandemic, when there is confusion, we have a real hard time keeping the virus under control,” said Adriane Casalotti, with the National Association of County and City Health Officials.
In the days since its revision, federal public health officials have defended the new policy, arguing it won’t lead to a reduction in testing.
CDC’s Dr. Redfield attempted to clarify the guidance by issuing a written statement to multiple media outlets this week. He says “testing may be considered” for those who have come in close contact with a “confirmed or probable” COVID-19 patient.
“Everyone who needs a COVID-19 test, can get a test,” he said. “Everyone who wants a test does not necessarily need a test.”
The message from federal coronavirus testing czar Brett Giroir, assistant secretary of health at the U.S. Department of Health and Human Services, was about more targeted testing, not less testing.
He told reporters on Wednesday that getting tested too soon after a possible exposure doesn’t mean a lot: A negative result doesn’t always mean there’s no infection.
“It’s not totally meaningless, but pretty close to it,” he said. “It should not give you a self-assurance that you will be negative. It should not give you a false sense of security. You should not engage in risky behaviors.”
There are legitimate questions about the best time for someone to get tested, says Dr. Lynn Paxton, district health director for the Fulton County Board of Health.
Still, she’s concerned that only testing people who’re symptomatic will lead to missed infections and more disease spread.
“To say that only if you develop symptoms should you be tested is just wrong,” Paxton said. “We know there’s so many people who are going to be asymptomatic, and we will not find them unless we test for them.”
That’s why Fulton County doesn’t plan to change its approach to handling people who have been in close contact with confirmed COVID-19 cases, she says: recommending they isolate and get tested around 10 days after exposure, whether or not they’re symptomatic.
(WABE reached out to the Georgia Department of Public Health and Governor Brian Kemp for comment on the CDC policy change but did not receive a response by deadline.)
Paxton worries the new CDC recommendations will make people who have been exposed to the coronavirus less likely to follow isolation guidance from Fulton County — she points out self-quarantine is a critical measure to slow the spread of the pandemic.
And that it could further undermine all messaging from public health officials about effective ways to fight the pandemic. Paxton says there are large, vocal factions of people ready to dismiss the threat of COVID-19 altogether.
“This guidance might be one thing they’ll choose to add to their arsenal,” she said. “To say ‘This is all overblown. It’s a hoax. Even the CDC is saying you don’t even need to be tested.’”