CDC director walks back new testing guidelines after facing backlash from experts

The Centres for Disease Control and Prevention (CDC) director has walked back new testing guidelines released by his agency after it sparked backlash among some of the nation’s top health experts.

Dr Robert Redfield issued a statement late Wednesday night that “testing may be considered for all close contacts of confirmed or probable Covid-19 patients,” adding that “everyone who needs a COVID-19 test can get a test.”

Despite the statement, the new testing CDC guidelines remained up on the agency’s website on Thursday morning and are unlikely to be taken down. An official told the New York Times that Dr Redfield issued the statement “to clarify the new policy.”

“Testing is meant to drive actions and achieve specific public health objectives,” Dr. Redfield wrote. “Everyone who needs a Covid-19 test, can get a test. Everyone who wants a test does not necessarily need a test; the key is to engage the needed public health community in the decision with the appropriate follow-up action.”

The statement came after the CDC revised its testing guidelines earlier this week, stating only those who had coronavirus symptoms should get tested.

Dr Redfield said the new guidelines were made in collaboration with the White House coronavirus task force, but reports indicated the CDC potentially felt pressure from the Trump administration to alter testing recommendations.

“It’s coming from the top down,” a federal official told CNN about the new directive.

Dr Anthony Fauci, a member of the White House’s coronavirus task force, said he was under anaesthesia when the decision was made to alter CDC guidelines about testing.

“I was under general anaesthesia in the operating room and was not part of any discussion or deliberation regarding the new testing recommendations,” Dr Fauci, who is also the director the National Institute of Allergy and Infectious Diseases, told CNN.

He added: “I am concerned about the interpretation of these recommendations and worried it will give people the incorrect assumption that asymptomatic spread is not of great concern. In fact it is.”

This concern was not just verbalised by Dr Facui, but also other top doctors and health experts across the US.

Chief scientific officer of the Association of American Medical College, Dr. Ross McKinney Jr, called the new guidelines “irresponsible” and “go against the best interests of the American people and are a step backward in fighting the pandemic”, the New York Times reported.

Dr Carlos del Rio, an infectious disease specialist and associate dean of Emory University School of Medicine, told CNN that “close to 40 per cent of the cases of the infections are asymptomatic and asymptomatic people transmit the infection.”

In a statement released by the Harvard Global Health Institute, the organisation said the guidelines moved away from “evidence-based policy.”

“The new guidance represents a major departure from the evidence-based policy on tracing and testing contacts of positive cases that has played a key role in the success of states such as New York and Massachusetts and countries such as Germany and South Korea to contain the virus,” the statement read, adding the move by the CDC was made “without an explanation.”

Reasoning behind the CDC updating its testing guidelines could be due to the number of false negatives that can happen when testing pre-symptomatic carriers.

Dr William Morice, the head of Mayo Clinic Laboratories, told The Independent that there’s less than a 50 per cent chance to obtain a positive specimen from an individual in the first couple of days of their exposure to the virus.

“That’s just because the virus is replicating within the individual, so the chance you would get a positive specimen is actually less than 50 per cent,” he said. “If you test too early, it’s a bit of a conundrum that you will have a high likelihood of a false negative result.”

Testing capabilities have increased to where the United States tested nearly one million people in a single day at its peak last month. This number has since declined to less than 700,000 tests over the last four days, according to data maintained by the COVID Tracking Project.

In times of surging cases, like what was seen in the last month in Southern states, testing facilities experienced an increased demand, which made it longer for people to get results back.

“It was taking people multiple days to get their test results back, and in that setting the tests are less helpful for containing the spread,” Dr Morice said.

He added the new CDC’s guidelines could be made in an effort to test all individuals who might spread the virus while paying attention to testing capacity.

“I do think it is really the government trying to balance the need to test as many people as possible with not doing so much testing where the system gets overwhelmed … where there are so many tests being ordered that people aren’t getting results back quickly,” he said. “That really doesn’t help anyone either. So it continues to strike the right balance.”

Donald Trump has previously said that the reason why US coronavirus cases are so high – the country has more than 5.8 million reported cases – was because of how many people were being tested. So the altered testing guidelines raised concerns this was in an effort to lower the number of cases recorded.

New York Governor Andrew Cuomo accused the president of playing politics for the updated guidelines.

“The only plausible rationale is they want fewer people taking tests because, as the president has said, if we don’t take tests you won’t know that people are Covid positive and the number of Covid positive people will come down,” Mr Cuomo told reporters on Wednesday.

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