Health and Science

CDC reverses controversial coronavirus guidance that said people without symptoms may not need a test

Key Points
  • The Centers for Disease Control and Prevention on Friday reversed controversial coronavirus testing guidance, which previously said that people who didn't have symptoms but were exposed to an infected person "do not necessarily need a test."
  • The new guidance said that people without symptoms who have been in close contact with an infected person "need a test."
  • CDC Director Dr. Robert Redfield told lawmakers earlier this week that the agency was planning on updating the guidance this week. 
Robert Redfield, director of the Centers for Disease Control and Prevention (CDC), speaks during a House Select Subcommittee on the Coronavirus Crisis hearing in Washington, D.C., July 31, 2020.
Erin Scott | POOL | Reuters

The Centers for Disease Control and Prevention on Friday reversed controversial coronavirus testing guidance that said people who were exposed to an infected person but weren't showing any symptoms did "not necessarily need a test."

The new guidance said that people without symptoms who have been in close contact with an infected person "need a test." The CDC defines "close contact" as being within 6 feet of a person with a confirmed Covid-19 infection for at least 15 minutes.

"Please consult with your healthcare provider or public health official. Testing is recommended for all close contacts of persons with SARS-CoV-2 infection," the new guidance said. "Because of the potential for asymptomatic and pre-symptomatic transmission, it is important that contacts of individuals with SARS-CoV-2 infection be quickly identified and tested."

Numerous studies have shown that people can carry and spread the virus without showing symptoms — both in the presymptomatic stage and in cases where they never develop symptoms. Public health specialists and officials at the World Health Organization have repeatedly emphasized the importance of testing people who don't have symptoms in order to cut off chains off transmission. 

Many public health specialists criticized the CDC's change in testing guidance in August for appearing to downplay the significance of testing people who don't have symptoms but who might be spreading the virus. 

The CDC called the shift in guidance a "clarification" and noted the "the need to test asymptomatic persons."

A health care worker use a nasal swab to test Eric Rodriguez for COVID-19 at a pop up testing site at the Koinonia Worship Center and Village on July 22, 2020 in Pembroke Park, Florida.
Joe Raedle | Getty Images

Representatives from the Department of Health and Human Services, which the CDC falls under, referred CNBC's request for comment to the CDC.

Dr. Robert Redfield, director of the CDC, sought to clarify the old guidance last month, saying in a statement that "testing may be considered for all close contacts of confirmed or probable COVID-19 patients," but he stopped short of recommending it for those without symptoms. 

"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," Redfield said in the same statement last month, adding italics in the written statement for emphasis.

Redfield told lawmakers earlier this week that his clarification "didn't solve the problem" and added that the agency was planning on updating the guidance this week and issuing a clearer clarification. He also said the guidance was "misinterpreted" and that "we were not trying to limit" testing.

"More tests actually can lead to less cases if testing is linked to public health action," Redfield said Wednesday at the hearing hosted by the Senate Appropriations subcommittee.

The new guidance advised people awaiting test results to "self-quarantine/isolate at home and stay separated from household members to the extent possible and use a separate bedroom and bathroom, if available."

The updated guidance also said that people who don't have symptoms and who have not been exposed to an infected person "do not need a test unless recommended or required by your healthcare provider or public health official." The previous guidance definitively said that such people do not need to be tested.

The updated guidance from the CDC comes amid heightened concerns of political intervention by the White House inside the nation's premier health agencies, including the CDC and the Food and Drug Administration. At the center of such concerns is Michael Caputo, a former Trump campaign official who was appointed earlier this year as the top spokesman for HHS in a move seen by many to align public health messaging with that of the White House.

Caputo and his allies reportedly meddled with internal CDC affairs, including the publication of the agency's Morbidity and Mortality Weekly Reports. Those serve as the main channel through which the CDC communicates with physicians and public health specialists across the country about trends and emerging health issues.

HHS announced earlier this week that Caputo will take a 60-day leave of absence. The agency also announced that one of Caputo's allies, Paul Alexander, who reportedly tried to influence what White House coronavirus advisor Dr. Anthony Fauci said in media appearances, will leave HHS. 

The old CDC guidance, which was heavily criticized by health officials, including the former Director of the CDC Dr. Tom Frieden, was posted to the agency's website in August despite objections from scientists within the CDC, The New York Times reported earlier this week, citing several people familiar with the matter as well as internal documents. 

"That was a doc that came from the top down, from the HHS and the task force," a federal official with knowledge of the matter told the Times. "That policy does not reflect what many people at the CDC feel should be the policy."

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Adm. Brett Giroir, an assistant secretary for health at HHS who is in charge of the federal government's testing efforts, defended the previous change in guidance last month on a conference call with reporters. He insisted that there was no "weight on the scales" from senior officials at HHS nor from the White House.

"Let me tell you, right up front that the new guidelines are a CDC action," he said, adding that members of the White House coronavirus task force, including Fauci and Redfield, discussed and agreed on the new guidelines. 

But Fauci, who at the time was recovering from a vocal cord surgery, later said that he "was under general anesthesia in the operating room and was not part of any discussion or deliberation regarding the new testing recommendations."

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