The U.S. Centers for Disease Control and Prevention (CDC) said this week that people exposed to COVID-19 but not symptomatic may not need to be tested, shocking doctors and politicians and prompting accusations the guidance was politically motivated.
The advice marks a reversal of the agency’s previous position recommending testing for all close contacts of people diagnosed with COVID-19.
Admiral Brett Giroir, the assistant secretary for health at the Department of Health and Human Services (HHS), said the goal was “appropriate testing,” not more testing for its own sake, and that there was no political pressure from the administration behind the decision.
CNN and The New York Times reported on Wednesday that U.S. public health officials were ordered by high-level members of the Trump administration to push forward with the changes.
“This was a product produced by the scientific and medical people that was discussed extensively at the task force,” said Giroir. The task force is led by Vice President Mike Pence.
The president of the American Medical Association, the largest U.S. association of physicians, said the advice could accelerate the spread of the virus.
“Suggesting that people without symptoms, who have known exposure to COVID-positive individuals, do not need testing is a recipe for community spread and more spikes in coronavirus,” AMA President Susan Bailey said in a statement.
Anthony Fauci, the top government infectious disease expert, told CNN he was having surgery during discussion of the change.
“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,” he said.
The Trump administration has been criticized for its handling of COVID-19 testing, with many states falling short of the volume needed to help contain the virus during major outbreaks.
Trump told a rally in June testing is a “double-edged” sword because it leads to more cases being discovered, causing the United States to appear worse off than it would otherwise. He added that he urged officials to “slow the testing down, please.” A White House official at the time told Reuters that the remark was a joke.
The United States has had more than 5 million diagnosed cases of COVID-19 and nearly 180,000 people have died.
California on Wednesday announced a deal with PerkinElmer to nearly double the state’s testing capacity, and New York Governor Andrew Cuomo quickly challenged the assertion that politics played no role in the change.
“We need public health people who do public health and not politics, and we’re going to disregard the CDC guidance totally,” he told MSNBC.
Tests of asymptomatic people conducted too early to accurately detect the virus can lead to a false sense of security and potentially help spread the virus, Giroir said.
Health experts said the move could hurt contact tracing efforts to prevent virus spread.
“It’s inexplicable why this guidance suddenly changed. There is no new science that we’re aware of,” Dr. Leana Wen, former Baltimore health commissioner and visiting professor at George Washington University Milken Institute School of Public Health, told CNN. “We need far more testing, not less.”