Carlos del Rio, executive associate dean at the Emory School of Medicine, told POLITICO the CDC guidelines do not make sense because individuals who have been in close contact with a confirmed case of Covid-19 for at least 15 minutes could potentially be infected and should be tested.
“Asymptomatic people transmit, and if you don’t isolate them and you don’t identify them, transmission will continue,” del Rio said. “I’m worried we are not diagnosing the people that we need to diagnose.”
New York Gov. Andrew Cuomo slammed the change as “political propaganda.” Officials in several other states, including California, Connecticut and Washington, said Wednesday that they would not alter their testing approach to match the new CDC guidelines.
“We will not be influenced by that change,” California Gov. Gavin Newsom said at a press conference. “We are influenced by those who are experts in the field and feel very differently.”
The CDC update comes as the Trump administration has increasingly shifted its testing focus toward settings like nursing homes and long-term care facilities, which officials argue are key sources of outbreaks and account for a disproportionate number of Covid-19 deaths.
The guidance posted Monday emphasizes the need for more regular testing of those living or working in nursing homes. And on Tuesday, CMS issued new rules that would require testing in nursing homes — though it remains unclear what the parameters will be for that mandate.
One person close to the CDC changes defended them as necessary to prioritize testing for those at higher risk of infection, arguing that demand has been stretched by people seeking out tests when it’s unlikely they’ve been exposed to the virus.
Giroir argued the administration “does not expect” new CDC guidelines to decrease the volume of tests being conducted. With new tests soon coming onto the market, the number of people who can be screened “will go up significantly over the next couple of months.” That increase will come from “strategically done tests, not just tests done for the sake of being tested,” he added.
The testing czar also denied that politics motivated the CDC switch, despite President Donald Trump’s repeated arguments that U.S. case numbers are high because the country conducts many tests.
“There is no direction from President Trump, the Vice President [Mike Pence] or [HHS Secretary Alex Azar] about what we need to do when,” Giroir said. “This is evidence based decisions that are driven by the scientists and physicians, both within the CDC, within my office and the lab task force.”
Eleanor Murray, assistant professor of epidemiology at Boston University School of Public Health, pushed back against the idea that different localities should take varying approaches to testing of potentially infected people, saying “the epidemiology isn’t location dependent.”
“The only possible flexibility I could see at the local level on this is whether to just mandate everyone does the full quarantine or allow testing to try to rule out infection,” Murray said. “The new CDC guidelines aren’t replacing testing with quarantine though. They’re just ignoring transmission pre-symptoms.”
Yet the abrupt — and unannounced — changes have already intensified scrutiny of the CDC’s independence, and the administration’s broader coronavirus response ahead of the November election.
Rep. Rosa DeLauro — who chairs the House appropriations subcommittee overseeing the health department — slammed the new guidelines on Wednesday as “clearly political” and “unfathomable that the CDC is implementing guidelines that completely ignore the data.”
Scientists, not just politicians, are also sounding the alarm about the potential motives behind the CDC’s latest action.
“With all the things that the president has been saying about testing, it’s hard to not be suspicious and say ‘hey, they don’t want to test people because they’re really worried that more people are going to be diagnosed and that impacts the numbers.’ I really don’t know,” del Rio said.
Victoria Colliver, Dan Goldberg, Shannon Young and Alice Miranda Ollstein contributed to this story.