Experts Question New CDC COVID-19 Testing Guidelines

The Centers for Disease Control (CDC) recently updated its coronavirus testing guidelines to exclude asymptomatic individuals, stating that people who have been in close contact with an infected individual “do not necessarily need a test” if they do not exhibit symptoms, with the exception of “vulnerable” individuals or cases in which a health-care provider or government official recommends testing.

Previously, the guidelines recommended testing “for all close contacts” of anyone infected with the coronavirus, regardless of symptoms.

The revision was met with criticism from health experts, who emphasized the importance of identifying infection during the small window prior to symptom onset when individuals seem to be most contagious.

“Any move right now to reduce levels of testing by changing guidelines is a step in the wrong direction,” Daniel Larremore, PhD, Assistant Professor in the Department of Computer Science and infectious diseases modeler at the University of Colorado Boulder, told The New York Times.

However, CDC director Robert Redfield, MD, issued a statement several days after the amendment to clarify that the agency was not discouraging testing.

“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,” he said. The clarification did not come with a change to the new guidelines, which remain on “Healthcare Workers & Labs” section of the CDC website as of late August. Other sections of the CDC website still recommend testing for those who have been in close contact to anyone with a COVID-19 infection.

Critics also expressed concern that the ambiguous language used in the recommendations could create confusion among patients and health-care providers. Leana Wen, MD, former Health Commissioner of Baltimore, told The New York Times she was concerned about the effect of the rule on insurance coverage for testing.

“What we need from the CDC is clear, specific, directive guidance,” said Dr. Wen. “It shouldn’t be a Rorschach blot that we’re looking at, and everybody’s getting a different response by looking at the same guidance.”

Sources: The New York Times, August 25, 2020; The New York Times, August 27, 2020; CDC Testing Guidelines, updated August 24, 2020.