CDC changes recommendation for testing

[CharonY]

Technically it could be news, but rather baffling, the CDC has changed public recommendation on who should be tested.

On some parts of the website they recommended:

Quote

Considerations for who should get tested

• People who have symptoms of COVID-19
• People who have had close contact (within 6 feet of an infected person for at least 15 minutes) with someone with confirmed COVID-19
• People who have been asked or referred to get testing by their healthcare provider, localor state health department.

Specifically, they stated reasonably:

Quote

Testing is recommended for all close contacts of persons with SARS-CoV-2 infection.  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.

But now the website reads:

Quote

f you have been in close contact (within 6 feet) of a person with a COVID-19 infection for at least 15 minutes but do not have symptoms:

• You do not necessarily need a test unless you are a vulnerable individual or your health care provider or State or local public health officials recommend you take one.
  • A negative test does not mean you will not develop an infection from the close contact or contract an infection at a later time.
• You should monitor yourself for symptoms. If you develop symptoms, you should evaluate yourself under the considerations set forth above.
• You should strictly adhere to CDC mitigation protocols, especially if you are interacting with a vulnerable individual. You should adhere to CDC guidelines to protect vulnerable individuals with whom you live.

Now it is likely that the ability of testing is getting overwhelmed (again), but testing folks, especially potential asymptomatic spreaders should be very high on any testing hierarchy. It is really just baffling to me why they would do that.

Edit: one thought might be that with limited testing available one cannot test folks repeatedly (as in other countries), and if only one shot is possible, it might make sense to delay the test until they can see positive results. But that is not really what is written there, either.

[hypervalent_iodine]

I've noticed that our recommendations are the same, though I'm not sure what they were before (I think they were the same as the CDC's were). We haven't had many cases, though last week a small cluster of about 9 popped up. Given how things have gone in VIC, and how fast our state premier was to close state borders back up, you'd think they're want everyone to get tested who may have been in contact? I had to get tested on Monday as I was showing symptoms and had been in one of the areas with a contact tracing alert, and while the line was very long (it took me two hours), they seemed to be coping and I got my result back within 48 hours (it came back negative). It is very odd for a state (or country) so desperate to avoid a second wave to explicitly tell people not to get tested unless they're symptomatic, given what we know about asymptomatic carriers. 

[CharonY]

I have a hard time seeing a good reason for doing that. Aggressive contact tracing is the best way to keep things open while slowing down spread. Not doing that is basically like putting a blindfold while going full throttle down the highway.

[studiot]

5 hours ago, CharonY said:

I have a hard time seeing a good reason for doing that. Aggressive contact tracing is the best way to keep things open while slowing down spread. Not doing that is basically like putting a blindfold while going full throttle down the highway.

+1

I would submit that there is a case that a strong and efficient testing regime is even more important now as communities are opening up and we ae seeing virus containment leaking at the edges.

Europe in particular is teetering on the edge of  a second wave.

[CharonY]

15 hours ago, studiot said:

I would submit that there is a case that a strong and efficient testing regime is even more important now as communities are opening up and we ae seeing virus containment leaking at the edges.

Exactly. I fail to see any benefit to change the existing policy other than political gain. And if that is true, and the CDC is not able to make independent health recommendation it basically means a catastrophe to public health, independent of COVID-19. Diseases do not care about affiliation,  other than they hit disadvantaged folks harder. 

In that context, the numbers also clearly highlight racial inequality in the US, where African Americans and Hispanics are not only more likely catch the virus but especially African Americans are also much more likely to do die from it. And that despite the fact that the Hispanic and African American population is actually younger than the white population. 

[CharonY]

Perhaps not that surprising, but there are reports of the administration interfering with other CDC reports:

 

Quote

The CDC's Morbidity and Mortality Weekly Reports are authored by career scientists and serve as the main vehicle for the agency to inform doctors, researchers and the general public about how Covid-19 is spreading and who is at risk. Such reports have historically been published with little fanfare and no political interference, said several longtime health department officials, and have been viewed as a cornerstone of the nation's public health work for decades.

But since Michael Caputo, a former Trump campaign official with no medical or scientific background, was installed in April as the Health and Human Services department's new spokesperson, there have been substantial efforts to align the reports with Trump's statements, including the president's claims that fears about the outbreak are overstated, or stop the reports altogether.

These reports are important tools to gauge public health and while it is not clear what or whether something might have been altered due to governmental pressure, it is worrying interference with science. That is not to say that this novel, other areas such as environmental studies have been targeted in the past, not only in the US but e.g. also in Canada (Harper) and other countries. 

Nonetheless, trying to influence health authorities during an outbreak is, I think, unprecedented.   

[StringJunky]

1 hour ago, CharonY said:

Perhaps not that surprising, but there are reports of the administration interfering with other CDC reports:

 

These reports are important tools to gauge public health and while it is not clear what or whether something might have been altered due to governmental pressure, it is worrying interference with science. That is not to say that this novel, other areas such as environmental studies have been targeted in the past, not only in the US but e.g. also in Canada (Harper) and other countries. 

Nonetheless, trying to influence health authorities during an outbreak is, I think, unprecedented.   

With any luck, with a new administration, we'll find out just how much they tried to interfere with those career admins that supplied information based on objectivity.

[CharonY]

There needs to be a mechanism to prevent such overreach, regardless of who is in power.