The Centers for Disease Control and Prevention (CDC) now says asymptomatic people no longer need to get tested for the novel coronavirus, a quiet change the federal agency recently made to its online guidelines regarding COVID-19.
“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,” the CDC now recommends.
The revised guidelines, posted on Monday, say individuals who have been in close contact with an infected person, typically meaning within six feet and for at least 15 minutes, “do not necessarily need a test” if they do not have symptoms. However, the CDC did state that there are exceptions, including “vulnerable” individuals or healthcare professionals where state or local public health officials may advise testing for the virus.
Further down the page, the CDC warns that “it is important to realize that you can be infected and spread the virus but feel well and have no symptoms.”
This is a change from the agency’s previous guidelines that recommended testing for all those who came in close contact with an infected patient for more than 15 minutes, even though they were asymptomatic.
The CDC has emphasized pre-symptomatic and asymptomatic transmission as a major factor in the transmission of the novel coronavirus, noting last month that its “best estimate” is 40 percent of those infected by the novel coronavirus don’t show symptoms.
“This Guidance has been updated to reflect current evidence and best public health practices, and to further emphasize using CDC-approved prevention strategies to protect yourself, your family, and the most vulnerable of all ages,” Adm. Brett P. Giroir, M.D., the assistant secretary for health (ASH) with the HHS said.
“The updated Guidance places an emphasis on testing individuals with symptomatic illness, those with a significant exposure or for vulnerable populations, including residents and staff in nursing homes or long term care facilities, critical infrastructure workers, healthcare workers and first responders, and those individuals (who may be asymptomatic) when prioritized by public health officials. Working with our health care professionals, we can continue to implement this Guidance and adapt it to the local situation as appropriate.”
“And finally, through continuously evaluating the data we know we have strong, proven preventive measures for reducing the spread of COVID-19: wearing a face mask, watching your distance, washing your hands and avoiding large gatherings and crowded indoor spaces,” he concluded.
Still, many healthcare professionals voiced concerns that the new CDC recommendations contradict what is currently known about the virus.
“The updated recommendations by the CDC stating that asymptomatic people may not need to be tested even if they have been in close contact with someone known to have the virus are very troubling as this is the exact patient population that should be tested,” Dr. Ravina Kullar, an infectious disease expert in California said in response to the change. “An individual has a high probability of getting the virus from close contact with someone that has had the virus; why would he/she not be recommended to get tested?”
Dr. Fred Davis, associate chair of emergency medicine at Northwell /Long Island Jewish, in New York, said: “While the CDC has recommended that those that might have been exposed to someone who tested [positive] for COVID but they themselves are asymptomatic might not need to be tested, there are delicate concerns.
“We know that someone can be infected and transmitting the virus and it can take 3-5 days after initial infection before they develop symptoms. It is suspected that upwards of 50 percent of transmissions occur during this time,” Davis continued.
“Testing those [who] have possibly been exposed to someone with COVID is an important part of contact tracing to help identify and reduce spread. When we have the resources to test, we should be testing those with known exposure to help identify and recommend proper quarantine,” the emergency department physician added.
Dr. Aaron Glatt, a member of the Infectious Disease Society of America, also weighed in.
“What this practically means to me as a clinician and epidemiologist is that we still must try and test individuals exposed to COVID-19, but recognize that a negative test is worthless to rule out infection. A 14-day quarantine is still required for all exposed individuals,” Glatt said.
“A positive test result remains very helpful to reinforce the absolute seriousness of their exposure, and testing should be obtained wherever possible to promote optimal quarantine compliance,” added Glatt, who is an infectious disease expert from Mount Sinai Hospital in New York.
“Suboptimal testing capabilities for COVID-19 have been the single most important issue we have faced in dealing with COVID-19. Delays in obtaining results, the accuracy of the results, and the inadequate resources to do mass testing have significantly impacted our ability to prevent COVID-19 spread. This issue is not addressed by the updated guidelines,” Glatt continued.
Meanwhile, Kullar cautioned that “it is important to get tested if you’ve been exposed to someone, even if asymptomatic, for contact tracing.”