CDC defends controversial new guidance for coronavirus testing

The Centers for Disease Control and Prevention is defending its controversial new guidance on coronavirus testing following outcry from various medical groups and allegations of political intervention.

Earlier this week, the CDC quietly revised its guidance on coronavirus testing, dropping its previous recommendation to test everyone who’s come into close contact with a person infected with Covid-19 — even those who don’t have symptoms. The agency previously advised testing everyone with a “recent known or suspected exposure” to the virus, saying the virus can be transmitted a few days before symptoms show as well as by asymptomatic people who never develop them.

Medical groups and some lawmakers raised concern about the new guidance, saying that early and widespread testing of people without symptoms can help contain the outbreak in the U.S.

The CDC, which referred calls to the Department of Health and Human Services all day Wednesday, defended the change in a statement from CDC Director Dr. Robert Redfield released around 10 p.m. Wednesday night.

“Everyone who needs a COVID-19 test, can get a test,” Redfield said. “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.”

Redfield said the new guidelines were “coordinated in conjunction with the White House Coronavirus Task Force,” adding that they “received appropriate attention, consultation and input from task force experts.”

On a conference call with reporters on Wednesday, Assistant Secretary for Health Adm. Brett Giroir, who leads the Trump administration’s testing effort, defended the policy change, saying it empowers local health officials and clinicians. He also denied allegations of bowing to political pressure from the Trump administration.

“Let me tell you, right up front that the new guidelines are a CDC action,” he said, adding that members of the White House coronavirus task force, including Dr. Anthony Fauci and Redfield, discussed and agreed on the new guidelines. 

But Fauci later told CNN’s chief medical correspondent Dr. Sanjay Gupta that he “was under general anesthesia in the operating room and was not part of any discussion or deliberation regarding the new testing recommendations.”

The New York Times reported later Wednesday that two federal health officials said the CDC was pressured into changing the guidance from top officials at the White House and HHS.

“There was no weight on the scales by the president or the vice president or Secretary Azar,” Giroir said on the call, referring to HHS Secretary Alex Azar. “We all signed off on it, the docs, before it ever got to a place where the political leadership would have even seen it, and this document was approved by the task force by consensus.”

It remains unclear exactly where the new guidance originated, though Giroir said it was a “CDC action.” Regardless of who is responsible for the updated guidance, a former CDC director, epidemiologists and medical associations have criticized the update as a setback in efforts to fight the coronavirus in the U.S.

The Infectious Diseases Society of America and the HIV Medicine Association called for the “immediate reversal” of the update in a joint statement. 

“It is essential that public health guidelines be rooted in the best available scientific evidence,” the two groups said. “Testing asymptomatic individuals who have been exposed to a person with COVID-19 remains a critical evidence-based strategy for containing the pandemic and reducing transmission.”

New York Gov. Andrew Cuomo and California Gov. Gavin Newsom, both Democrats, said their states will continue testing asymptomatic people.  

“We’re not going to follow the CDC guidance. I consider it political propaganda. I would caution private companies against following the CDC guidance. I think it is wholly indefensible on its face. I think it is inherently self-contradictory. It is the exact opposite of what the CDC has been saying,” Cuomo said on a conference call with reporters Wednesday. “So either the CDC is schizophrenic or they are admitting error in their first position or this is just political dictations.”

Cuomo pointed to comments previously made by President Donald Trump in June in which he said “testing is a double-edged sword.” He added that he directed officials to “slow the testing down, please.” White House officials later said the president had been “clearly speaking in jest.” 

“The utter failure to establish a robust national testing system is the very core of President Trump’s incompetence in handling the pandemic,” Senate Democratic leader Chuck Schumer said in a statement Wednesday. “He thinks that by ignoring the truth of 180,000 deaths he can just sweep COVID-19 under the rug and no one will notice his failures. But his denial only makes things worse.”