CDC Reverses Guidance for Asymptomatic COVID Contacts Save

Asymptomatic people who have been exposed to COVID-19 should be tested, the CDC said on Friday, in a reversal of controversial guidance the agency introduced in late August.

It is now unequivocal, with the agency stating that for individuals without symptoms who have been in close contact with an infected person for at least 15 minutes: "You need a test."

The Infectious Diseases Society of America (IDSA) applauded Friday's reversal. Its president, Thomas File, MD, said in an emailed statement, "The return to a science-based approach to testing guidance from the Centers for Disease Control and Prevention is good news for public health and for our united fight against this pandemic."

Until a few weeks ago, the CDC recommendations stated: "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 the agency quietly altered its guidance on August 24, stating that if patients did not have symptoms, they did not "necessarily" need a test, unless it was recommended by a healthcare provider or state/local health official or they were "vulnerable" -- bringing a barrage of criticism from public health professionals.

Adm. Brett Giroir, assistant secretary for health in the Department of Health and Human Services, defended the policy, asserting that screening asymptomatic contacts of infected people was unhelpful and testing should focus on individuals with symptoms. Those remarks, in turn, followed President Trump's repeated complaints about excessive testing.

Friday's reversal added more fodder to a snowballing story regarding political interference with the CDC. On Thursday, the New York Times reported that HHS officials wrote the revised testing guidelines about not testing asymptomatic individuals, and placed them on the CDC's website over agency scientists' objections.

In addition, emails reviewed by Politico detailed how HHS officials, including Michael Caputo, tried to alter the Morbidity and Mortality Weekly Report, and how Paul Alexander, MSc, PhD, sent orders to Anthony Fauci, MD, on what to say publicly about risks of COVID-19 in children. Caputo was recently put on medical leave after he accused CDC staff of "sedition," and Alexander is no longer with HHS.