August 27, 2020

Amid controversy, CDC director seeks to clarify new coronavirus testing guidelines

Daily Briefing

    CDC Director Robert Redfield on Thursday sought to clarify the agency's newly updated coronavirus testing guidance amid controversy sparked by reports that members of the White House's coronavirus task force had pressured CDC to narrow its recommendations.

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    US new coronavirus cases surpass 5.8M, deaths top 179K

    The news comes as U.S. officials as of Thursday morning had reported a total of 5,837,800 cases of the novel coronavirus virus since the country's epidemic began—up from 5,792,900 cases reported as of Wednesday morning.

    Data from the New York Times shows that Guam, the U.S. Virgin Islands, and eight states—Connecticut, Hawaii, Iowa, Kansas, Maine, North Dakota, South Dakota, and Wyoming—saw their average daily numbers of newly reported coronavirus cases rise over the past 14 days.

    The Times' data also shows that the average daily numbers of newly reported coronavirus cases over the past two weeks remained mostly stable in 21 states: Alaska, Colorado, Illinois, Indiana, Kentucky, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Jersey, New York, North Carolina, Oklahoma, Rhode Island, Utah, Vermont, West Virginia, and Wisconsin.

    In addition, the Times' data shows that Puerto Rico; Washington, D.C.; and 21 states saw their average daily numbers of newly confirmed coronavirus cases decrease over the past 14 days: Alabama, Arizona, Arkansas, California, Delaware, Florida, Georgia, Idaho, Louisiana, Maryland, Nevada, New Hampshire, New Mexico, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington.

    U.S. officials as of Thursday morning also had reported a total of 179,604 deaths linked to the coronavirus since the country's epidemic began—up from 178,410 deaths reported as of Wednesday morning.

    According to the Times' data, 10 states saw their average daily numbers of newly reported deaths linked to the coronavirus rise over the past 14 days: Alaska, Arkansas, Delaware, Idaho, Iowa, Kentucky, Oklahoma, Rhode Island, Tennessee, and Virginia.

    Federal officials say White House coronavirus task force directed CDC to update testing guidelines

    As the coronavirus continues to spread, CDC on Monday updated its coronavirus testing recommendations to exclude most people who do not show symptoms of Covid-19—even if they've been exposed to someone with a known infection.

    The move came as spikes in coronavirus cases have led to shortages of testing capacity. Still, many public health experts have called for the country to continue ramping up testing to help better monitor America's epidemic. Further, according to Axios' "Vitals," many experts continue to urge testing asymptomatic people who have been exposed to the coronavirus, because evidence suggests asymptomatic patients likely contribute to the virus' spread.

    Following CDC's update of its guidelines, there were conflicting reports on who called for the changes. Several media outlets—including CNN, the Times, and Politico—on Wednesday reported that Trump administration officials on the White House's coronavirus task force directed CDC to make the change.

    However, HHS Assistant Secretary for Health Brett Giroir, who currently is serving as the administration's coronavirus testing czar, on Wednesday denied those allegations. "The new guidelines are a CDC action," Giroir said. "As always, the guidelines received appropriate attention, consultation, and input from task force experts."

    Specifically, Giroir said Scott Atlas, a special advisor to President Trump; Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases; FDA Commissioner Stephen Hahn; and CDC Director Robert Redfield "extensively" discussed the update to the guidelines, and all of them "signed off."

    STAT News reports that, when Giroir was asked directly whether Fauci had approved the updated guidelines, Giroir "paused noticeably" and then responded, "The only reason I'm hesitant is because I don't want to talk about internal deliberations. … But yes, all the docs signed off on this before it even got to the task force level."

    During a brief interview with the Times, Fauci said he had reviewed an early version of the updated guidelines and did not have any opposition at the time. However, he said he did not attend the task force's meeting last Thursday to approve the final recommendations, because he was having vocal cord surgery.

    Fauci separately told CNN, "I was under general anesthesia in the operating room" during that task force meeting "and was not part of any discussion or deliberation regarding the new testing recommendations" at that time.

    Fauci on Wednesday said he has "some concerns" about the final updated guidelines, because people who are infected with the coronavirus but are asymptomatic still could be spread the pathogen. Fauci in a statement issued to CNN said, "I am concerned about the interpretation of these recommendations and worried it will give people the incorrect assumption that asymptomatic spread is not of great concern. In fact, it is."

    Redfield seeks to clarify guidance

    Redfield on Thursday sought to clarify the guidance, saying anyone who comes in contact with a person who has a confirmed or suspected coronavirus infection could seek testing. "Testing may be considered for all close contacts of confirmed or probable Covid-19 patients," he said.

    Redfield continued, "Testing is meant to drive actions and achieve specific public health objectives. 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."

    Redfield also said CDC had worked on the updated guidance with the White House's coronavirus task force (Lim/Cancryn, Politico, 8/26; Stolberg, New York Times, 8/27; Branswell/Sheridan, STAT News, 8/26; Weixel, The Hill, 8/26; Diamond et al., CNN, 8/27; Baker, "Vitals," Axios, 8/27; Devine/Griffin, CNN, 8/26; McEvoy, Forbes, 8/26; Stobbe, Associated Press, 8/27; New York Times, 8/26; Wilson, The Hill, 8/27; New York Times, 8/27).

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