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September 21, 2020

After uproar, CDC changes guidance on coronavirus testing

Daily Briefing

    CDC in updated guidelines released Friday clarified its stance on testing for asymptomatic people who have been exposed to the novel coronavirus, recommending that the close contacts of infected patients be tested for the virus regardless of whether they have symptoms.

    The 3 biggest questions about Covid-19 testing, answered

    US new coronavirus cases surpass 6.8M, deaths top 199K

    As of Monday morning, U.S. officials reported a total of 6,825,700 cases of the novel coronavirus virus since the country's epidemic began—up from 6,698,700 cases reported as of Friday morning.

    According to data from the New York Times, the rates of newly reported cases are "staying high" in Puerto Rico and 16 states that have had comparatively high case rates, meaning a daily average of at least 15 newly reported cases per 100,000 people over the past week. Those states are Alabama, Arkansas, Idaho, Iowa, Kansas, Missouri, Montana, Nebraska, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, and Wisconsin.

    Meanwhile, the rates of newly reported cases over the past seven days are "going down" in Georgia, Guam, Kentucky, and Mississippi, which had previously seen elevated case rates.

    In eight states that have had comparatively low case rates, rates are now "going up," according to the Times. Those states are Arizona, Colorado, Connecticut, Maine, New Hampshire, New Jersey, Rhode Island, and Wyoming

    In the remaining states and U.S. territories, rates are "staying low," according to the Times' analysis.

    U.S. officials as of Monday morning also reported a total of 199,361 deaths linked to the coronavirus since the country's epidemic began—up from 197,529 deaths reported as of Friday morning.

    CDC recommends testing asymptomatic patients with exposure to coronavirus

    As the new coronavirus continues to spread throughout the United States, CDC on Friday updated its testing guidelines to remove language suggesting asymptomatic people who have been exposed to the new coronavirus should not be tested.

    According to Politico, CDC last month received criticism from public health experts when the agency revised its coronavirus testing guidelines to exclude recommendations that people who were exposed to the novel coronavirus but who were not exhibiting symptoms of Covid-19 undergo testing. According to Times reporting published on Thursday, HHS officials wrote and published the revised guidelines without going through CDC's ordinary scientific review process.

    On Friday, however, CDC made "clarifications" to its testing guidance to "further reinforc[e] the need to test asymptomatic persons, including close contacts of a person with documented" new coronavirus infections. CDC wrote that it issued the clarification "[d]ue to the significance of asymptomatic and pre-symptomatic transmission."

    In the updated guidelines, CDC recommends testing for anyone who has been within six feet of a person with a documented new coronavirus infection for at least 15 minutes. "You need a test," CDC wrote in the guidelines.

    In addition, CDC now recommends that the close contacts of infected patients self-quarantine at home for 14 days away from members of their household—in a separate bedroom if feasible—even if they've tested negative for the new coronavirus.

    "A single negative test does not mean you will remain negative at any time point after that test," CDC wrote in the guidelines. "Even if you have a negative test, you should still self-isolate for 14 days."

    Many public health experts lauded the updated guidelines, Politico reports.

    Thomas File, the president of the Infectious Diseases Society of America, said, "The return to a science-based approach to testing guidance from [CDC] is good news for public health and for our united fight against this pandemic. We urge officials to support the work of controlling this pandemic by following medical guidance of experts in the field."

    CDC says coronavirus spreads mainly through aerosols and droplets—and then reverses course

    Also on Friday, CDC updated separate guidance on how the new coronavirus spreads, but the agency on Monday retracted that guidance, saying a draft version was accidentally posted.

    CDC previously has stated that the novel coronavirus is primarily transmitted when a non-infected person inhales large droplets emitted when an infected person coughs, sneezes or talks. On Friday, CDC updated its guidance to state that transmission can also occur if individuals inhale smaller particles known as aerosols that are released into the air by infected people when they breathe, cough, sing, sneeze, or talk.

    However, CDC on Monday retracted that update. In an email to the Wall Street Journal, a CDC spokesperson wrote, "A draft version of proposed changes to these recommendations was posted in error to the agency's official website." The spokesperson added that the agency is still working on its guidance regarding airborne transmission of the coronavirus.

    CDC on Friday also noted that people "may get Covid-19 by touching the surface or object that has the virus on it and then touching their own mouth, nose, or eyes." However, the agency said, "Spread from touching surfaces is not thought to be the main way the virus spreads."

    How to safeguard from infection

    To protect against infection, the agency continued to advise people to "stay at least six feet away from others, whenever possible," wear a mask, and regularly disinfect hands and surfaces. It also added recommendations that people stay home when ill and "use air purifiers to help reduce airborne germs in indoor spaces" (Cirruzzo, Inside Health Policy, 9/18 [subscription required]; Stobbe, AP/ABC News, 9/18; Lim, Politico, 9/18; Read, Los Angeles Times, 9/20; Thomas, CNN, 9/20; New York Times, 9/21; McCabe, Wall Street Journal, 9/21).

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