9 leaders, medical associations react to CDC's new testing guidelines

The CDC updated its COVID-19 testing guidelines Aug. 24, saying people without symptoms don't always need to be tested. 

The original guidelines recommended testing for all close contacts of known COVID-19 patients. The updated version says known contacts "do not necessarily need a test" if they don't have symptoms. 

Below are nine statements and reactions to the change:

Editor's note: Responses were lightly edited for length and style. This is not an exhaustive list. 

Susan R. Bailey, MD, president of the American Medical Association: 

"Months into this pandemic, we know COVID-19 is spread by asymptomatic people. Suggesting that people without symptoms, who have known exposure to COVID-positive individuals, do not need testing is a recipe for community spread and more spikes in coronavirus. When the Centers for Disease Control and Prevention updates a guidance, the agency should provide a rationale for the change. We urge CDC and the Department of Health and Human Services to release the scientific justification for this change in testing guidelines."

Association of American Medical Colleges President and CEO David J. Skorton, MD, and Chief Scientific Officer Ross McKinney Jr., MD:

"The AAMC is alarmed at the changes to the CDC's guidelines for SARS-CoV-2 (COVID-19) testing, which recommends that individuals who have been exposed to someone with COVID-19 do not need to be tested unless they show symptoms of the disease. This recommendation is irresponsible when we know that roughly 40 percent of SARS-CoV-2 transmissions come from an asymptomatic person. The revised guidance will result in less testing at exactly the time when we need more testing in order to control the pandemic. 

"These CDC guidelines go against the best interests of the American people and are a step backward in fighting the pandemic. The AAMC urges the CDC to return to its earlier testing recommendations, and we stand ready to discuss and work with our colleagues at the CDC to optimize future recommendations."

California Gov. Gavin Newsom: 

"I don't agree with the new CDC guidance, period, full stop. It's not the policy in the state of California. We will not be influenced by that change. We're influenced by those who are experts in the field who feel very differently," the governor stated during an Aug. 26 news briefing, as reported by KABC-TV.

New York Gov. Andrew Cuomo said his state won't be following the new guideline, according to an Aug. 26 interview with MSNBC. Mr. Cuomo said CDC officials suggested to New York Health Commissioner Howard Zucker, MD, that the change in guidelines was more of a "political position" and not a scientific one.  

Daniel Larremore, PhD, a mathematician and infectious diseases modeler at the University of Colorado Boulder, told The New York Times:

"I think it's bizarre. Any move right now to reduce levels of testing by changing guidelines is a step in the wrong direction."

Patrick McConnon, president of the CSTE Foundation who worked at the CDC for 39 years, told CIDRAP News:

"This is atypical of any language I've seen coming from the CDC. I've never seen something so equivocating as, 'You do not necessarily need a test.' Well, what should someone do if they get a call from a contact tracer and are told they have been exposed?"

Aaron Glatt, MD, chair of the department of medicine and chief of infectious diseases at Oceanside, N.Y.-based Mount Sinai South Nassau, told Fox News:

"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. 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."

American Nurses Association:

"The American Nurses Association is concerned at the recent changes to the CDC COVID-19 guidelines ... We maintain that it is essential that scientific findings and data be used as evidence in healthcare decision-making, practice interventions and policy. A recent JAMA article (Aug 2020) indicated that many individuals (30-40 percent) with SARS-CoV-2 infection remained asymptomatic for a prolonged period, and viral load was similar to that in symptomatic patients.  

"Trust and transparency are key principles and the public’s expectations of nurses, physicians, health care workers, public health officials and government agencies like the CDC. Providing new guidance that does not align with the needs of the public health emergency thwarts our efforts with providing safe patient care, protecting nurses, healthcare professionals and the communities we serve. We urge the CDC to provide an evidence informed rationale for the change in guidelines and absent that, to maintain its original guidance."

Heather E. Gantzer, MD, Chair of the Board of Regents of the American College of Physicians

"The American College of Physicians, representing 163,000 internal medicine physicians (internists), related subspecialists and medical students, strongly supports the use of science, based on the best available evidence, in the fight against COVID-19. Public health agencies should not be subjected to pressure or be influenced to issue policies that are not based on evidence and expert recommendations of their own scientists. This can have a detrimental effect on the public’s trust and adherence to evidence-based guidelines."

"The recent revision of the CDC's COVID-19 testing guidelines of asymptomatic individuals lacks transparency and clarity, sending a confusing message to both physicians and the public on appropriate and necessary testing that will ultimately help to mitigate the spread of COVID-19. Asymptomatic patients contribute to the spread of COVID-19. The ability to conduct widespread testing using a rapid and accurate test is critical to appropriately manage the spread of SARS-CoV2. ACP recommends that in the absence of currently effective vaccine or treatment options available for COVID-19, state and local authorities should prioritize a strategy of case finding, screening and surveillance to track and reduce further spread. ACP believes that the United States should urgently expand health system capacity to diagnose, test, and conduct contact tracing (with privacy protections)."

Editor's note: This article was updated Aug. 27-28 to include additional reponses.

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