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CDC Reverses Controversial Guidelines Regarding Coronavirus Testing

SACHA PFEIFFER, HOST:

The Centers for Disease Control and Prevention has reversed its controversial recommendation that people who may have been exposed to the coronavirus don't necessarily have to get tested. NPR health correspondent Rob Stein joins us now with the latest.

Hi, Rob.

ROB STEIN, BYLINE: Hey there, Sacha.

PFEIFFER: And, Rob, can you remind us briefly - what is this controversy about?

STEIN: It started last month, when some guidelines on the CDC website suddenly changed. The new language suggested that people who might have been exposed to the coronavirus don't necessarily have to get tested to see if they've been infected. And that set off all kinds of alarm bells.

PFEIFFER: Right. Explain to us - why is that so concerning, that change?

STEIN: Yeah. So, you know, the key to stopping the spread of the virus is finding people who might have been exposed to the virus as soon as possible and testing them as soon as possible to stop them from spreading the virus even more, you know, and to prevent new outbreaks from occurring. I talked to Marc Lipsitch about this. He's an epidemiologist at Harvard.

MARC LIPSITCH: To recommend that that's not necessary is undermining one of the key strategies that has been successful in many places in controlling this pandemic.

STEIN: You know, so the idea that the CDC might be questioning that just kind of shocked and dismayed public health experts. That prompted CDC Director Robert Redfield to put out a statement trying to clarify the change almost immediately. And again, just this week during congressional testimony, he tried to say the agency wasn't saying any possibly exposed people shouldn't get tested. But there is still a lot of confusion about that the CDC was actually saying.

PFEIFFER: And now the CDC has reversed that guidance. What exactly did the agency do?

STEIN: Right. So the CDC posted revised language on the website today that says this - and I'll read it - it says, if you have been in close contact such as within 6 feet of a person with documented SARS-CoV-2 infection - that's the virus that causes COVID-19 - for at least 15 minutes and do not have symptoms, you need a test. And it goes on to say, testing is recommended for all close contacts of persons with SARS-CoV-2 infection because of the potential for asymptomatic and pre-symptomatic transmission. And that's really important because it's become clear that a lot of people who are spreading the virus don't necessarily have any symptoms. So it's really important to catch these so-called silent spreaders fast.

PFEIFFER: What has the reaction been to this?

STEIN: Public health experts are definitely glad to see the CDC reversing the guidance and making it clear that anyone who might have been exposed to the virus should get tested. I talked to Joshua Sharfstein at Johns Hopkins about this.

JOSHUA SHARFSTEIN: I think this is a step on the road for CDC's regaining credibility. I think this is both an attempt to get the policy right and an attempt for CDC to reassert that the agency will be back in control of its communications.

PFEIFFER: And, Rob, the CDC's credibility has been an issue for a while. What can you tell us about that?

STEIN: Yeah. Yeah. There's been a lot of concern about the Trump administration, you know, undermining the CDC's integrity and its independence. Earlier this week, some emails came out indicating that political appointees might be meddling with the CDC's scientific reports. And several news organizations reported that the White House was behind this testing back-and-forth. Here's Mark Lipsitch again from Harvard.

LIPSITCH: That's corrosive to our ability to fight this pandemic, and it's corrosive to public health in general.

PFEIFFER: And this isn't the first time that this kind of thing has happened. Review that with us.

STEIN: Yeah. You know, it's just the latest in a series of situations where the White House has been at odds with the CDC and scientists at other federal agencies throughout the pandemic. You know, President Trump - he's long kind of downplayed the seriousness of the pandemic. He's promoted treatments that didn't necessarily have strong evidence. He's questioned the value of wearing masks. And just this week, he directly contradicted the CDC director about how soon a vaccine might be widely available. Here's Joshua Sharfstein at Johns Hopkins again.

SHARFSTEIN: We are in the middle of a pandemic, and we're approaching 200,000 deaths right now. And there's just no question that it's hurting our ability to fight a pandemic. And the net result is that more people are getting sick and dying.

STEIN: Yeah. So, you know...

PFEIFFER: Rob, can you give us - I'm sorry. Go ahead.

STEIN: Yeah. I was going to say, you know, there's a lot of, you know, hope that, you know, that we might start hearing more directly from some government scientists, from more people like, you know, Tony Fauci at the NIH and Dr. Collins at the NIH and have - and there's been a lot of calls for regular briefings from the top officials at the CDC to really keep people abreast of where we are with the pandemic and giving clear, strong advice about what people should be doing to try to get this pandemic finally under control.

PFEIFFER: Right, and efforts to restore institutional credibility. That's NPR health correspondent Rob Stein.

Thank you.

STEIN: You bet. Transcript provided by NPR, Copyright NPR.

Rob Stein
Rob Stein is a correspondent and senior editor on NPR's science desk.