As the number of Covid-19 cases in the United States nears six million, and with more than 176,000 Americans dead from the virus, the Centers for Disease Control and Prevention has quietly altered its coronavirus guidelines, worrying public health experts and raising suspicions among healthcare advocates that the moves are politically motivated.
"This is a stunning betrayal of public health that will spread the pandemic and lead to more unnecessary deaths," Chuck Idelson of National Nurses United wrote on his personal Twitter account Tuesday night, referring to the CDC's newest recommendation that not all individuals potentially exposed to Covid-19 should be tested.
Idelson said the move offered "clear evidence of how Trump has destroyed every public agency that is supposed to carry out the public interest rather than hucksterism for his cult."
The CDC just revised their testing guidance to exclude people without symptoms. Our work on the ‘silent’ spread underscores the importance of testing people who have been exposed to #COVID-19 regardless of symptoms. This change in policy will kill. https://t.co/5zMctSS4wD— Alison Galvani (@Alison_Galvani) August 26, 2020
On Friday the CDC released new guidelines for travelers, advising: "You may have been exposed to Covid-19 on your travels. You may feel well and not have any symptoms, but you can be contagious without symptoms and spread the virus to others. You and your travel companions (including children) pose a risk to your family, friends, and community for 14 days after you were exposed to the virus."
The agency had previously urged international travelers and those traveling from areas within the U.S. with high Covid-19 infection rates to self-quarantine for 14 days. Multiple states currently have their own recommendations for out-of-state visitors, including a 14-day self quarantine on arrival.
On Monday, the CDC released guidance for business owners and employees regarding customers who refuse to wear masks in a given establishment, writing: "Don't argue with a customer if they make threats or become violent. If needed, go to a safe area (ideally, a room that locks from the inside, has a second exit route, and has a phone or silent alarm)." And "don't attempt to force anyone who appears upset or violent to follow Covid-19 prevention policies or other policies or practices related to Covid-19 (e.g., limited on number of household or food products)."
That guidance comes as retail workers, restaurant workers, and other frontline employees continue to be threatened by people refusing to comply with Covid-19 social distancing measures, including wearing masks.
Two unexplained, inexplicable, probably indefensible changes, likely imposed on CDC's website.— Dr. Tom Frieden (@DrTomFrieden) August 26, 2020
* Dammit, if you come from a place with lots of Covid, quarantine for 14 days
* If you're a contact, get tested. If +, we can trace your contacts and stop chains of spread.
A sad day.
But the guideline change that has created the most controversy so far concerns testing for Covid-19 in asymptomatic individuals. The new CDC recommendations, also released Monday, contradict what the agency and its director, Robert Redfield have been saying for weeks.
Redfield told ABC News in July, "Anyone who thinks they may be infected—independent of symptoms—should get a test."
But the new recommendations don't go that far. Instead, they read: "If you have been in close contact (within six feet) of a person with a Covid-19 infection for at least 15 minutes but do not have symptoms...You do not necessarily need a test unless you are a vulnerable individual or your healthcare provider or state or local public health officials recommend you take one."
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"Wow, that is a walk-back," Dr. Susan Butler-Wu, a clinical microbiologist at the Keck School of Medicine of the University of Southern California, said in a New York Times article Wednesday. "We're in the middle of a pandemic, and that's a really big change.”
The Times reported, "By the CDC's own estimates, roughly 40 percent of people infected with the coronavirus may never go on to develop symptoms, remaining asymptomatic for the duration of their tenure with the virus."
"I think it's bizarre," Daniel Larremore, a mathematician and infectious diseases modeler at the University of Colorado Boulder, told the Times. "Any move right now to reduce levels of testing by changing guidelines is a step in the wrong direction."
A chorus of watchdogs, scientists, and doctors agree, and are sounding the alarm on social media.
It has taken Trump less than four years to completely destroy the credibility of the federal government. Nothing agencies like the CDC recommend can be taken at face value anymore. https://t.co/yg9OPPrSpl— Aaron Rupar (@atrupar) August 26, 2020
Without explanation, the @CDCGov made remarkable and troubling changes to their guidelines on coronavirus testing this week.— Carl T. Bergstrom (@CT_Bergstrom) August 26, 2020
They've gone from indicating testing for all close contacts to suggesting that testing is not necessary for close contacts of known cases. pic.twitter.com/naszBdVXTn
Now what the hell kind of CDC recommendation is this? We need to be doing MORE testing, not less. https://t.co/hv1bPM5wdj— Dr. Angela Rasmussen (@angie_rasmussen) August 24, 2020
When the New York Times asked the CDC for comment on the guideline changes this week, the agency referred the Times to the Department of Health and Human Services. An HHS spokesperson told the Times, "Testing capacity has massively expanded, and we are not utilizing the full capacity that we have developed. We revised the guidance to reflect current evidence and the best public health interventions."
But skeptics remain unconvinced as the CDC, the Food and Drug Administration, and the Trump administration remain under fire for spreading misinformation about Covid-19 testing, vaccine development secrecy and potential conflicts of interest, and promoting unverified potential cures for the virus ahead of scientific review.
"I feel like this is going to make things worse," Dr. Krutika Kuppalli, an infectious disease physician in Palo Alto, California, told the Times. "If people are getting exposed, and they're not getting tested, and they're not isolating, that's a huge problem," she said.
In a tweet late Tuesday, Alison Galvani, Director of the Center for Infectious Disease Modeling and Analysis and professor of epidemiology at Yale University, put her concerns more bluntly. "This change in policy will kill," she wrote.