Amid Controversy, HHS Defends Change in COVID-19 Testing Guidance

HHS defended a change by the CDC on who to test for SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), and said the recommendation to limit testing of asymptomatic individuals was not politically motivated.

Earlier in the week, the CDC changed its guidance on testing, saying that even if one had come into contact with an infected individual (within 6 feet and for at least 15 minutes), a test is not necessary if there are no symptoms, unless the person has health conditions that makes them more vulnerable to the virus or if a health care provider or local health official suggests getting one.

But The New York Times reported Wednesday afternoon that the White House had pressured the CDC to make the change.

Earlier in the day, Admiral Brett M. Giroir, MD, the HHS official in charge of COVID-19 testing, said reports of pressure were untrue, even as the move was denounced by public health officials and Democratic governors, such as Andrew Cuomo of New York. New York and Connecticut were among the states Wednesday saying the change will not shift their advice telling people to get tested.

Giroir said during a media briefing that the guidelines are the product of the CDC and that about “probably 20 drafts” were reviewed by the coronavirus task force, and that all medical personnel on the task force, including the head of the CDC, Robert Redfield, MD; Anthony Fauci, MD, head of the National Institute of Allergy and Infectious Diseases; FDA Commissioner Stephen Hahn, MD; and Deborah L Birx, MD, the State Department official assigned to work with Vice President Mike Pence’s office on the task force, had signed off on them.

“I circulated the manuscripts,” he said.

No CDC officials spoke during the briefing.

The estimated rate of transmission of the virus from people who are asymptomatic has been difficult to pin down, but a study published earlier this month in JAMA Internal Medicine suggested that people in South Korea without symptoms were shedding the virus nearly as long as those who were ill.

Giroir said the changes were based on “evidence” and said that a negative test could give a false sense of confidence.

He also said he didn‘t understand how anyone could quibble with the guidelines, “unless they believed anyone, anywhere, should be tested every day at their own whim. They really cannot argue with this.”

The amended guideline stresses that a negative test does not mean that the virus might not be contracted later. The change also says that even if one is visiting an area that is a COVID-19 hotspot and attending a gathering of more than 10 people without any mitigation measures, such as mask wearing and social distancing, a test is not needed.

“There was no weight on the scales by the president or the vice president or the secretary,” he said, referring to Alex Azar, the HHS secretary.